Double-blind placebo-controlled trial of amitriptyline for the treatment of irritable bowel syndrome in adolescents.

Author(s): Bahar RJ, Collins BS, Steinmetz B, Ament ME

Affiliation(s): Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, UCLA Geffen School of Medicine, Los Angeles, CA 91316, USA. bahar@bizla.rr.com

Publication date & source: 2008-05, J Pediatr., 152(5):685-9. Epub 2008 Feb 20.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

OBJECTIVES: To determine the efficacy of amitriptyline (AMI) in treating irritable bowel syndrome (IBS) in adolescents. STUDY DESIGN: Adolescents 12 to 18 years with newly diagnosed IBS were surveyed with a symptom checklist, pain rating scale, visual analog scale, and IBS quality of life (QOL) questionnaire. Subjects were randomized in a double-blinded fashion to receive AMI or placebo, and again completed surveys at 2, 6, 10, and 13 weeks. RESULTS: Thirty-three patients (24 female) were enrolled. Patients receiving AMI were more likely to experience improvement from baseline in overall QOL at 6, 10, and 13 weeks (P = .019, .004, and .013). Patients receiving AMI were also more likely to experience a reduction in IBS-associated diarrhea at 6 and 10 weeks (P = .029 for both), a reduction in periumbilical pain at 10 weeks (P = .018), and a reduction in right lower quadrant pain at 6, 10, and 13 weeks (P = .014, .039, and .004). CONCLUSION: AMI significantly improves overall QOL in adolescents with IBS and should be a therapeutic option for adolescents with this disorder.