dicyclomine / Generic mfg. - LARVOL DELTA

Gastric Schwannoma versus Gastrointestinal Stromal Tumor: A Case Report and the Future of Artificial Intelligence in Differentiating Subepithelial Gastric Lesions (ACG 2025) - "Dicyclomine and a proton pump inhibitor (PPI) were started, but with no relief of symptoms...(D) Endoscopic ultrasound (EUS) identifying a well-defined, hypoechoic mass originating from the muscularis propria layer (red arrow).Figure: Figure 2. Comparison of conventional EUS and AI-assisted EUS in key diagnostic capabilities, highlighting the superior performance of AI-assisted imaging in lesion differentiation, early detection, and data integration.*EUS = Endoscopic Ultrasound"

Case report • Clinical • Stroma • Brain Cancer • Gastric Cancer • Gastrointestinal Cancer • Gastrointestinal Stromal Tumor • Melanoma • Oncology • Sarcoma • Solid Tumor • Spindle Cell Sarcoma • CD34 • KIT • PRAME

Diagnostic Dilemma: Overlap Syndrome in the Young—Antimitochondrial Antibodies Meet NAFLD (ACG 2025) - "We present a case of a young, obese male with AMA-positive MASLD who underwent liver biopsy for further evaluation.Case Description/ A 27-year-old obese male (BMI 40) with hypertension and prior robotic cholecystectomy for symptomatic cholelithiasis presented with persistently elevated liver enzymes (ALT 67, AST 72), proteinuria (albumin/creatinine: 101, 50, 301), and thrombocytosis...Medications included lisinopril, Flonase, azelastine, meclizine, and dicyclomine...AMA positivity, proteinuria, and cholestatic features may indicate advanced disease and serve as diagnostic/prognostic markers for MASH. Emerging therapies include tirzepatide (a GIP/GLP-1 agonist) for weight and fat reduction, and resmetirom, the first FDA-approved treatment for MASH with fibrosis (F2–F3).Figure: fibroscan"

Brain Cancer • Cardiovascular • Fibrosis • Gastroenterology • Glioblastoma • Hematological Disorders • Hepatology • Hypertension • Immunology • Infectious Disease • Metabolic Disorders • Metabolic Dysfunction-Associated Steatohepatitis • Metabolic Dysfunction-Associated Steatotic Liver Disease • Musculoskeletal Pain • Obesity • Otorhinolaryngology • Primary Biliary Cholangitis • Renal Disease • Solid Tumor • Thrombocytosis • Vertigo

Diarrhea with Depression: Sertraline-Induced Microscopic Colitis (ACG 2025) - "2 months ago, she had switched from duloxetine to sertraline 100mg for uncontrolled mood symptoms without psychiatric consultation...Per guidelines, sertraline was held, and budesonide, loperamide, cholestyramine, and dicyclomine were started. Symptoms resolved at 4 weeks.Since sertraline is a commonly used and well-tolerated first-line agent for mood disorders, clinicians should suspect MC in patients with chronic diarrhea after starting it. Discontinuation and close follow-up to monitor for relapses are key to management.Figure: Colonoscopy"

Chronic Obstructive Pulmonary Disease • CNS Disorders • Colonic Polyps • Depression • Fatigue • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Mood Disorders • Peptic Ulcer • Psychiatry • Respiratory Diseases

May-Thurner Meets the Gut-Brain Axis: Multilevel Dysfunction in Hypermobile Ehler-Danlos Sydnrome (ACG 2025) - "A medication review revealed chronic use of tramadol and dicyclomine. Pelvic venous outflow obstruction (e.g. MTS) and neurological impairments (e.g. TCS) may coexist and potentiate gut dysfunction, particularly in connective tissue disorders. A high index of suspicion and a multidisciplinary approach are essential for identifying and managing overlapping anatomic and functional contributors to intractable constipation in hEDS.Figure: The right common iliac artery compresses the left common iliac vein against the vertebra with venous collaterals into the spinal veins."

Cardiovascular • Constipation • Gastroenterology • Gastrointestinal Disorder • Hypertension • Inflammation • Inflammatory Bowel Disease • Rheumatology

Rectosigmoid Endometriosis Masquerading as Colon Cancer (ACG 2025) - "She has one bowel movement per week and uses dicyclomine...Radiological imaging is supportive, but endoscopic procedures like colonoscopy or endoscopic ultrasound with biopsies have diagnostic value. Surgical treatment is considered in symptomatic patients with invasive intestinal compromise, or for patients with progressive lesions, and impaired sexual function.Figure: Endoscopic view of rectosigmoid massFigure: Polypoid, frond like villous partially obstructing mass"

Anemia • Colon Cancer • Colorectal Cancer • Constipation • Endometriosis • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Gynecology • Oncology • Solid Tumor • Uterine Leiomyoma • Women's Health • ER

The Efficacy of Dicyclomine for the Unspecified Abdominal Pain (UAP) in the Emergency Department: A Retrospective Study (ACG 2025) - "The study included 280 patients with a median age of 40.7 ± 16.8 years; 55.7% were female. First-time ED presentation for UAP occurred in 57.1% (160), and 55.7% (156) had no known comorbidities. Dicyclomine was administered within 30 minutes of physician evaluation in 74.3% (208) of cases, and within 1 hour in 25.7% (72)."

Retrospective data • Gastrointestinal Disorder • Inflammatory Bowel Disease • Pain

Unintended consequences of medical interventions - A rare case of iatrogenic dicyclomine and paracetamol dependence. (PubMed, Indian J Psychiatry) - No abstract available

Journal

Pharmacological basis for medicinal use of Cymbopogon proximus Hochst. ex A. Rich. Essential oil in hyperactive gastrointestinal disorders. (PubMed, Front Pharmacol) - "The EOCP, exhibited a protective effect against castor oil-induced diarrhea in rats at 100 and 200 mg/kg, similar to the standard drug, dicyclomine...In contractions elicited by different agents, EOCP showed higher potency in relaxing carbachol (CCh)-induced contractions compared to those induced by high K+ concentrations...The Ca++ channel inhibitory effect of EOCP was confirmed by its rightward shift of Ca++ concentration-response curves and suppression of the maximal response, resembling the effects of verapamil, a well-established Ca++ antagonist. These results suggest that EOCP produces antidiarrheal and antispasmodic effects, possibly mediated via direct effect on intestinal smooth musclesf followed by dual inhibition of muscarinic receptors and Ca++ channels, thus providing a pharmacological basis for its traditional use in hyperactive gut disorders such as diarrhea and spasms."

Journal • Gastroenterology • Gastrointestinal Disorder

Adjuvant treatment of nonalcoholic fatty liver fibrosis with probiotics and its effects on intestinal barrier function and serum inflammatory factors (APASL 2025) - "The control group was administered dicyclomine tablets (50 mg per dose, three times daily), while the observation group received additional supplementation with Bifidobacterium probiotics (1 sachet/day, containing 10^9 CFU/g) alongside the control treatment... Combined probiotic therapy not only enhances liver function, blood glucose, lipid profiles, liver fibrosis indices, and inflammatory factors but also improves clinical outcomes. Additionally, it significantly enhances intestinal barrier function."

Clinical • Fibrosis • Hepatology • Immunology • Liver Cirrhosis • Metabolic Dysfunction-Associated Steatotic Liver Disease • IL6 • TNFA

Thrombosis Secondary to Intravenous Dicyclomine Administration: A Case Report and Literature Review. (PubMed, J Pharm Pract) - "The patient was started on therapeutic enoxaparin subcutaneously. He was enrolled in a patient assistance program and was discharged on rivaroxaban dispensed from the hospital's outpatient pharmacy...The pharmacist submitted an adverse drug event report and revisions to barcode medication administration were implemented. Thrombotic complications are possible following IV dicyclomine administration and pharmacy personnel must implement safeguards to prevent inadvertent administration."

Journal • Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Immunology • Infectious Disease • Pain • Thrombosis

Comparison chart: Safety of drugs for IBS in pregnancy and lactation. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • Gastrointestinal Disorder

Drugs for irritable bowel syndrome. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • Constipation • Gastroenterology • Gastrointestinal Disorder

Figure 1: Treatments for irritable bowel syndrome (IBS) in adults. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • Constipation • Gastroenterology • Gastrointestinal Disorder

Comparison chart: Some drugs for abdominal pain in irritable bowel syndrome (IBS). (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • Gastrointestinal Disorder • Pain

Intermittent Sinus Pause/Asystole in the Setting of Anticholinergic Overdose. (PubMed, Cureus) - "This case report presents a 68-year-old female patient who exhibited some of these signs and symptoms after ingesting an unknown quantity of dicyclomine...While rare, clinicians should consider anticholinergic toxicity as a potential cause of intermittent sinus pause, especially in patients taking anticholinergic medications. Increased clinical vigilance could impact treatment decisions, including potentially avoiding unnecessary procedures such as permanent pacemaker placement, if symptoms resolve with cessation of the offending agent."

Journal • Cardiovascular • CNS Disorders • Hypertension • Ophthalmology

Hormone Replacement Therapy Is Associated With Increased Risk of Developing Irritable Bowel Syndrome in Post-Menopausal Women (ACG 2024) - "Medications including lubiprostone (OR=1.76 95% CI [1.32-2.35]), linaclotide (OR=1.90 95% CI [1.58-2.28]), plecanatide (OR=2.73 95% CI [1.68-4.45]), dicyclomine (OR=1.46 95% CI [1.30-1.64]), and TCAs (OR=1.84 95% CI [1.68-2.02]) were more likely to be prescribed. We identified 51,395 post-menopausal women prescribed HRT and 1,311,581 not prescribed HRT after exclusion criteria. Post-propensity matching, each cohort comprised 46,627 patients. Among post-menopausal women prescribed HRT, 992 developed IBS at least 30 days after being prescribed HRT compared to 581 not prescribed HRT (OR=1.75, 95% CI [1.58-1.94])."

Clinical • Celiac Disease • Colon Cancer • Colorectal Cancer • Crohn's disease • Dyspepsia • Gastrointestinal Disorder • Immunology • Metabolic Disorders • Oncology • Rare Diseases

Intravenous Immunoglobulin (IVIG) for Chronic Norovirus (ACG 2024) - "Psyllium, loperamide and dicyclomine were unhelpful. Small intestinal bacterial overgrowth was considered, and she was trialed on rifaximin, only to provide one week of symptom relief...Until anti-noroviral therapies are developed, recognizing norovirus as a chronic infection in immunocompromised patients should prompt increased preventive measures to avoid infection and subsequent transmission. While there is no consensus on a definitive treatment for immunosuppressed patients with chronic norovirus, this case displays the use of increased frequency of IVIG as a therapeutic option."

Celiac Disease • Chronic Kidney Disease • Follicular Lymphoma • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Immunology • Infectious Disease • Lymphoma • Nephrology • Oncology • Renal Disease

Beaver Tail Liver: A Case Report on a Variant in Hepatic Morphology (ACG 2024) - "The patient was discharged from the ED to follow-up with gastroenterology in outpatient setting and to use dicyclomine as needed...Figure: Figure 1. CT of the abdomen and pelvis showing beaver tail liver anomaly"

Case report • Clinical • Diabetes • Gastroenterology • Metabolic Disorders • Pain • Type 1 Diabetes Mellitus

Abdominal Pain in Gastroparesis: Comparing PAGI-SYM and SF-8 Survey Scores Among Opiate and Non-Opiate Analgesic Management (ACG 2024) - "Patients reported managing AP with 31.3% using nothing, 25% ice, hot showers or heating pads, 20.8% acetaminophen, 14.6% hyoscyamine, 11% opiate analgesics, 11% marijuana, 8.3% NSAIDs, 3.7% benzodiazepines, 2.1% calcium carbonate, 2.1% dicyclomine, 2.1% domperidone, and 2.1% gabapentin...Patients taking opiates for AP had more morphine milliequivalent use than for non-AP (77.5±21.9 vs. 31.8±14.1; p=0.037)... 54 patients completed the survey. 72% reported AP, 98% reporting that AP was part of GP symptoms. Mean body mass index was 26.8 and mean age was 45 years."

Gastrointestinal Disorder • Immunology • Musculoskeletal Diseases • Musculoskeletal Pain • Pain • Rheumatology

A Case of Retrograde Cricopharyngeus Dysfunction or "No Burp" Syndrome (ACG 2024) - "We present a patient with RCPD successfully treated with Botox injection...She was recommended to start rifaximin, dicyclomine, and simethicone but saw no symptom improvement...Reported success rates of botulism injection range from 88.2–95%. Overall, RCPD is rare and requires a comprehensive approach involving gastroenterologist and otolaryngologists for proper diagnosis, treatment, and improving patient quality of life."

Clinical • Constipation • Gastroenterology • Gastrointestinal Disorder • Infectious Disease • Mood Disorders • Otorhinolaryngology • Pain • Psychiatry

Stanford Type A Aortic Dissection Masquerading as Subacute Diarrhea (ACG 2024) - "He had a negative cardiac work up and was given dicyclomine & antibiotics...Figure 3: right sided colon biopsy with small colonic crypts, reminiscent of the "microcrypts" often found in ischemic colitis. Figure 4: sagittal thoracic aorta dissection, showing extension from ascending aorta and root to the diaphragm"

Atherosclerosis • Cardiovascular • Dyslipidemia • Gastroenterology • Gastrointestinal Disorder • Hypertension • Immunology • Metabolic Disorders • Pain • Vasculitis

The Hidden Dangers of Meftal: A Drug Safety Alert for a Frequently Used NSAID. (PubMed, Curr Pharm Des) - No abstract available

Journal

GLP-1 AGONISTS AND GIP PRESCRIPTIONS ARE INCREASING MORE THAN ANY OTHER GASTROINTESTINAL MEDICAITON AND CORRELATE WITH SIGNIFICANT INCREASE IN ASSOCIATED ADVERSE EVENTS (DDW 2024) - "6)] compared to buproprion-naltrexone an alternative weight loss agent. (PMID: 377965 7) This is a cross-sectional study at a single academic center to understand the change in prescription pattern of GLP-1 (liraglutide dulaglutide exenatide semaglutide) GLP-1/GIP (tirzepatide) opioids the top 5 most commonly prescribed gastrointestinal medications [proton pump inhibitors (PPI) famotidine diclyclomine linzess anti-nausea medications] and associated complications (nausea vomiting gastroparesis and pancreatitis) from 018- 0 3... From 018- 0 3 57 110 GLP1 and GIP agonists prescriptions over 131 914 clinic visits were included in the study. There was a 84% increase in GLP-1 and GLP-1/GIP from 018 to 0 3 greatest increase noted for semaglutide liraglutide and tirzepatide (Figure 1 and ). In comparison to PPI (15% increase) opioids (stable) famotidine (6 % increase) dicyclomine (11% increase) linzess (67% increase) anti-nausea medications ( 8% increase) GLP-1 and GLP-1/GIP..."

Adverse events • Addiction (Opioid and Alcohol) • Diabetes • Gastrointestinal Disorder • Genetic Disorders • Metabolic Disorders • Obesity • Pancreatitis

Over-the-Counter Medications Encountered in the Postmortem Pediatric Population from 2010-2020. (PubMed, J Anal Toxicol) - "A total of 1413 positive cases contained one or more of the following common OTC medications: antihistamines (brompheniramine, chlorpheniramine, diphenhydramine, doxylamine, and pheniramine), pain relievers (acetaminophen, naproxen, ibuprofen, and salicylates), cold/flu medications (dextro/levomethorphan, guaifenesin, ephedrine, and pseudoephedrine), gastrointestinal (GI) aids (dicyclomine and loperamide), and/or sleep aids (melatonin). Of note, the prevalence of cases involving those aged 6-11 years old was far less than their younger and older pediatric counterparts. With the widespread availability of OTC medications, unintentional overdoses, recreational misuse, and suicidal overdoses can occur in the vulnerable, pediatric population."

Journal • Gastrointestinal Disorder • Infectious Disease • Pain • Pediatrics

Accelerated Inpatient Transition from Methadone to Long-Acting Injectable Buprenorphine (ASAM 2024) - "He experienced mild gastrointestinal-related withdrawal symptoms controlled with ondansetron...She received 2.1mg of IV buprenorphine over one hour for the management of severe opioid withdrawal, 1mg of IV dilaudid, and 1mg of lorazepam...Her ongoing withdrawal symptoms were controlled with as-needed clonidine, dicyclomine, and 20mg oxycodone every 4 hours for 24 hours, with significant improvement... Patient #1 successfully transitioned from methadone to LAIB using an accelerated approach using a 24-hour IV buprenorphine infusion with adjunctive full opioid agonists, as detailed below. He received LAIB on hospital day 2. Patient #2 also successfully transitioned from methadone to LAIB using an accelerated approach using a faster rate of IV buprenorphine infusion and received LAIB on hospital day 1, as detailed below."

Clinical • Addiction (Opioid and Alcohol) • Anemia • Cardiovascular • Chronic Obstructive Pulmonary Disease • CNS Disorders • Gastrointestinal Disorder • Heart Failure • Hematological Disorders • Human Immunodeficiency Virus • Hypertension • Immunology • Infectious Disease • Musculoskeletal Pain • Nephrology • Pain • Pneumonia • Psychiatry • Pulmonary Disease • Renal Disease • Respiratory Diseases • Substance Abuse