Effect of Trimebutine on Postprandial Colonic Motor Activity in Healthy Subjects and Patients with Irritable Bowel Syndrome

We examined the effect of orally administered trimebutine maleate (200 mg) on postprandial motor activity measured manometrically in the sigmoid colon of 11 healthy subjects and nine patients with constipation‐predominant irritable bowel syndrome (IBS) in a double‐blind, placebo·controlled trial. Eight normal subjects showed increased motor activity following the meal after placebo, with a mean increase of 21.9%± 4.5%. Seven IBS patients showed increased motor activity after placebo and the meal, with a mean increase of 49.1 % that was significantly greater than that seen in healthy subjects. Following trimebutine, the mean postprandial increase in normal subjects was 23.9%± 12.0%, a value not significantly different from placebo. In contrast, in patients with IBS, following trimebutine ingestion the mean postprandial increase was 28.9%± 5.9%, a value significantly less than placebo response in that group, but not different from that observed in normal subjects after placebo. We conclude that orally administered trimebutine has no effect on postprandial sigmoid motor activity in normal subjects, but attenuates the increase observed in patients with constipation‐predominant IBS. The results also illustrate the heterogeneous nature of postprandial motor responses in healthy subjects and patients with IBS.