Abdominal pain tegaserod

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. 

Ischemic colitis has been observed in some patients taking tegaserod. The drug should be discontinued promptly if rectal bleeding, bloody diarrhea, or worsening abdominal pain occurs. 

Assess 5-HT4 receptor agonists (tegaserod) for relief of crampy abdominal pain and bloating. 

Diarrhea Do not initiate tegaserod in patients who are currently experiencing or frequently experience diarrhea. Discontinue tegaserod immediately in patients with new or sudden worsening of abdominal pain. In most cases, diarrhea occurred within the first week of treatment. Typically, diarrhea resolved with continued therapy. Patients should consult their health care provider if they experience severe diarrhea or if the diarrhea is accompanied by severe cramping, abdominal pain, or dizziness. Discontinue tegaserod immediately in patients who develop severe diarrhea, hypotension, or syncope. 

Ischemic colitis Ischemic colitis and other forms of intestinal ischemia have been reported in patients receiving tegaserod during marketed use of the drug. Discontinue tegaserod immediately in patients who develop symptoms of ischemic colitis, such as rectal bleeding, bloody diarrhea, or new or worsening abdominal pain. 

If drugs are used, the first choice should be a bulk laxative, e.g. isphagula or sterculia gum. Nonabsorbent carbohydrates with osmotic activity also work well but often cause flatulence. Salinic laxatives like polyethylene glycol and magnesium oxide are very effective but often cause stomach upsets like flatulence and abdominal pain. Tegaserod, a 5-HT4 partial agonist, appears to improve the frequency of bowel movements in those with chronic constipation (see Evans et ah, 2007). 

Muller-Lissner SA, EumagalU I, BardUan KD, et al. Tegaserod, a 5-HT4 receptor partial agonist, relieves symptoms in irritable bowel syndrome patients with abdominal pain, bloating and constipation. AUment Pharmacol Ther 2001 15 1655-1666. 

Observational studies In two identical open studies (El, E2) of oral tegaserod (6 mg bd over 1 year) in 780 women with dysmotility-like functional dyspepsia, who had previously completed two 6-week, randomized, placebo-controlled trials with tegaserod at the same dosage, tegaserod was effective against dyspeptic symptoms. Most adverse events were reported within the first 6 months, and the most common included diarrhea, headache, nausea, abdominal pain, vomiting, and constipation. One patient developed severe bradycardia. 

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