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References

DOI: 10.1053/j.gastro.2022.04.016

• The AGA suggests using TCAs in patients with IBS.
• The type of TCA studied included amitriptyline (n = 3), desipramine (n = 2), trimipramine (n = 1), imipramine (n = 1), and doxepin (n = 1).
• The dose of the TCA varied from 10 mg to up to 150 mg and most studies used >50 mg per day.
• The AGA suggests using antispasmodics in patients with IBS.
• Of the antispasmodics studied, only hyoscine, dicyclomine, and peppermint oil are available in the United States.
• Compared with placebo, TCAs were associated with global symptom relief (RR, 0.67; 95% CI, 0.54–0.82) and abdominal pain relief (RR, 0.76–0.94).
• Likewise, compared with placebo, antispasmodics showed improvement in abdominal pain (RR, 0.74; 95% CI, 0.59–0.93).