Diverticulosis, diarrhea

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. 

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]. 

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). 

A European monograph indicates use for habitual constipation, in case where soft stool is desired as in cases of anal fissures, hemorrhoids, and post-rectal surgery irritable bowel syndrome, diverticulosis as a dietary supplement where increases in dietary fiber are required and adjuvant therapy for diarrhea (escop 2). 

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