Low doses of amitryptilin have been suggested for the management of functional bowel disorder such as irritable bowel syndrom (IBS). Our AIM was to verify the action of amitryptilin in patients with IBS. METHODS: 1) 12 patients complaining of IBS identified by ROME criteria and with documented rectal hypersensitivity were included in this study; 2) patients received amitryptilin 10 mg hs for 2 weeks and then 25 mg hs for the following 4 weeks; 3) before and at the end of the amitryptilin treatment, the severity of the GI symptoms was assessed by a GI index and the pain threshold to rectal distension was measured by a barostat programed for phasic ascending distension. RESULTS: 1) GI index significantly decreased for an initial value of 91.6±5.6 to a score of 61.8±9.1 at the end of the treatment (p<0.01). Pain threshold to rectal distension significantly increased from 27.7±1 to 33.7±1.9 (p<0.01) after drug treatment; 2) the decrease in the GI index and the increase in the rectal sensitivity threshold were directly correlated (r=–0.71; p<0.01); 3) in patients who improved (n=6) with the treatment (decrease in GI index by more than 20%) the final GI index was 42.5±1% of the initial value, while in non improved patients (n=6) the GI index stayed at 92.5±5% (p<0.001). Pain threshold to rectal distension increased to 137.7±7.1% in improved patients and stayed at 107.7±7% in non improved patients; 4) Pain threshold to rectal distension could be restored to normal values (above 40 mmHg) in 4/12 patients. CONCLUSIONS: Low doses amitryptilin decreased GI symptoms in IBS hypersensitive patients and improved visceral sensitivity.

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