Pharmacotherapeutic characteristics of the combination of phloroglucinol and simethicone in the context of the treatment of spastic conditions of the gastrointestinal tract (literature review)

Background. Spastic conditions of the gastrointestinal tract, such as irritable bowel syndrome, significantly reduce patientsʼ quality of life, create substantial socio-economic burden, and are a common reason for seeking medical care. The lack of a universal therapy, the complexity of the pathogenesis, and individual patient responses to treatment necessitate new approaches to pharmacotherapy. One promising direction is the use of a combination of phloroglucinol and simethicone. Purpose – аnalysis of the pathogenetic mechanisms underlying the development of spastic conditions of the gastrointestinal tract and justification of the appropriateness of using a combination of phloroglucinol and simethicone in their therapy based on a systematic review of literature sources, preclinical, and clinical studies. Materials and Methods. To evaluate the clinical efficacy and safety of using the combination of the antispasmodic phloroglucinol with the absorbent simethicone, the authors conducted a literature review based on the Scopus and Web of Science databases, as well as specialized sources. The review was prepared in accordance with the PRISMA guidelines. Results. Clinical manifestations of spastic disorders of the gastrointestinal tract, particularly irritable bowel syndrome, have been described, including the high prevalence of chronic abdominal pain, increased use of diagnostic resources, and frequent comorbid anxiety and depression. It has been shown that phloroglucinol possesses pronounced antispasmodic, anti-inflammatory, antioxidant, antinociceptive, and membranestabilizing properties. Its mechanisms of action include inhibition of cyclooxygenases, neurotransmitter pathways, reduction of pro-inflammatory cytokine production, oxidative stress, and others. Simethicone, in turn, does not have systemic effects but effectively reduces flatulence and discomfort by decreasing the surface tension of gas bubbles in the intestinal lumen. In vivo studies demonstrate that simethicone potentiates the effect of antispasmodics by reducing bowel hypersensitivity. Clinical observations indicate that the combination of phloroglucinol and simethicone provides statistically significant relief of pain syndrome, reduction of bloating, and other symptoms in patients with irritable bowel syndrome and functional dyspepsia. Conclusions. The combination of phloroglucinol and simethicone is a promising and scientifically justified approach to the treatment of spastic conditions of the gastrointestinal tract. Thanks to the combination of antispasmodic, anti-inflammatory, and analgesic effects, this combination allows for a comprehensive impact on the pathogenetic mechanisms of the disorders and demonstrates high efficacy and safety