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https://www.readbyqxmd.com/read/25903209/successful-management-of-chronic-high-output-ileostomy-with-high-dose-loperamide
#1
Alicia Mackowski, Han-Kuang Chen, Michael Levitt
High-stoma output is a common problem that can lead to dehydration and electrolyte disturbance. The following report describes three patients with end ileostomy who had high-stoma outputs where conventional medical management was unsuccessful in controlling stoma output. All three patients responded to high-dose loperamide, resulting in significant clinical improvement. High-dose loperamide therapy should be considered in patients with high-stoma output who have failed conventional medical management.
April 22, 2015: BMJ Case Reports
https://www.readbyqxmd.com/read/25596962/intractable-and-dramatic-diarrhea-in-liver-transplantation-recipient-with-vasoactive-intestinal-peptide-producing-tumor-after-split-liver-transplantation-a-case-report
#2
W Haiqing, Y Jiayin, Y Jian, Y Lunan
Diarrhea after liver transplantation is a common complication. Vasoactive intestinal peptide-producing tumor (VIPoma) is a rare cause of watery diarrhea; 80% of such tumors occur in the pancreas, but it is rare in liver. Hypersecretion of vasoactive intestinal polypeptide can stimulate intestinal water and electrolyte secretion, and patients with VIPoma present with watery diarrhea, hypokalemia, and dehydration. Here we report on a 50-year-old man who presented with a 7-month history of watery diarrhea. He had undergone an orthotopic split-liver transplantation for hepatocellular carcinoma in November 2011...
January 2015: Transplantation Proceedings
https://www.readbyqxmd.com/read/25525380/targeted-therapy-of-short-bowel-syndrome-with-teduglutide-the-new-kid-on-the-block
#3
REVIEW
Kishore Vipperla, Stephen J O'Keefe
Extensive intestinal resection impairs the absorptive capacity and results in short-bowel syndrome-associated intestinal failure (SBS-IF), when fluid, electrolyte, acid-base, micro-, and macronutrient homeostasis cannot be maintained on a conventional oral diet. Several factors, including the length and site of the resected intestine, anatomical conformation of the remnant bowel, and the degree of postresection intestinal adaptation determine the disease severity. While mild SBS patients achieve nutritional autonomy with dietary modification (eg, hyperphagia, small frequent meals, and oral rehydration fluids), those with moderate-to-severe disease may develop SBS-IF and become dependent on parenteral support (PS) in the form of intravenous fluids and/or nutrition for sustenance of life...
2014: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/24884619/pediatric-gastroenteritis-in-the-emergency-department-practice-evaluation-in-belgium-france-the-netherlands-and-switzerland
#4
COMPARATIVE STUDY
Raphaëlle Pelc, Sébastien Redant, Sébastien Julliand, Juan Llor, Mathie Lorrot, Rianne Oostenbrink, Vincent Gajdos, François Angoulvant
BACKGROUND: Based on European recommendations of ESPGHAN/ESPID from 2008, first line therapy for dehydration caused by acute gastroenteritis (AGE) is oral rehydration solution (ORS). In case of oral route failure, nasogastric tube enteral rehydration is as efficient as intra-venous rehydration and seems to lead to fewer adverse events. The primary objective was to describe rehydration strategies used in cases of AGE in pediatric emergency departments (PEDs) in Belgium, France, The Netherlands, and Switzerland...
May 16, 2014: BMC Pediatrics
https://www.readbyqxmd.com/read/24316107/discovery-and-development-of-antisecretory-drugs-for-treating-diarrheal-diseases
#5
REVIEW
Jay R Thiagarajah, Eun-A Ko, Lukmanee Tradtrantip, Mark Donowitz, A S Verkman
Diarrheal diseases constitute a significant global health burden and are a major cause of childhood mortality and morbidity. Treatment of diarrheal disease has centered on the replacement of fluid and electrolyte losses using oral rehydration solutions. Although oral rehydration solutions have been highly successful, significant mortality and morbidity due to diarrheal disease remains. Secretory diarrheas, such as those caused by bacterial and viral enterotoxins, result from activation of cyclic nucleotide and/or Ca(2+) signaling pathways in intestinal epithelial cells, enterocytes, which increase the permeability of Cl(-) channels at the lumen-facing membrane...
February 2014: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/24163167/-antidiarrheal-drugs-for-chronic-diarrhea
#6
REVIEW
B Vohmann, J C Hoffmann
Chronic diarrhea can be caused by multiple disease entities. Basic diagnostic tests are required in order to administer specific therapies whenever possible. If no specific treatment can be used, a symptomatic management should be initiated in order to prevent massive electrolyte- and water losses. Substances that can be used are loperamide, cholestyramine, bulking agents, probiotics, anticholinergic agents and in severe cases opioids. If used properly these agents can be prescribed longterm with an acceptable side effect profile...
November 2013: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/23507881/ursodeoxycholic-acid-attenuates-colonic-epithelial-secretory-function
#7
Orlaith B Kelly, Magdalena S Mroz, Joseph B J Ward, Carolina Colliva, Michael Scharl, Roberto Pellicciari, John F Gilmer, Padraic G Fallon, Alan F Hofmann, Aldo Roda, Frank E Murray, Stephen J Keely
Dihydroxy bile acids, such as chenodeoxycholic acid (CDCA), are well known to promote colonic fluid and electrolyte secretion, thereby causing diarrhoea associated with bile acid malabsorption. However, CDCA is rapidly metabolised by colonic bacteria to ursodeoxycholic acid (UDCA), the effects of which on epithelial transport are poorly characterised. Here, we investigated the role of UDCA in the regulation of colonic epithelial secretion. Cl(-) secretion was measured across voltage-clamped monolayers of T84 cells and muscle-stripped sections of mouse or human colon...
May 1, 2013: Journal of Physiology
https://www.readbyqxmd.com/read/23343999/increased-intestinal-absorption-in-the-era-of-teduglutide-and-its-impact-on-management-strategies-in-patients-with-short-bowel-syndrome-associated-intestinal-failure
#8
Douglas L Seidner, Lauren K Schwartz, Marion F Winkler, Khursheed Jeejeebhoy, Joseph I Boullata, Kelly A Tappenden
Short bowel syndrome-associated intestinal failure (SBS-IF) as a consequence of extensive surgical resection of the gastrointestinal (GI) tract results in a chronic reduction in intestinal absorption. The ensuing malabsorption of a conventional diet with associated diarrhea and weight loss results in a dependency on parenteral nutrition and/or intravenous fluids (PN/IV). A natural compensatory process of intestinal adaptation occurs in the years after bowel resection as the body responds to a lack of sufficient functional nutrient-processing intestinal surface area...
March 2013: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/23086913/lactobacillus-acidophilus-upregulates-intestinal-nhe3-expression-and-function
#9
Varsha Singh, Geetu Raheja, Alip Borthakur, Anoop Kumar, Ravinder K Gill, Anas Alakkam, Jaleh Malakooti, Pradeep K Dudeja
A major mechanism of electroneutral NaCl absorption in the human ileum and colon involves coupling of Na(+)/H(+) and Cl(-)/HCO(3)(-) exchangers. Disturbances in these mechanisms have been implicated in diarrheal conditions. Probiotics such as Lactobacillus have been indicated to be beneficial in the management of gastrointestinal disorders, including diarrhea. However, the molecular mechanisms underlying antidiarrheal effects of probiotics have not been fully understood. We have previously demonstrated Lactobacillus acidophilus (LA) to stimulate Cl(-)/HCO3- exchange activity via an increase in the surface levels and expression of the Cl(-)/HCO3- exchanger DRA in vitro and in vivo...
December 15, 2012: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/22842693/treatment-related-diarrhea-in-patients-with-cancer
#10
REVIEW
Colleen Shaw, Loryn Taylor
Diarrhea caused by chemotherapy or radiation in patients with cancer can cause dehydration, electrolyte imbalance, malnutrition, fluid depletion, and hospitalization. In severe cases, uncontrolled diarrhea can lead to therapy dose reductions or even death. Oncology professionals may simply assess for the absence or presence of diarrhea, rather than using a standard assessment tool; they also may lack awareness regarding availability of established assessment and treatment guidelines. However, use of treatment guidelines can lead to optimal prevention and management of treatment-induced diarrhea in patients with cancer...
August 2012: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/22121455/childhood-diarrhoea-failing-conventional-measures-what-next
#11
REVIEW
Faraj Alkizim, Duncan Matheka, Anne Muriithi
BACKGROUND: Diarrhoea is one of the leading causes of infant mortality. This article analyzes its contribution towards the realization of millennium development goal number 4 (MDG-4). METHODS: A PubMed search using keywords acute infant diarrhea together with prevalence, management, or prevention 23 of the 634 generated articles were reviewed for inclusion. RESULTS: WHO first expressed concern about diarrhoeal mortality in 1979. Two decades later it reported diarrhoea as the second leading cause of infant mortality worldwide...
2011: Pan African Medical Journal
https://www.readbyqxmd.com/read/20951914/pharmacological-management-of-diarrhea
#12
REVIEW
Alexandra J Kent, Matthew R Banks
According to the World Health Organization, there are approximately 2 billion annual cases of diarrhea worldwide. Diarrhea is the leading cause of death in children younger than 5 years and kills 1.5 million children each year. It is especially prevalent in the developing world, where mortality is related to dehydration, electrolyte disturbance, and the resultant acidosis, and in 2001, it accounted for 1.78 million deaths (3.7% of total deaths) in low- and middle-income countries. However, diarrhea is also a common problem in the developed world, with 211 million to 375 million episodes of infectious diarrheal illnesses in the United States annually, resulting in 73 million physician consultations, 1...
September 2010: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/20044511/lactobacillus-acidophilus-stimulates-the-expression-of-slc26a3-via-a-transcriptional-mechanism
#13
Geetu Raheja, Varsha Singh, Ke Ma, Redouane Boumendjel, Alip Borthakur, Ravinder K Gill, Seema Saksena, Waddah A Alrefai, Krishnamurthy Ramaswamy, Pradeep K Dudeja
Clinical efficacy of probiotics in treating various forms of diarrhea has been clearly established. However, mechanisms underlying antidiarrheal effects of probiotics are not completely defined. Diarrhea is caused either by decreased absorption or increased secretion of electrolytes and solutes in the intestine. In this regard, the electroneutral absorption of two major electrolytes, Na(+) and Cl(-), occurs mainly through the coupled operation of Na(+)/H(+) exchangers and Cl(-)/OH(-) exchangers. Previous studies from our laboratory have shown that Lactobacillus acidophilus (LA) acutely stimulated Cl(-)/OH(-) exchange activity via an increase in the surface levels of the apical anion exchanger SLC26A3 (DRA)...
March 2010: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/18843696/antimotility-agents-for-chronic-diarrhoea-in-people-with-hiv-aids
#14
REVIEW
Chukwuemeka E Nwachukwu, Joseph U Okebe
BACKGROUND: AIDS-related diarrhoea is a common cause of morbidity and mortality in HIV positive individuals, especially in the sub-Saharan Africa where 70% of deaths from HIV occur. It often compromises quality of life both in those receiving antiretroviral therapy (ART) and the ART naive. Empirical antidiarrhoeal treatment may be required in about 50% of cases which are non-pathogenic or idiopathic and in cases resulting from antiretroviral therapy. Antimotility agents (Loperamide, Diphenoxylate, Codeine) and adsorbents (Bismuth Subsalicylate, Kaolin/Pectin, Attapulgite) are readily available, and have been found to be useful in this condition and so, are often used...
2008: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/18635327/decompression-effects-of-erythritol-on-endolymphatic-hydrops
#15
COMPARATIVE STUDY
Taizo Takeda, Setsuko Takeda, Akinobu Kakigi, Rie Nishioka, Masahiko Nishimura
OBJECTIVE: The effect of the uptake of erythritol with and without the addition of pectin on fecal condition, p-OSM and p-AVP levels, and the endolymphatic volume was investigated to consider the possibility that erythritol is applicable as a therapeutic agent for Meniere's disease. MATERIALS AND METHODS: Two experiments were performed using 100 female Hartley guinea pigs. Experiment 1 was designed to morphologically investigate the influence of the uptake of erythritol with or without the addition of pectin on the endolymphatic volume...
April 2009: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/18627238/cryptosporidiosis-in-20-alpaca-crias
#16
Laura H Waitt, Christopher K Cebra, Anna M Firshman, Erica C McKenzie, John W Schlipf
CASE DESCRIPTION: 20 alpaca crias (13 females and 7 males) were examined for diarrhea (n=20), weight loss (15), and poor appetite (5). Fourteen crias were between 8 and 18 days of age at time of admission. CLINICAL FINDINGS: Cryptosporidiosis was diagnosed in all crias. Common biochemical abnormalities included acidemia, hyperlactemia, azotemia, and hyperglycemia and increases in aspartate transaminase and gamma-glutamyltransferase activities. Serum sodium and chloride concentrations were high or low...
July 15, 2008: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/18411014/evaluation-and-management-of-treatment-related-diarrhea-in-patients-with-advanced-cancer-a-review
#17
REVIEW
Nathan I Cherny
Diarrhea is a common and significant problem among patients with advanced cancer. Treatment-induced diarrhea can be severe and be associated with life-threatening dehydration and electrolyte abnormalities. The causes of diarrhea among patients with advanced cancer are diverse and some causes of diarrhea require specific therapies. Thus, careful evaluation of the underlying cause is necessary. Palliative care clinicians, particularly those dealing with patients receiving ongoing disease-modifying therapies, must be familiar with the common causes of diarrhea among cancer patients and the strategies to evaluate and manage these common and distressing symptoms...
October 2008: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/18192964/treatment-of-diarrhea-in-patients-with-inflammatory-bowel-disease-concepts-and-cautions
#18
REVIEW
Shamita B Shah, Stephen B Hanauer
Diarrhea continues to be a prevalent symptom in patients with inflammatory bowel disease (IBD), requiring a wide differential diagnosis to define the pathophysiologic mechanisms in individual patients. It is essential that physicians properly evaluate complaints of diarrhea by assessing both patient symptoms and potential physiologic impacts on fluid and electrolyte status. Underlying mechanisms of diarrhea with IBD are the location, extent, and severity of inflammation; malabsorption; altered motility; and iatrogenic causes such as medications, diet, and antibiotic-associated colitis (eg, Clostridium difficile)...
2007: Reviews in Gastroenterological Disorders
https://www.readbyqxmd.com/read/18192961/loperamide-a-pharmacological-review
#19
REVIEW
Daniel E Baker
Loperamide is an antidiarrheal medication approved for the control of diarrhea symptoms and is available without a prescription. Loperamide works by a number of different mechanisms of action that decrease peristalsis and fluid secretion, resulting in longer gastrointestinal transit time and increased absorption of fluids and electrolytes from the gastrointestinal tract. It is a phenylpiperidine derivative with a chemical structure similar to opiate receptor agonists such as diphenoxylate and haloperidol. It was designed to maintain the antidiarrheal activity of these drugs, but minimize the negative aspects associated with their effects on the opiate receptor...
2007: Reviews in Gastroenterological Disorders
https://www.readbyqxmd.com/read/17704977/-time-and-again-it-hits-the-little-ones-herbal-therapy-for-childhood-diarrhea
#20
REVIEW
Andreas Biller
Acute diarrhea is amongst the most common childhood illnesses. Of paramount importance is an oral rehydration with glucose-electrolyte solutions. A number of herbal therapies are available to shorten the duration of the diarrhea and to alleviate the unpleasant symptoms. Although herbal preparations are generally well tolerated, only a few have been tested on children and adjusted to their needs. Various therapies for diarrhea in childhood are highlighted with regard to the clinical trials with children, and their user-friendliness...
2007: Wiener Medizinische Wochenschrift
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