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Review Article
Online Published: 26 Sep 2025
 


Low dose amitriptyline in irritable bowel syndrome: a systematic review and a meta-analysis

Hosam Hadi Awaji, Osama Mohammed Alkhani, Saja Ali Almusallam, Mohammed Mansour M. Alqahtani, Eyad Mohammed Alzahrani, Mohammed Abdulkarim Alatawi, Abdullah Omar Musleh, Emad Mohammed Alzahrani, Wesam Muslih Alsahafi, Saif Dhafer Aldossari, Rayan Ali Alshehri, Sarah Almuhanna.


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.


 
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How to Cite this Article
Pubmed Style

Awaji HH, Alkhani OM, Almusallam SA, Alqahtani MMM, Alzahrani EM, Alatawi MA, Musleh AO, Alzahrani EM, Alsahafi WM, Aldossari SD, Alshehri RA, Almuhanna S. Low dose amitriptyline in irritable bowel syndrome: a systematic review and a meta-analysis. IJMDC. 2025; 9(8): 1868-1877. doi:10.24911/IJMDC.51-1754080644

Web Style

Awaji HH, Alkhani OM, Almusallam SA, Alqahtani MMM, Alzahrani EM, Alatawi MA, Musleh AO, Alzahrani EM, Alsahafi WM, Aldossari SD, Alshehri RA, Almuhanna S. Low dose amitriptyline in irritable bowel syndrome: a systematic review and a meta-analysis. https://www.ijmdc.com/?mno=274846 [Access: June 27, 2026]. doi:10.24911/IJMDC.51-1754080644

AMA (American Medical Association) Style

Awaji HH, Alkhani OM, Almusallam SA, Alqahtani MMM, Alzahrani EM, Alatawi MA, Musleh AO, Alzahrani EM, Alsahafi WM, Aldossari SD, Alshehri RA, Almuhanna S. Low dose amitriptyline in irritable bowel syndrome: a systematic review and a meta-analysis. IJMDC. 2025; 9(8): 1868-1877. doi:10.24911/IJMDC.51-1754080644


Vancouver/ICMJE Style

Awaji HH, Alkhani OM, Almusallam SA, Alqahtani MMM, Alzahrani EM, Alatawi MA, Musleh AO, Alzahrani EM, Alsahafi WM, Aldossari SD, Alshehri RA, Almuhanna S. Low dose amitriptyline in irritable bowel syndrome: a systematic review and a meta-analysis. IJMDC. (2025), [cited June 27, 2026]; 9(8): 1868-1877. doi:10.24911/IJMDC.51-1754080644


Harvard Style

Awaji, H. H., Alkhani, . O. M., Almusallam, . S. A., Alqahtani, . M. M. M., Alzahrani, . E. M., Alatawi, . M. A., Musleh, . A. O., Alzahrani, . E. M., Alsahafi, . W. M., Aldossari, . S. D., Alshehri, . R. A. & Almuhanna, . S. (2025) Low dose amitriptyline in irritable bowel syndrome: a systematic review and a meta-analysis. IJMDC, 9 (8), 1868-1877. doi:10.24911/IJMDC.51-1754080644


Turabian Style

Awaji, Hosam Hadi, Osama Mohammed Alkhani, Saja Ali Almusallam, Mohammed Mansour M. Alqahtani, Eyad Mohammed Alzahrani, Mohammed Abdulkarim Alatawi, Abdullah Omar Musleh, Emad Mohammed Alzahrani, Wesam Muslih Alsahafi, Saif Dhafer Aldossari, Rayan Ali Alshehri, and Sarah Almuhanna. 2025. Low dose amitriptyline in irritable bowel syndrome: a systematic review and a meta-analysis. International Journal of Medicine in Developing Countries, 9 (8), 1868-1877. doi:10.24911/IJMDC.51-1754080644


Chicago Style

Awaji, Hosam Hadi, Osama Mohammed Alkhani, Saja Ali Almusallam, Mohammed Mansour M. Alqahtani, Eyad Mohammed Alzahrani, Mohammed Abdulkarim Alatawi, Abdullah Omar Musleh, Emad Mohammed Alzahrani, Wesam Muslih Alsahafi, Saif Dhafer Aldossari, Rayan Ali Alshehri, and Sarah Almuhanna. "Low dose amitriptyline in irritable bowel syndrome: a systematic review and a meta-analysis." International Journal of Medicine in Developing Countries 9 (2025), 1868-1877. doi:10.24911/IJMDC.51-1754080644


MLA (The Modern Language Association) Style

Awaji, Hosam Hadi, Osama Mohammed Alkhani, Saja Ali Almusallam, Mohammed Mansour M. Alqahtani, Eyad Mohammed Alzahrani, Mohammed Abdulkarim Alatawi, Abdullah Omar Musleh, Emad Mohammed Alzahrani, Wesam Muslih Alsahafi, Saif Dhafer Aldossari, Rayan Ali Alshehri, and Sarah Almuhanna. "Low dose amitriptyline in irritable bowel syndrome: a systematic review and a meta-analysis." International Journal of Medicine in Developing Countries 9.8 (2025), 1868-1877. Print. doi:10.24911/IJMDC.51-1754080644


APA (American Psychological Association) Style

Awaji, H. H., Alkhani, . O. M., Almusallam, . S. A., Alqahtani, . M. M. M., Alzahrani, . E. M., Alatawi, . M. A., Musleh, . A. O., Alzahrani, . E. M., Alsahafi, . W. M., Aldossari, . S. D., Alshehri, . R. A. & Almuhanna, . S. (2025) Low dose amitriptyline in irritable bowel syndrome: a systematic review and a meta-analysis. International Journal of Medicine in Developing Countries, 9 (8), 1868-1877. doi:10.24911/IJMDC.51-1754080644




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