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Posted by: Gastroenterologist in Diarrhea on December 23rd, 2011
Although most acute nonspecific diarrhea in the United States is self-limiting, nonprescription antidiarrheal products may provide relief and will usually do no harm when used according to label instructions. Table Recommended Dosages of Antidiarrheal Agents for Acute Diarrhea lists dosage and administration guidelines for these agents. Scientific evidence that pharmacologic agents, with the exception of loperamide and Bismuth subsalicylate. reduce stool frequency or duration of disease in adults is lacking. Likewise, antidiarrheal drugs have not been shown to significantly improve clinical outcomes of acute nonspecific diarrhea in infants and children. Importantly, a change in stool consistency toward more formed stools does not necessarily indicate that antidiarrheal therapy has successfully treated the underlying problem. Comparison of Electrolyte and Dextrose Concentrations of Household Fluids Clear Liquids Sodium (mEq/L) Potassium (mEq/L) Bicarbonate (mEq/L) Dextrose (g/L) Osmolarity (mOsm/L) Cola 2 0.1 13 50-150 dextrose and fructose 550 Ginger ale 3 1 4 50-150 Read more [...]
Posted by: Gastroenterologist in Diarrhea on June 16th, 2011
A number of different agents are used to control acute and long-term chronic diarrhea. As pointed out above, definitive treatment requires a correct diagnosis. In this section, the general use of pharmacologic agents in SD is dealt with, and in the following section, specific comments on some of the specific diseases are made. Opiates and synthetic long-acting somatostatin analogues (octreotide, lanreotide) are the most commonly used. Other agents that may be helpful are a2-adrenergic agonists, corticosteroids, absorbent agents, prostaglandin synthetase inhibitors, calcium channel blockers, and phenothiazines. The use of each is briefly discussed below. Opiates Opiates are usually the first-line therapy for most mild to moderate diarrheas. Commonly used preparations include paregoric, tincture of opium, codeine, Lomotil (diphenoxylate with atropine), Imodium (loperamide), and difenoxin with atropine. These agents inhibit transit throughout the gastrointestinal (gastrointestinal) tract; therefore, they increase the contact time between intestinal luminal contents and the mucosa, increasing absorption. Read more [...]
Posted by: Gastroenterologist in Management of Diarrhea on June 16th, 2011
Chronic diarrhea is a frequent manifestation in patients with diabetes mellitus, and is present in patients with type 1 or type 2 diabetes. According to some evidence, up to 15% of patients with diabetes mellitus may experience diarrhea. However, other studies have found no difference in the prevalence of diarrhea between diabetics and community control subjects. Thus, in the general population there might be no increased prevalence or association between diarrhea and diabetes, and the symptoms of diarrhea might be attributable to other common conditions, such as irritable bowel syndrome (irritable bowel syndrome), occurring in a patient with diabetes. Nonetheless, some patients with diabetes have significant diarrhea and present for examination and treatment. Mechanisms of Chronic Diarrhea in Diabetes Mellitus Table Mechanisms, Concomitant Conditions,and Clinical Characteristics of Diarrhea in Diabetes Mellitus provides an overview of the pathophysiological mechanisms and conditions associated with diarrhea in diabetes. The mechanisms of chronic diarrhea in diabetes are incompletely understood. Read more [...]
Posted by: Gastroenterologist in Management of Diarrhea on June 16th, 2011
When available, we recommend directing the therapeutic intervention to the relevant underlying mechanism of chronic diarrhea by the use of appropriate testing. We prefer this approach to sequential empiric trials with antidiarrheals and other trials (eg, with dietary alteration and antibiotics). Celiac Sprue If the clinical examination or routine laboratory tests are suggestive of malabsorption, further testing should be undertaken to identify potentially relevant conditions, specifically celiac sprue, bacterial overgrowth, and pancreatic exocrine insufficiency. Anti-endomysial and antitissue transglutaminase antibodies should be sought, and, eventually, a jejunal biopsy will be needed to confirm any positive serological findings. In patients with concomitant diabetes and celiac disease confirmed by jejunal biopsy, the institution of a gluten-free diet leads to the regression of mucosal abnormalities and typically normalizes bowel habits. There is a separate chapter on celiac. Gut Dysmotility and Hypersecretion The presence of gut dysmotility can be assessed by means of radiographic, breath Read more [...]
Posted by: Gastroenterologist in Treatment of Diarrhea on June 16th, 2011
Travel to the developing countries is a marvelous way to experience the diversity of humankind. Visiting historic treasures, observing the wonders of nature, and experiencing the fascinations of different cultures and the taste of new cuisine are the inherent values of this type of travel. Unfortunately, along with the benefits of travel come the possibilities of unusual "tropical" illness, the most frequent of which is travelers diarrhea. Although called by many colorful names (Montezuma's revenge, Delhi belly, Aztec two-step) according to location, they all represent the same illness. This type of illness was first recognized by Kean and Waters in the 1950s as a distinct entity in which large numbers of vacationers and students from the developed world began to visit the developing world, where water and sanitation were substandard. When it was first described it was attributed to changes in composition of food and water and to jet lag, and was thought generally not to be infectious or viral because bacteriological cultures were not helpful in defining an etiologic agent. Infectious Etiology When Read more [...]
Posted by: Gastroenterologist in Treatment of Diarrhea on June 16th, 2011
Rehydration The restoration and maintenance of adequate hydration is the most important component of the treatment of acute infectious diarrhea. Rehydration is particularly important in the elderly, pediatric, or immunocompromised patient. In otherwise healthy patients with mild to moderate diarrhea, increasing intake of most fluids is usually adequate to replace fluid losses. In moderate to severe diarrhea, however, fluids with appropriate electrolyte concentrations are needed. Water, juices, and sports drinks will not adequately replace electrolyte losses. For dehydrating diarrhea, aggressive oral rehydration with electrolyte solutions or intravenous (IV) fluids is required. The formulation of "oral rehydration solutions" (ORS), as determined by the World Health Organization (WHO), includes precise concentrations of sodium, potassium, chloride, citrate/bicarbonate, and glucose to replace fluid and electrolyte losses from diarrhea and avoid IV fluid administration. Commercial pediatric formulations are readily available (eg,Pedialyte).Ahome ORS recipe, based on WHO formulations, is available Read more [...]
Posted by: Gastroenterologist in FAQ on April 18th, 2010
Question from Ken of Virginia, USA: My mother had surgery to remove colon polyps (about 12-18" of colon removed). This occurred about 3 weeks ago, and she has recovered as expected from the surgery. However, there has been a continuation of severe gas pains and diarrhea ever since. Is this normal, and how long should you expect it to last. The doctor has only said "these things take time." Dear Ken It is not unusual for patients who have had a portion of the colon removed to experience diarrhea for a period of time; this is most common when the sigmoid colon is removed, but can occur after loss of any area of the colon. This usually does improve with time, although bulk agents (such as psyllium) are sometimes needed to solidify the stools, as well as the use of antidiarrheal meds in some such as Loperamide (Imodium) or Diphenoxylate (Lomotil). These should not be use without consulting a physician. Another frequent cause of diarrhea after almost any type of surgery is known as Antibiotic Associated Diarrhea or Colitis (also known as Pseudomembranous Colitis). This is due to the use of Read more [...]
Posted by: Gastroenterologist in Diarrhea on March 27th, 2010
Nonpharmacologic Adult individuals with acute diarrhea who are otherwise healthy are not likely to develop dehydration. Lost fluids and electrolytes can be replaced with virtually any beverage plus a source of sodium chloride (salted crackers, etc.). Patients can rest the bowel by avoiding high-fiber foods, fats, milk and other dairy products, caffeine and alcohol. A bland diet emphasizing such foods as bananas, clear soups, juice, gelatin and boiled vegetables may be helpful. The diet can gradually be returned to normal as tolerated and as stools become formed. For less than severe diarrhea, an oral glucose-electrolyte solution may be given if nausea and vomiting are not severe. Intravenous fluid therapy is necessary for the treatment of severe dehydration or diarrhea that is accompanied by severe vomiting. The degree of dehydration present determines the treatment of a child with diarrhea. Children with diarrhea who are not dehydrated should continue to be fed age-appropriate diets. Oral rehydration therapy (ORT) is the preferred treatment of fluid and electrolyte losses caused by diarrhea Read more [...]

Spanish And French Translations Of Common Medication Words:

English Spanish French
Medications Medicamentos Médicaments
Tablets Comprimidos Comprimés
Capsules Cápsulas Gélules
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