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PubMedDate not supplied

[Effect of clonidine on oro-cecal transit time in normal man].

The aim of our study was to explore the effect of clonidine on the mouth to caecum transit time in healthy man. Hydrogen-breath test, using lactulose 10 g, was carried out in 10 healthy male volunteers, in double-blind conditions and in random sequences of medications, placebo or clonidine (0.3 mg per os). Clonidine increased the mouth to caecum transit time significantly (p = 0.013): from 85 +/- 12 min. (with placebo) to 139 +/- 16 min. (mean +/- SE). This study suggests that the antidiarrheal action of clonidine is due, at least in part, to effect on motility of the proximal gut.

Adult↗

PubMedDate not supplied

[Travelers' diarrhea].

Travelers' diarrhea is an acute infection of the gastrointestinal tract which has been known for many years, but which only recently has acquired epidemiologic and economic importance. The etiology is multiple and includes bacteria, viruses and protozoa, but the most frequently found agent is enterotogenic E. coli (ETEC). The symptomatology is characterized by watery acute diarrhea, without mucus, inflammatory cells and blood, usually without febrile elevation. The syndrome is normally self-limiting, without any specific antibiotic therapy, while antidiarrheal agents reduce entity and length of the symptomatology. Antimicrobial therapy is indicated in persistent forms only after ascertainment of the etiologic agent.

Bacterial Infections↗

PubMed1989

Radiation therapy with/without simultaneous weekly 5 F.U. in locally recurrent carcinoma of the recto-sigmoid.

Forty-eight patients received radiation therapy to the pelvis for locally recurrent carcinoma of the recto-sigmoid. The average duration before the development of local recurrence in the pelvis after curative surgery was 18 months. Thirty-seven patients had undergone a previous adbominoperineal resection. Twenty-five patients had Dukes' Stage-C carcinoma. Twenty-one patients had Stage-B and only two patients had Stage-A carcinoma of the rectosigmoid according to the Dukes' classification. All patients received radiation therapy to the pelvis to an average total dose of 5,000 rads in 25 to 28 fractions over a period of five to five and one half weeks. Twenty-three patients also received simultaneous weekly 5 F.U. by a single I.V. bolus of 1000mg to potentiate the action of radiation therapy. The treatments were well tolerated. The major complication was diarrhea, which responded satisfactorily to antidiarrheals such as Lomotil or Immodium tablets. Eighty per cent of the patients had pain relief. The median survival was 18 months for the patients receiving radiation therapy alone, but the patients treated with both radiation therapy and 5 F.U. had an average survival of 21 months and better palliation of symptoms.

Adenocarcinoma↗

PubMed1987

Hyperglycemic effect of lidamidine in the rat.

Lidamidine, a new antidiarrheal agent, produced a dose-dependent increase in plasma glucose levels in fed rats. The hyperglycemic response was evident 10 min after oral administration of lidamidine and lasted for 4 hr. Lidamidine's effect was absent in alloxanized rats. Insulin administration prevented the hyperglycemia. Pretreatment with the alpha 2-adrenoceptor antagonists yohimbine or RX781094A blocked the hyperglycemic response, while prazosin, propranolol, and hexamethonium pretreatment had no effect. These results indicate that the hyperglycemic effect of lidamidine is primarily due to the activation of peripherally located alpha 2-adrenoceptors that inhibit the release of insulin from pancreatic beta-cells.

Adrenergic beta-Antagonists↗

PubMed1987

Modified quadruple-loop (W) ileal reservoir for restorative proctocolectomy.

Reconstructive ileal pouch procedures are well-accepted alternatives to a permanent ileostomy in select patients requiring proctocolectomy for ulcerative colitis and familial polyposis. Double-, triple-, and quadruple-loop and lateral isoperistaltic designs have been described; however, the ideal pouch capacity and configuration are still debatable. Evidence has been reported that improved functional results and lower stool frequency with less antidiarrheal medication can be achieved with larger volume reservoirs. We describe a new modification of a quadruple-loop pouch that has been successfully performed in 10 patients. This new approach to pouch construction produced excellent functional results 6 to 12 months after ileostomy takedown and was easier to construct and engage into the muscular cuff of the distal rectum than quadruple-loop pouches of equal length loops.

Adenomatous Polyposis Coli↗

PubMed1987

[Rational diagnosis and therapy of irritable colon].

The irritable bowel syndrome is a common motility disorder of the gut characterized by constipation, diarrhea and abdominal pain. Symptoms are markedly influenced by psychological factors. The diagnosis is based on typical symptoms and exclusion of organic diseases. Psychological support by the physician is an important part of the patients' treatment. High fiber diets and bulking agents may be prescribed in addition. Antispasmodic and antidiarrheal drugs should be given only the shortest time possible, while psychotropic drugs are seldom necessary.

Colonic Diseases, Functional↗

PubMed1986

[Postoperative management of total pancreatectomy].

Sixteen patients given total pancreatectomy were experienced, and the essential points of postoperative management were reported. The morbid states after total pancreatectomy consist of: a deficiency of pancreatic endocrine function, a deficiency of pancreatic exocrine function, loss of the duodenum and upper jejunum, the influence of partial or total gastrectomy, and the influence of dissection around the superior mesenteric artery. These states influence each other and become more complicated. The management period is divided into five parts as follows; a period of intravenous nutrition, the early half; water replacement period, the late half; hyperalimentation period, a period of intravenous and enteral nutrition, a period of enteral, intravenous and oral nutrition, a period of oral and enteral nutrition, and a period of oral nutrition. In each period, a special form of management is needed. The essential points of long-term management are as follows: The use of suitable doses of pancreatic enzyme and antidiarrheal agents for the cure of severe maldigestion and malabsorption. Also, intermittent IVH or elemental diet are effective for recovery from deteriorative malnutrition. For the prevention of hypoglycemic attack, training of the patients and the maintainance of good nutrition are important. These patients have a high incidence of infection, and so speedy treatment must be given if this occurs. Fatty liver must be treated by intermittent IVH or elemental diet. As total pancreatectomy imposes a severe burden on the patient, including self-injection of insulin, the indications of this operation must be decided carefully giving due consideration to its radicality.

Enteral Nutrition↗

PubMed1988

Incidence and management of diarrhea during longterm auranofin therapy.

The incidence, severity, and management of diarrhea during longterm administration of auranofin (AF)--up to 33 months--were evaluated prospectively in 137 patients with active rheumatoid arthritis. At least 1 episode of diarrhea was reported in 101 patients (74%), but the rate of occurrence/patient-months of therapy was 24% (569 events/2,370 patient-months of treatment). The monthly prevalence declined from a range of 30-40% during the initial 6 months to about 10% for patients treated for 18-24 months. Most diarrhea was intermittent and mild; only 11 patients (8%) discontinued treatment because of diarrheal symptoms. No intervention was required in 46 of the 101 patients affected. In 44 others, loose stools were successfully managed with antidiarrheal medications, a reduction in dosage, or both. Although diarrhea is a common event during AF administration, particularly early in therapy, for most patients it usually does not significantly interfere with treatment.

Adult↗

PubMed1987

[The effect of bismuth subnitrate on cisplatin toxicity].

Bismuth subnitrate (BSN), a bismuth compound medically used for antidiarrheics, was orally administered to see whether it can reduce CDDP nephrotoxicity or not. Thirteen patients aged 19 approximately 60 with ovarian cancer entered this BSN-CDDP trial. A total of thirty three courses of BSN-CDDP treatment was undergone. BSN was administered orally at a dose of 50 mg/kg for five days before CDDP therapy. CDDP was infused for two hours. No vigorous hydration or diuresis was performed. Only 2,000 ml of saline with 20 mEq per liter of KCl was given for post-hydration. The median dose of CDDP was 100 mg/m2. The renal toxicity of BSN-CDDP treatment was minimum. 82% of the courses at the sixth day after the treatment had creatinine clearance levels which were more than 80% of those before the treatment. But twenty-four hour NAG and beta 2-microglobulin excretion were significantly increased. Bone marrow suppression and gastrointestinal disturbance were commonly observed. The results of our study indicate that BSN pretreatment reduces the renal toxicity of CDDP to some extent.

Acetylglucosaminidase↗

PubMed1987

Effects of loperamide hydrochloride on experimental diarrhea and gastrointestinal myoelectrical activity in calves.

The antidiarrheal action of loperamide hydrochloride was tested against diarrhea experimentally induced in calves by intraduodenal infusion of castor oil or hypertonic solution of mannitol. The motility of 4 levels of the digestive tract (abomasum, jejunum, and proximal and spiral loops of the colon) was concomitantly recorded, using an electromyographic technique. Loperamide hydrochloride given per os at 0.4 mg/kg or intraduodenally or subcutaneously at 0.1 mg/kg 1 hour before mannitol or castor oil was given delayed diarrhea. Loperamide hydrochloride given alone orally at a dosage of 0.4 mg/kg did not modify the motility pattern of the digestive tract. Intraduodenally administered loperamide hydrochloride (0.1 mg/kg) increased the frequency of the cyclic activity of the jejunum, whereas subcutaneously administered loperamide hydrochloride at the same dose selectively inhibited the motility of the jejunum. Intraduodenal infusion of mannitol was followed by a disruption of the cyclic activity of the jejunum, and this effect was not antagonized by loperamide hydrochloride, whatever the route of administration. Castor oil infusion was not accompanied with changes in gastrointestinal motility. These results indicate that loperamide hydrochloride is active against an experimentally induced diarrhea in calves and that this action is not mediated through an effect on the digestive motility, at least monitored by this electromyographic technique.

Abomasum↗

PubMed1987

Prevention of lethal and renal toxicity of cis-diamminedichloroplatinum(II) by induction of metallothionein synthesis without compromising its antitumor activity in mice.

The participation of renal metallothionein (MT) in the toxicity and antitumor activity of cis-diamminedichloroplatinum(II) (cis-DDP) in male mice was examined. Preinduction of MT in the kidney by the s.c. administration of bismuth compounds decreased the lethality and renal and gastrointestinal toxicity caused by a single s.c. injection of cis-DDP. In the present study a correlation between the protective effect of pretreatment with bismuth nitrate against cis-DDP toxicity and the preinduced MT levels in the kidney was observed. Bismuth nitrate pretreatment showed no effect on the antitumor activity of cis-DDP against several transplantable tumors, probably because it induces MT in the kidney but not in tumor tissues. The fact that p.o. preadministration of bismuth subnitrate, an antidiarrheal drug, also depressed the lethal toxicity of cis-DDP is promising for its prompt application in medical attention. Thus, bismuth pretreatment allows higher doses of cis-DDP with no apparent toxicity, resulting in more efficient utilization of this anticancer drug.

Animals↗

PubMed1985

Experience with the endorectal pull-through and S pouch for ulcerative colitis and familial polyposis in adults.

An experience is reported with 23 patients who underwent rectal mucosectomy, total colectomy, creation of S-type pouch, and ileoanal anastomosis for ulcerative colitis (21 patients) or familial polyposis (two patients). There were no deaths. There were 23 complications requiring 18 operations in 16 patients. Twenty-one patients have been followed an average of 17.8 months (range 2 to 34 months) Frequency of bowel movement averaged 9.8 per day initially and 6.2 per day at the time of follow-up. None of the patients consider themselves incontinent, although 15 have had some degree of perianal soiling and at least on occasion have worn a pad. One patient intubates the pouch regularly, six intubate it on occasion, and 14 do not intubate at all. The size of the outflow treat of the pouch has been shortened from 5 to 2 cm in the last seven patients; six of these patients do not intubate and four report no soiling at all. Eleven patients have made changes in their diet or eating habits to promote more predictable bowel function and 13 take a variety of antidiarrheal medications. Nineteen patients are satisfied with the procedure and prefer the pouch to a conventional ileostomy; the other two have since undergone conversion to a Brooke ileostomy. Despite frequent bowel movements, complications, and some problems with perianal soiling, patient acceptance remains high with the endorectal pull-through and S pouch in adults, and further study, particularly using a shortened outflow tract, appears warranted.

Adult↗

PubMed1985

Early radiation-induced proctosigmoiditis responds to magnesium therapy.

A group of 10 patients with cervical carcinoma with early radiation-induced proctosigmoiditis and low serum Mg levels was treated with low residue diet and antidiarrheals. The diarrhea cleared within a period of 2-6 weeks. A second group of 10 patients with hypomagnesemia was treated with intravenous infusion of Mg sulfate for 3 consecutive days. The diarrhea disappeared by the end of treatment, paralleling normalization of serum Mg levels.

Colitis↗

PubMed1979

Chronic diarrhea in infants and children.

A useful clinical classification of chronic diarrhea is based on the character of the stool--watery, fatty or bloody. Pathophysiologic mechanisms include osmotic and secretory diarrheas, bacterial overgrowth leading to excess colonic bile acids and fatty acids, defective anion exchange systems, mucosal damage and abnormal motility and transit. Evaluation may require hospitalization. Antidiarrheal agents are not used. Antibiotics are generally not indicated. Parenteral hydration and feedings of special formulas are carefully monitored.

Bile Acids and Salts↗

PubMed1979

Chenodeoxycholic acid-induced diarrhea in rats: effects of atropine and codeine.

Orally administered chenodeoxycholic acid (300 mg/kg) produced diarrhea and accumulation of gastro-intestinal fluid in rats. The fluid in the stomach and small intestine remained accumulated even after the accumulated colonic fluid and the diarrheal excretion decreased. When instilled into an intestinal closed-loop, chenodeoxycholic acid caused a marked inhibition of fluid absorption in the colon and jejunum but less effect in the ileum. On the contrary, an intravenous administration of chenodeoxycholic acid caused neither diarrhea nor impairment of colonic absorption of fluid. Atropine and codeine (10 mg/kg s.c.) blocked or at least delayed the diarrhea produced by oral administration of chenodeoxycholic acid. The antidiarrheal activity of codeine was found to be more potent and longer-lasting than that of atropine. Both drugs delayed the passage of chenodeoxycholic acid containing gastric fluid into the duodenum, but neither of them prevented chenodeoxycholic acid-induced jejunal secretion of fluid and electrolytes. These results indicate that the diarrheal excretion by chenodeoxycholic acid was ascribable to the impairment of fluid absorption in the colonic mucosa and partly to the activation of gastro-intestinal propulsive motility.

Analgesia↗

PubMed1979

[Treatment of diarrhea with difenoxin hydrochloride in children (author's transl)].

In an open clinical study symptomatic treatment was given to 93 children aged 16 days to 24 months who suffered from acute diarrhea. All the patients received antidiarrheal diet suited to their age. If indicated, the children were rehydrated with electrolyte and buffer solutions. In order to reduce the intestinal motility as well as the loss of water and electrolyte in the stool, but not to stop the stools, difenoxin hydrochloride (Lyspafen) in the commercial composition was prescribed. The dose was 1 drop/kg body weight/day administered in 3 single doses. The preparation was administered to the children for 4-6 days on the average. Regardless of the bacteriological findings in the stools, very good results were obtained in 59 patients (63.44%); sufficient results in 19 children (20.43%); and poor results in 15 children (16.13%). In the group with negative stool samples very good results were obtained in 74% of the patients. The therapeutic results were very good to sufficient in the majority of cases belonging to the group with facultative pathogenic germs and pathogenic coli in the stools. In 66.67% (4 cases) of the children infected by Salmonellae and Shigellae the treatment was insufficient. No undesirable adverse reactions were seen in the children treated. Summing-up of the results revealed that cure of or improvement in the diarrhea was obtained in 83.87% of the test population.

Child, Preschool↗

PubMed1977

[Therapeutic induction of abortion in the 1st and 2nd trimesters with intramuscular 15-methyl-prostaglandin F2 alpha].

The effectiveness of intramuscular 15-methyl-prostaglandin F2alpha (15-methyl-PGF2alpha) application for therapeutic abortion was studied in 16 women during the first and second trimester (12 to 17 weeks) of pregnancy. 250 microgram 15-methyl-PGF2alpha were administered initial and at intervals of 2 hours. Of the 16 subjects, 2 aborted completely, 13 aborted incompletely and 1 failed to abort. The mean abortion time for the 15 successful abortions was 11,25 hours and the mean 15-methyl-PGF2alpha dosage 1,35 mgs. Vomiting and diarrhea were the most prevalent side effects occurring in 12 of 16 patients. No serious complications occurred. In 9 women between 7 to 13 weeks of pregnancy a single intramuscular injection of 250 microgram 15-methyl-PGF2alpha was administered 11 to 13 hours prior to vacuum aspiration. All subjects had a gradual softening and dilatation of the cervix (5 to 8 mm). In 7 of 9 patients occurring gastro-intestinal side effects. Acute ascension was observed in 2 women after vacuum aspiration. All subjects had a gradual softning and dilatation of the cervix (5 to 8 mm). In 7 of 9 patients occurring gastro-intestinal side effects. Acute ascension was observed in 2 women after vacuum aspiration. Intramuscular administration of 15-methyl-PGF2alpha appears to be an effective abortifacient. Gastro-intestinal side effects can be reduced by antiemetic and antidiarrheal agents or lowering the initial dose of 15-methyl-PGF2alpha.

Abortion, Therapeutic↗

PubMedDate not supplied

Prostaglandin F2 alpha for interrupting pregnancy, managing intrauterine death and molar pregnancy and inducing labor.

Serial intramuscular injections of 250 microgram of 15 (S), 15-methyl-prostaglandin F2 alpha were given to 105 women every 1-3 hours in an attempt to induce second-trimester abortion (N = 80) or labor (N = 25), the latter because of late intrauterine death or anencephaly. The treatment was highly successful; the cumulative expulsion rates at 12 and 24 hours were 69% and 95%, respectively. There were no serious complications, and significant alterations in the mother's vital signs were uncommon. Gastrointestinal side effects are tolerable if the woman is properly premedicated and maintained on the antiemetic, antidiarrheic and analgesic treatments.

Abortion, Induced↗