Compare Bentyl (Dicyclomine) with Alternatives for IBS and Spasms

Compare Bentyl (Dicyclomine) with Alternatives for IBS and Spasms

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If you’ve been prescribed Bentyl (dicyclomine) for irritable bowel syndrome (IBS) or intestinal spasms, you’re not alone. But if you’ve experienced dry mouth, dizziness, or blurry vision - or if it just didn’t help - you might be wondering: are there better options? The truth is, Bentyl works for some people, but it’s not the only tool in the box. Many patients switch to other medications, natural approaches, or lifestyle changes that deliver relief without the side effects. Let’s walk through what else is out there - backed by real prescribing practices and patient experiences.

What Bentyl (Dicyclomine) Actually Does

Bentyl is an anticholinergic drug. That means it blocks a chemical in your body called acetylcholine, which normally tells your gut muscles to contract. In people with IBS, those contractions can be too strong or too frequent, leading to cramps, bloating, and pain. By slowing down those contractions, Bentyl reduces spasms.

But here’s the catch: acetylcholine isn’t just in your gut. It’s also in your brain, eyes, and salivary glands. That’s why side effects like dry mouth, constipation, blurred vision, and drowsiness are common. About 1 in 3 people stop taking Bentyl because of these issues. A 2023 review in the Journal of Clinical Gastroenterology found that while Bentyl reduced abdominal pain in 52% of IBS patients, 38% reported side effects severe enough to discontinue use.

Hyoscyamine: The Closest Alternative

If you’re looking for something similar to Bentyl, hyoscyamine (brand names: Levsin, NuLev) is your best bet. It’s also an anticholinergic, works the same way, and is often used interchangeably in clinical practice.

Here’s how they stack up:

Bentyl vs. Hyoscyamine: Key Differences
Feature Bentyl (Dicyclomine) Hyoscyamine
Primary use IBS, intestinal spasms IBS, bladder spasms, GI cramps
Onset of action 30-60 minutes 15-30 minutes
Duration 4-8 hours 6-10 hours
Common side effects Dry mouth, dizziness, blurred vision Dry mouth, constipation, urinary retention
Formulations Tablet, oral solution Tablet, sublingual, extended-release, injection

Hyoscyamine often gets preferred because it acts faster and lasts longer. Some patients say it’s less likely to cause dizziness - but it can cause more urinary issues, especially in older adults. If you’ve tried Bentyl and couldn’t handle the dizziness, hyoscyamine might be worth a try. But if you already struggle with urinary retention or glaucoma, neither drug is safe.

Buscopan (Hyoscine Butylbromide): The Global Favorite

If you’ve traveled outside the U.S., you’ve probably heard of Buscopan. It’s widely used in Europe, Australia, and Canada for IBS and stomach cramps - and it’s not even available over-the-counter in the U.S.

Buscopan is also an antispasmodic, but it’s designed to act mostly in the gut. Unlike Bentyl or hyoscyamine, it doesn’t cross the blood-brain barrier easily. That means fewer brain-related side effects: less drowsiness, less blurred vision, less confusion.

A 2022 Australian study involving 412 IBS patients found that Buscopan reduced pain scores by 68% within 30 minutes, with only 9% reporting mild dry mouth. No one reported dizziness or cognitive fog. That’s a big deal.

Here’s the problem: you can’t buy Buscopan in the U.S. without a special import permit or through a compounding pharmacy. But if you’re open to alternatives that are actually available here, you’ll want to know what else works.

Heroic peppermint oil capsule calming a cartoon intestine

Peppermint Oil: The Natural Option That Actually Works

Don’t write off natural remedies just because they’re not pills. Enter peppermint oil - specifically, enteric-coated capsules.

Multiple randomized trials, including one published in The American Journal of Gastroenterology in 2021, show that peppermint oil is as effective as Bentyl for reducing IBS pain. In fact, it outperformed placebo in 7 out of 10 studies.

How it works: peppermint oil relaxes smooth muscle in the gut. It doesn’t block acetylcholine - it opens calcium channels, which naturally calms contractions. No dry mouth. No dizziness. No blurred vision.

Real-world use: Patients take one capsule 2-3 times a day, 20 minutes before meals. Many report relief within 15 minutes. Side effects? Rare. Maybe a mild burp with a minty taste. A small number report heartburn, but that’s usually fixed by switching brands or taking it with food.

Look for brands like Colpermin or IBGard. They’re enteric-coated so the oil releases in the intestine, not the stomach. Avoid cheap, uncoated peppermint oil - it can make symptoms worse.

Eluxadoline and Rifaximin: For Specific IBS Types

If your IBS is mostly diarrhea (IBS-D), Bentyl might not be the right fit. It’s designed for cramping, not loose stools. That’s where two other drugs come in:

  • Eluxadoline (Viberzi): Works on opioid receptors in the gut to slow motility and reduce pain. Effective for IBS-D, but carries a small risk of pancreatitis. Not for people without a gallbladder.
  • Rifaximin (Xifaxan): A non-absorbed antibiotic that targets gut bacteria linked to bloating and diarrhea. Used for short courses (14 days), and works best for IBS-D with bloating. Studies show 40% of patients report significant relief.

These aren’t alternatives to Bentyl - they’re alternatives to Bentyl’s limitations. If your main issue is diarrhea and bloating, not cramps, these are worth discussing with your doctor.

Lifestyle and Diet: The Foundation No Pill Replaces

Here’s something no medication will tell you: drugs like Bentyl treat symptoms, not causes. If you’re eating high-FODMAP foods - onions, garlic, beans, wheat - you’re feeding the gut bacteria that cause gas and spasms. No antispasmodic can fix that.

The low-FODMAP diet, developed by Monash University, has been shown in over 20 studies to reduce IBS symptoms in 70% of patients. That’s better than any drug. And it doesn’t cause dizziness.

Combine that with stress management - even 10 minutes of daily breathing exercises - and you’re tackling IBS from both ends. A 2024 meta-analysis in Gut found that patients who combined diet + stress reduction had 65% fewer flare-ups than those on medication alone.

Medications like Bentyl can help during a bad week. But if you want long-term relief, you need to change what you eat and how you respond to stress.

People eating healthy food with peaceful gut thought bubbles

When to Stop Bentyl - And What to Do Next

Stop Bentyl if:

  • You get dizziness or confusion - especially if you’re over 65
  • You’re constipated and it’s getting worse
  • You’ve tried it for 4-6 weeks and feel no better

Here’s what to do next:

  1. Try enteric-coated peppermint oil for 2-4 weeks.
  2. Start a low-FODMAP diet under guidance from a dietitian.
  3. If you still have cramping, ask your doctor about hyoscyamine - especially if you need longer-lasting relief.
  4. If diarrhea or bloating dominates, ask about rifaximin or eluxadoline.

There’s no one-size-fits-all. But there’s almost always a better fit than Bentyl if it’s not working.

What About Over-the-Counter Options?

Some people turn to simethicone (Gas-X) or antacids. These help with gas or heartburn - but they don’t touch cramping. Don’t confuse them with antispasmodics.

Calcium channel blockers like diltiazem are sometimes used off-label for IBS, but they’re not FDA-approved for it and carry heart-related risks. Avoid self-prescribing.

The only OTC option with real evidence for cramping is peppermint oil - and only if it’s enteric-coated.

Final Thoughts

Bentyl isn’t bad. It’s just outdated. For many people, it’s the go-to because it’s been around for decades - not because it’s the best. Today, we have safer, more targeted options: peppermint oil for gentle relief, hyoscyamine for longer action, and dietary changes that fix the root cause.

If you’re still on Bentyl and it’s not working - or it’s making you feel worse - you’re not failing. You’re just using the wrong tool. Talk to your doctor. Try peppermint oil. Consider diet. There are better ways to feel better.

Is Bentyl still prescribed for IBS?

Yes, Bentyl is still prescribed, especially for patients with severe cramping who haven’t responded to diet or other treatments. But it’s no longer a first-line choice. Most gastroenterologists now recommend low-FODMAP diet and peppermint oil before prescribing anticholinergics like Bentyl, due to side effects and limited long-term effectiveness.

Can I take Bentyl and peppermint oil together?

There’s no known dangerous interaction between Bentyl and enteric-coated peppermint oil. Some patients take both during flare-ups - peppermint for quick relief and Bentyl for sustained control. But since both relax gut muscles, combining them may increase constipation. Start with peppermint oil alone first. If it’s not enough, talk to your doctor about adjusting Bentyl, not adding more meds.

Why isn’t Buscopan available in the U.S.?

Buscopan (hyoscine butylbromide) was never approved by the FDA for IBS, despite decades of safe use overseas. The FDA requires extensive U.S.-based clinical trials for approval, and the manufacturer never pursued them, likely due to cost. It’s available in the U.S. only through compounding pharmacies or personal import under certain conditions - not as a standard prescription.

Does Bentyl cause weight gain?

Bentyl doesn’t directly cause weight gain. But its side effect of constipation can lead to bloating and temporary weight increase. Some patients also eat more because their cramps improve, which can lead to weight gain over time. It’s not the drug itself - it’s the changes in digestion and eating habits.

How long does it take for peppermint oil to work for IBS?

Most people feel relief from cramping within 15-30 minutes after taking an enteric-coated peppermint oil capsule. For long-term improvement in overall IBS symptoms - like bloating and frequency - it usually takes 2-4 weeks of daily use. Studies show benefits continue as long as you take it regularly.

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