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

Abstract

To determine the efficacy of amitriptyline (AMI) in treating irritable bowel syndrome (IBS) in adolescents. 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. 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). AMI significantly improves overall QOL in adolescents with IBS and should be a therapeutic option for adolescents with this disorder.