Article Text

other Versions

Download PDFPDF
Oral propantheline in palliative care: two further cases – bowel/bladder spasm and high-output stoma
  1. Mark Banting
  1. Palliative Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to Dr Mark Banting, Palliative Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK; mark.banting{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

I wrote recently to describe the case of a woman with motor neuron disease for whom we used propantheline to reduce her respiratory secretion burden. I am now writing to describe two further cases in which we used oral propantheline successfully to treat different symptoms: bowel/bladder spasm and increased stoma output.

Propantheline is a quaternary ammonium compound that is a non-specific acetylcholine antagonist at muscarinic M1–M3 receptors. Receptors are present in the bladder, salivary glands, the gastrointestinal (GI) tract and central nervous system to name but a few. As discussed, the potential benefits of propantheline versus other available anticholinergics are increased oral bioavailability, less sedation and the ability to administer the medication via parenteral feeding tubes.

It can be seen that propantheline has the potential to be used for many systemic symptoms including salivary secretions (see my previous letter, Mar 2023, 13 (1) 63-64; DOI:10.1136/spcare-2022-004109), GI secretions, GI motility and bladder spasms. This then leads me to my two cases.

The first is a 77-year-old woman with metastatic pancreatic cancer, diverticular disease and a colovesical fistula. She was admitted to the hospital following several …

View Full Text


  • Contributors MB is the sole contributor of the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.