Abstract

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder (GID). Low-dose amitriptyline has been suggested as a significant therapeutic option for IBS, but its efficacy and safety remain uncertain. To assess the efficacy and safety of low-dose amitriptyline in IBS treatment through a meta-analysis of randomized controlled trials (RCTs). A systematic literature search was performed through scientific databases to identify RCTs comparing low-dose amitriptyline with placebo in adult IBS subjects. Primary outcomes included improvement in IBS symptoms, reduction in abdominal pain, and relief of diarrhea and constipation. Secondary outcomes included adverse effects, such as sleepiness, dry mouth, and constipation. Four RCTs involving 1,150 subjects were included in the meta-analysis. Low-dose therapy was significantly more effective than placebo in reducing overall IBS symptoms and relieving diarrhea. However, the evidence for its efficacy in reducing abdominal pain and constipation was less conclusive. The most common adverse effect was sleepiness. Low dose amitriptyline seems to be a promising therapy for IBS, particularly for improving overall symptoms and relieving diarrhea. However, further high-quality RCTs are required to confirm such findings and to identify the long-term safety and efficacy of this treatment.

Key words: irritable bowel syndrome, low dose, amitriptyline.