A systematic review 1 including 70 studies with a total of 4 836 subjects was abstracted in DARE. Bulking agents: 3 of the 7 high-quality RCTs reported benefit. Smooth muscle relaxants: 13 of 16 RCTs (including all the 7 high-quality RCTs) reported benefit. Prokinetic agents: 2 of 6 RCTs (one of 4 high-quality RCTs) reported benefit. Loperamide: All 4 RCTs reported an improvement in diarrhoea, and the 2 RCTs that assessed global status improvement reported benefit. Psychotropic agents: 3 of the 5 RCTs reported global improvement, and 4 of the 7 reported improvement in abdominal pain, but none reported any difference in constipation. Ondansetron (2 RCTs) showed some benefit.
Comment: The quality of evidence is downgraded by potential reporting bias.
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