Constipation Intestine

Aluminum-containing antacids—constipation, intestinal impaction, anorexia, weakness, tremors, and bone pain... 

Gastrointestinal tract—nausea, vomiting, diarrhea, constipation, epigastric pain, indigestion, abdominal distress or discomfort, intestinal ulceration, stomatitis, jaundice, bloating, anorexia, and dry mouth... 

Constipation, caused by a decrease in intestinal motility, may occur in tiiose taking one of tiiese drag s on a regular basis. Drowsiness may occur widi die use of diese dm, but at times tins adverse reaction is desirable Fbr example when atropine is used preoperatively to reduce die production of secretions in die respiratory tract, drowsiness is part of die desired response... 

Substantial individual differences were observed in the response to study breads and the ranges of enterolactone concentration changes in the groups were as follows -54.5-60.0 nmol/1 (placebo), -26.2-101.3 nmol/1 (LP), -19.6-81.8 nmol/1 (HP). This was something that could have been expected as in several studies dietary factors have explained only 10% of the variation in serum enterolactone (Vanharanta et al, 2002b Kilkkinen et al., 2001). This gives further support to the major role of intestinal bacteria in the synthesis of enterolactone. Decreased concentrations of enterolactone may occur due to an increased fiber intake, which may shorten the retention time in the colon and lead to incomplete metabolism of plant lignans. Constipation was earlier shown to be associated with an increased level of serum enterolactone (Kilkkinen et al., 2001). 

Tegaserod maleate (Zelnorm) is a partial serotonin (5-HT4) receptor agonist that causes an increase in peristaltic activity and intestinal secretion and moderation of visceral sensitivity. It increases the frequency of bowel movements and reduces abdominal discomfort, bloating, and straining. It is indicated for the treatment of patients younger than 65 years of age who experience chronic idiopathic constipation. The most common adverse effects include headache, abdominal pain, diarrhea, and nausea. 

Lubiprostone (Amitiza), a bicyclic acid oral agent, is approved for treatment of chronic idiopathic constipation in adults. It has not been studied in children. Lubiprostone acts locally on intestinal chloride channels and increases intestinal fluid secretion, resulting in increased intestinal motility and thereby increasing the passage of stool.6... 

Stimulation of 5-HT3 receptors triggers hypersensitivity and hyperactivity of the large intestine. Alosetron (Lotronex) is a selective 5-HT3 antagonist that blocks these receptors and is used to treat women with severe diarrhea-predominant IBS. Eligible patients should have frequent and severe abdominal pain, frequent bowel urgency or incontinence, and restricted daily activities. Alosetron has been shown to improve overall symptoms and quality of life. Alosetron can cause constipation in some patients. 

Tegaserod maleate (Zelnorm) stimulates 5-HT4 receptors in the GI tract, thereby increasing intestinal secretion, peristalsis, and small bowel transit. It also reduces sensitivity related to abdominal distention. It has been shown to be more effective than placebo in improving global IBS symptoms and altered bowel habits in constipation-predominant IBS.21 Diarrhea is a possible adverse effect. 

Hirschsprung s disease A disease of the small intestine that causes constipation (bowel movements are difficult). 

Acute physiological responses to opiate administration occur rapidly and include constricted pupils, decreased pulse rate, reduced body temperature, slowed respiration rate and impaired reflexes. In addition, there is a marked slowing of the digestive system through an altering of the tonus and motility of the stomach and intestines, allowing for greater water absorption. This last effect is not subject to tolerance, and constipation is a common side effect even for chronic users. Indeed, some report that this is the worst side effect of opiate use. 

Rifaximin Rifamycin Antibiotic Gut bacteria Enteric infection Diarrhea, infectious Hepatic encephalopathy Small intestine bacterial overgrowth Inflammatory bowel disease Colonic diverticular disease Irritable bowel syndrome Constipation Clostridium difficile infection Helicobacter pylori infection Colorectal surgery Bowel decontamination, selective Pancreatitis, acute Bacterial peritonitis, spontaneous Nonsteroidal anti-inflammatory drug enteropathy... 

All opiate derivatives are associated with constipation, but the degree of intestinal inhibitory effects seems to differ between agents. Orally administered opiates appear to have greater inhibitory effect than parenterally administered agents oral codeine is well known as a potent antimotility agent. 

In a small percentage of patients presenting with complaints of constipation, surgical procedures (such as intestinal resection) are necessary. Surgery is usually necessary with most colonic malignancies and with GI obstruction from a number of causes. 

Castor oil is metabolized in the GI tract to an active compound, ricinoleic acid, which stimulates secretory processes, decreases glucose absorption, and promotes intestinal motility, primarily in the small intestine. Castor oil usually results in a bowel movement within 1 to 3 hours of administration. Because the agent has such a strong purgative action, it should not be used for the routine treatment of constipation. 

Four liters of this solution is administered over 3 hours to obtain complete evacuation of the GI tract. The solution is not recommended for the routine treatment of constipation, and its use should be avoided in patients with intestinal obstruction. 

Besides causing loss of appetite and quality of life, longstanding and severe constipation can lead to diverticulosis, diverticulitis and in worst cases perforation of the large intestine with life threatening peritonitis (McConnell et al. 2003). Diverticulosis, irritable bowel syndrome and haemorrhoids are caused by chronic constipation and can lead to bleeding and anaemia. 

Digestive system g agonists decrease secretion of stomach acid, reduce gastric motility, and prolong gastric emptying. Pancreatic, biliary, and intestinal secretions are reduced. Intestinal transit is also slowed. Peristaltic movements are reduced, but tone is increased, sometimes causing spasm. As a result, constipation is a frequent problem with opioid use. Bile duct pressure is also increased by opioids. 

Ricinoleic acid (18 1 with an hydroxyl group on Cl2) from Ricims communis, the castor oil plant. Castor oil, containing 90% of ricinoleic acid, is poorly digested (because of the hydroxyl group) and acts as a lubricant and a slight irritant to the intestines, hence its use to relieve constipation. 

Incidents of vincristine overdosage have been reported relatively frequently in the medical literature. Some of these have involved inadvertent administration of the intravenous formulation into the central nervous system by the intrathecal route this produces devastating results by a combination of chemical damage to sensitive neuronal tissue as well as biochemical perturbations. Two representative cases of vincristine overdose were described (46) involving administration of vincristine to patients scheduled to receive vinblastine. In one patient toxicity initially involved vomiting and diarrhea with subsequent constipation and paralytic ileus (inhibition of motor activity in the small intestine). Muscle pain... 

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