Diarrhoea treatment

Islam, M. A., D. Mahalanabis, and N. Majid. Use of rice-based oral rehydra-tion solution in a large diarrhoea treatment centre in Bangladesh in-house production, use and relative cost. J Trop Med Hyg 1994 97(6) 341-346. Okai, Y., T. Eksttikul, O. Svendsby, M. Izukz, K. Ito, andN. Minamiura. Antitumor activity in an extract of Thai rice seedlings. J Ferment Bioeng 1993 76(5) 367-370. 

L. rhamnosus GG Shortening of diarrhoea Treatment/prevention of allergy Delay of first onset of pouchitis Guandalini et al. (2000) Kalliomaki et al. (2001) Gosselink et al. (2004)... 

Main consequences of frequently used in-feed antibiotics for diarrhoea treatment... 

Antidiarrhoeal drugs are used for the symptomatic treatment of diarrhoea (the frequent passage of liquid... 

Several nonpeptidic, orally active vasopressin receptor antagonists have been developed. The dual V1A/V2R antagonist conivaptan is used in the treatment of hyponatraemia and could also become useful for diseases such as congestive heart failure, in which increased peripheral resistance and dilutional hyponatremia both are present [4]. Side effects of conivaptan include headache, injection site reactions, vomiting, diarrhoea, constipation and thirst. 

LONGANGA OTSHUDI A, VERCRUYSSE A, FORIERS A (2000) Contribution to the ethnohotanical, phytochemical and pharmacological studies of traditionally used medicinal plants in the treatment of dysentery and diarrhoea in Lomela area. Democratic Repuhhc of Congo (DKC). J Ethnopharmacol. 71 411-23. 

OTSHUDI A L, FORIERS A, VERCRUYSSE A, VAN ZEEBROECK A, LAUWERS S (2000) / vittV antimicrobial activity of six medicinal plants traditionally used for the treatment of dysentery and diarrhoea in Democratic Repnblic of Congo (DRC). Phytomedicine. 7 167-72. 

Nematode parasites present a serious problem for most animals and for humans in developing countries. These parasites produce various symptoms including ill thrift, poor growth, diarrhoea and, in around 1 % of cases, loss of life. The economic forces are such that new drugs for the treatment of nematode parasites have been developed first for animal use and only later for human use. A recent example is the development of the antibiotic anthelmintic, ivermectin, which was introduced first for the treatment of cattle nematode parasites and has subsequently been used to control river blindness , an eye condition seen in west Africa caused by farvae of Onchocerca volvulus. 

Alvisi A, D Ambrosi A, Onofri W, Catellani M, Palazzini E Treatment of secretory diarrhoeas. A double-blind trial of the effectiveness of rifaximin (L 105) and neomycin. Clin Trials J 1984 21 215-223. 

Frisari L, Viaggiano V, Pelagalli M An open, controlled study of two non-absorbable antibiotics for the oral treatment of pediatric infectious diarrhoea. Curr Med Res Opin 1997 14 39—45. 

Wilcox MH, Howe R Diarrhoea caused by Clostridium difficile Response time for treatment with metronidazole and vancomycin. J Antimicrob Chemother 1995,36 673-679. 

Wunderlich PF, Braun L, Fumagalli I, D Apuz-zo V, Heim F, Karly M, Lodi R, Politta G, Vonbank F, Zeltner L Double-blind report on the efficacy of lactic-acid-producing Enterococcus SF68 in the prevention of antibiotic-associated diarrhoea and in the treatment of acute diarrhoea. J Int Med Res 1989 17 333-338. 

Many chronic diseases can cause hypotension. Heart conditions (and drugs used for its treatment) can lead to bradycardia, thyroid dysfunction (either under- or over activity), diabetes mellitus, Parkinson s disease and neuropathies. Also, all acute conditions with the risk of dehydration, such as fever, vomiting, diarrhoea and bleeding, can cause hypotension. 

ADP ribosylation results in inhibition of GTPase activity and hence maintains the a-subunit in the active form. The constant activity of the G-protein results in an increase in adenyl cyclase activity and therefore a chronic increase in the cychc AMP level. This stimulates an ion channel in the enterocyte which results in a loss of Na ions and hence water from the cells into the intestine. This leads to diarrhoea and a massive loss of fluid from the body which can be sufficiently severe to result in death. Since 2000 there have been epidemics in South America and parts of central Africa. Infection is usually caused by drinking water contaminated with faecal matter. Treatment consists of hydration with rehydration fluids (Chapter 5). 

Loperamide is an antidiarrhoeal drug indicated for use in adults and children over 12 years. Loperamide should not be administered in children under 4 years v/ho have diarrhoea. Children are more sensitive to the occurrence of the side-effect of respiratory depression. Fluid and electrolyte replacement are first-line treatments in diarrhoea. 

Loperamide is an opioid analogue that binds to the opiate gut receptors, thereby decreasing intestinal motility and increasing transit time. Loperamide is contraindicated in patients with active ulcerative colitis and children under 4 years. It is used in the treatment of diarrhoea. 

De Bruyn G, Hahn S, Berwick A. Antibiotic treatment for travellers diarrhoea. Cochrane Database Syst Rev 2000. 

In immunocompromised patients, crampy abdominal pain and prolonged severe watery diarrhoea occur. Fluid replacement and the use of an-tidiarrhoeals are the mainstay of treatment. In patients with acquired immunodeficiency syndrome... 

Anti-secretory treatment, by reducing the acid barrier to infection approximately doubles the risk of infective diarrhoea. Fears that treatment like H2 receptor antagonists or proton pump inhibitors would increase the risk of gastric cancer have not been realised. Raised frequencies of oesophageal cancer in patients taking proton pump inhibitors reflect underlying predisposition in Barrett s disease. 

Opiates are the most effective non-specific agents, and the peripheral opiate agonist loperamide may be adequate in most individuals. Whilst giving such empirical treatment the possible need of fluid replacement must be remembered. Opiates are not replacements for oral rehydration fluids (based on salt and glucose) or intravenous rehydration fluids in acute diarrhoea. 

VIII.b.1.3. Extensive disease. Rectal therapies are insufficient, and patients should receive, if outpatients, oral corticosteroids, and if in-patients oral or parenteral corticosteroids with full supportive treatment including parenteral fluids and blood transfusion. The need for intensive in-patient treatment is indicated by the presence of severe diarrhoea, anaemia, fever and tachycardia with radiographic evidence of colonic mucosal oedema on plain X-ray, or of toxic megacolon. 

Patients with frequent relapses despite apparently adequate prophylactic treatment should be reviewed carefully. Associated milk intolerance or coeliac disease need treatment on their merits. Colonoscopic evidence of dysplasia raises the question of undiagnosed malignancy. Occasionally the prophylactic agents themselves can cause watery diarrhoea (particularly olsalazine) or a hypersensitivity colitic disease. Prophylactic azathioprin should be considered in those in whom relapse is frequent despite use of aminosalicylates or if they are poorly tolerated. In the effective dose of 2 mg/kg adverse effects of bone marrow depression are uncommon, but still occur, and regular haematological review is essential (monthly or bi-monthly). Azathioprin-induced pancreatitis is an uncommon but well-recognised entity. 

Benefits of treatment were also seen on measures of activities of daily living and behavioural disturbances. Although there is less evidence for other than mild to moderate dementia. There is evidence of more adverse events in total in the patients treated with a ChEl than with placebo. Although many types of adverse event were reported, nausea, vomiting, diarrhoea, were significantly more frequent. 

Adverse effects are usually due to excessive doses (which may occur if the initial increase in metabolism is too rapid) and correspond to symptoms of hyperthyroidism, but they usually disappear after dose reduction or withdrawal of treatment. The most common adverse effects affect the following system as Heart arrhythmias, anginal pain, Central nervous system headache, hyperactivity, sweating, tremor, heat intolerance, Gastrointestinal tract diarrhoea, excessive weight loss, vomiting, Musculoskeletal system muscle cramps, muscle weakness. 

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