Diverticulosis

Antiflatulents are used for die relief of painful symptoms of excess gas in the digestive tract. These drugs are useful as adjunctive treatment of any condition in which gas retention may be a problem (ie, postoperative gaseous distention, air swallowing, dyspepsia, peptic ulcer, irritable colon, or diverticulosis). In addition to its use for tiie relief of intestinal gas, charcoal may be used in the prevention of nonspecific pruritus associated with kidney dialysis treatment and as an antidote in poisoning. Simethicone is in some antacid products, such as Mylanta liquid and Di-Gel liquid. 

A laxative is most often prescribed for the short-term relief or prevention of constipation. Certain stimulant, emollient, and saline laxatives are used to evacuate the colon for rectal and bowel examinations. Fecal softeners or mineral oil are used prophylactically in patients who should not strain during defecation, such as after anorectal surgery or a myocardial infarction. Psyllium may be used in patients with irritable bowel syndrome and diverticular disease. Fblycarbophil may be prescribed for constipation or diarrhea associated with irritable bowel syndrome and diverticulosis. Mineral oil is... 

Noninfectious causes of acute diarrhea include drugs and toxins (Table 18-3), laxative abuse, food intolerance, irritable bowel syndrome (IBS), inflammatory bowel disease, ischemic bowel disease, lactase deficiency, Whipple s disease, pernicious anemia, diabetes mellitus, malabsorption, fecal impaction, diverticulosis, and celiac sprue. 

Barium enema, sigmoidoscopy, or colonoscopy maybe indicated in the presence of red flag symptoms (fever, weight loss, bleeding, and anemia, which maybe accompanied by persistent severe pain), which often point to a potentially serious non-IBS problem. A barium enema may identify polyps, diverticulosis,... 

There are a variety of other disease states whose influence on drug absorption has been reported, including cystic fibrosis, villous atrophy, celiac disease, diverticulosis, and Crohn s disease. The results of these studies are frequently divergent, and therefore general statements cannot be made. A thorough discussion of these findings is beyond the scope of this... 

Metronidazole Bjorneklett et al., 1983 [23] NA 6 radiation fibrosis, small bowel diverticulosis 83%... 

Rifaximin, a nonabsorbable derivative of rifamycin, has shown promising bactericidal action against both aerobes and anaerobes, such as bacterioides, lactobacilli and clostridia [33, 34], The development of resistance to this antibiotic can occur, but resistant strains rapidly disappear from the intestine thus allowing cyclic administration of rifaximin. Controlled clinical trials showed efficacy of rifaximin in adult and pediatric patients with infectious diarrhea [36,37], hepatic encephalopathy [38], post-surgical complications [39] and colonic diverticulosis [40], Only recently was the efficacy of rifaximin in the treatment of SIBO demonstrated [41-43]. 

Schiffer LM, Faloon WW, Chodos RB Malabsorption syndrome associated with intestinal diverticulosis. Gastroenterology 1962 42 63-68. 

Elsborg L Malabsorption in small intestinal diverticulosis treated with a low dosage sul-phonamide-trimethoprim. Dan Med Bull 1977 24 33-35. 

There is some evidence that long-term cyclic administration of rifaximin combined with fiber supplementation is effective for inducing symptomatic relief in patients with uncomplicated diverticular disease of the colon. A therapeutic gain of approximately 30% compared to fiber supplementation only can be expected. The drug is well tolerated and no relevant side effects have been reported. Symptoms attributed to diverticula (abdominal pain or discomfort, bloating, disturbance of bowel habits) are nonspecific symptoms and are also features of irritable bowel syndrome. It has been suggested that irritable bowel syndrome and diverticular disease of the colon may coexist in many people and when bowel symptoms occur with diverticulosis coli, they may be due to a coexistent irritable bowel rather to the diverticula themselves [47, 48]. This hypothesis is supported by the fact that many patients with symptomatic diverticular disease show co-... 

Narasaka T, Watanabe H, Yamagata S, Muna-kata A, Tajima T, Matatsunaga F Statistical analysis of diverticulosis of the colon. Tohoku J Exp Med 1975 115 271-275. 

Manousos O, Day NE, Tzonou A, Papadimi-triou C, Kapetanakis A, Polychronopoulou-Trichopoulou A, Trichopoulou D Diet and other factors in the aeliology of diverticulosis An epidemiological study in Greece. Gut 1985, 26 544-549. 

Ritchie L Similarity of bowel distension characteristics in the irritable bowel syndrome and diverticulosis. Gut 1977 18 990. 

Gold MH, Carlson GM, Mathias JR Colonic myoelectric activity in diverticulosis. Gastroenterology 1979 76 1139. 

Diverticulosis, or the presence of several diverticula, affects 50% or more of the population over the age of 60 years in several countries (Ye and others 2005). Studies have established an association between low-fiber diets and the presence of diverticulosis (Aldoori and Rayan-Harschman 2002). The intake of fruit and vegetable fiber was inversely associated with risk of diverticulosis in a large prospective study of male health professionals, and therefore a high-fiber diet including fruits and vegetables remains an important aspect of therapy for diverticulosis (American Dietetic Association 2002). 

Ye H, Lozada M and West B. 2005. Diverticulosis coli Update on a Western disease. Adv Anat Pathol 12 74-80. 

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. 

Psyllium Useful in patients with irritable bowel syndrome and diverticular disease. Polycarbophil For constipation or diarrhea associated with conditions such as irritable bowel syndrome and diverticulosis acute nonspecific diarrhea. 

Three patients who had taken metformin for more than 2 years developed diarrhea (98). After withdrawal of metformin the diarrhea resolved within 1 month. A fourth patient developed diarrhea after taking metformin for 4 months, which stopped after withdrawal rechallenge with metformin 8 months later led to recurrence. Three of these patients had bowel disease (diverticulosis, irritable bowel syndrome, and diabetic neuropathy). 

Esophageal disorders (achalasia, diffuse esophageal spasm, esophageal diverticulosis)... 

Bacterial overgrowth syndromes in various diseases (diabetes, scleroderma, jejunal diverticulosis, blind loops)... 

Q13 Unless the diverticula are removed by a surgical procedure, which is usually not necessary, Daria has some risk of recurrence. However, if her diet is adjusted to contain more dietary fibre, transit of intestinal contents will be enhanced without the development of a high intraluminal pressure, and the chance of recurrence is greatly diminished. Fortunately, the majority of patients with known diverticulosis remain asymptomatic throughout their lifetime. 

A barium X ray shows a patient with diverticulosis (an intestinal disorder). PHOTOGRAPH BY MICHAEL ENGLISH. CUSTOM MEDICAL STOCK PHOTO. 

This type of laxative does not cause dependency. It can be used with diverticulosis, irritable bowel syndrome, and ileostomy and colostomy. Commonly used bulk-forming laxatives are ... 

Menstrual losses of blood average 28 milligrams monthly. One in four college-age women are iron deficient, possibly due to ignoring the need for increased iron intake prior to and during menstruation. Diseases that cause iron deficiency are colon cancer, hiatal hernia, ulcers, hemorrhoids, bladder tumor, and diverticulosis. Soft drinks high in phosphates cause iron to be excreted in the urine. Lack of copper or manganese in the diet reduces iron assimilation, as does a deficiency of vitamin C. Oxalic acid foods, such as chard and rhubarb, can block iron intake. 

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