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Zhongguo Dang Dai Er Ke Za Zhi =... Jun 2009To evaluate the roles of enteric nervous system neurotransmitters, nitric oxide (NO), substance P (SP) and vasoactive intestinal polypeptide (VIP), and interstitial...
OBJECTIVE
To evaluate the roles of enteric nervous system neurotransmitters, nitric oxide (NO), substance P (SP) and vasoactive intestinal polypeptide (VIP), and interstitial cells of Cajal (ICC) in the colon in slow transit constipation in rats.
METHODS
Thirty-two healthy Wistar rats were randomly assigned to control and constipated groups. In the constipated group, the rats were daily administered with diphenoxylate (8 mg/kg) to develop slow transit constipation, while the control rats were fed with water. The number and the weight of fecal granule and the body weight of rats were recorded every 5 days for 90 days. Transit functions of intestinal movement were examined by an activated charcoal suspension pushing test one week after stopping the administration of diphenoxylate. The levels of NO and SP in the colonic mucosa were measured by nitrate reductase methods and ELISA respectively. The distribution of VIP and ICC positive cells confirmed with symbolic c-kit+ cells in the colonic wall were observed by immunohistochemical methods.
RESULTS
The daily number of fecal granule in the constipated group was significantly less than that in the control group (P<0.01). The mean weight of each fecal granule in the constipated group was significantly higher than that in the control group (P<0.01). The discharge time of the first granule of black faeces in the constipated group (430.2+/- 132.1 min) was significantly longer than that in the control group (337.2+/- 74.7 min; P<0.05). There were no significant differences in NO and SP levels and the density of VIP positive cells in the distal colonic segment between the two groups. The number of c-kit+ cells in the distal colonic wall in the constipated group was significantly reduced compared with that in the control group (P<0.05).
CONCLUSIONS
The reduction of ICC number in the distal colon may be contributed to the pathogenesis of slow transit constipation in rats.
Topics: Animals; Body Weight; Coiled Bodies; Colon; Constipation; Male; Neurotransmitter Agents; Nitric Oxide; Proto-Oncogene Proteins c-kit; Rats; Rats, Wistar; Substance P; Vasoactive Intestinal Peptide
PubMed: 19558815
DOI: No ID Found -
Current Oncology (Toronto, Ont.) Feb 2007Chemotherapy-induced diarrhea (cid) is a common side effect of cancer treatment and can cause significant morbidity and mortality. Diarrhea is frequently severe enough...
Prevention and management of chemotherapy-induced diarrhea in patients with colorectal cancer: a consensus statement by the Canadian Working Group on Chemotherapy-Induced Diarrhea.
Chemotherapy-induced diarrhea (cid) is a common side effect of cancer treatment and can cause significant morbidity and mortality. Diarrhea is frequently severe enough to require a dose reduction of, a delay in, or a discontinuation of chemotherapy. Diarrhea-associated mortality has been reported to be as high as 3.5% in clinical trials of irinotecan and bolus 5-fluorouracil in colorectal cancer. The frequency of cid and its impact on patient management are frequently under-recognized in clinical practice.A Canadian working group, consisting of medical oncologists and an oncology pharmacist, was formed in 2001 to review the optimal approach to managing cid and to identify and implement new areas of research. The recommendations that follow are the result of the group's work.Acute medical management of cid includes loperamide or diphenoxylate as first-line agents. Subcutaneous octreotide is recommended for intractable grade 2 diarrhea and may be considered for grade 1 cid that does not resolve with high-dose loperamide. Hospitalization is recommended for patients with grades 3 and 4 cid; in-hospital care includes rehydration, antibiotic therapy, and octreotide.A chemotherapy dose reduction is generally advised for patients who have experienced grade 3 or 4 diarrhea in a previous chemotherapy cycle. If a dose reduction is not desired, prophylaxis with intramuscular long-acting release octreotide may be considered.The foregoing recommendations are based on expert opinion and require validation in prospective clinical trials.
PubMed: 17576459
DOI: 10.3747/co.2007.96 -
African Journal of Traditional,... Oct 2007Rhus semialata Murr. (Anacardiaceae) is a deciduous tree of north eastern India. The fruit of this plant is traditionally used to control diarrhoea and dysentery. The...
Rhus semialata Murr. (Anacardiaceae) is a deciduous tree of north eastern India. The fruit of this plant is traditionally used to control diarrhoea and dysentery. The Present study was undertaken to evaluate anti-diarrhoeal potency of methanol extract of fruits of R. semialata using Wister albino rats to substantiate folklore claims. The extract at graded doses (100, 200, 400 and 600 mg/kg body weight) was investigated for anti-diarrhoeal activity in term of reduction in the rate of defecation in castor oil induced diarrhoea. To understand the mechanism of its antidiarrhoeal activity, the gastrointestinal transit and PGE(2)-induced intestinal fluid accumulation (enteropooling) were further evaluated. At graded doses, the extract showed a remarkable anti-diarrhoeal activity evidenced by the reduction in the rate of defecation up to 80.70% of control diarrhoeal animals at the dose of 600 mg/kg body weight. Results are comparable to that of standard drug diphenoxylate (50 mg/kg body weight). Extract produced profound decrease in intestinal transit (8.02-47.05%) at selected doses comparable to that of single intraperitoneal injection of standard drug atropine sulphate at doses of 0.1 mg/kg body weight. It significantly inhibited PGE(2)-induced enteropooling (21.98-56.03%). The results indicated that the methanol extract of the fruits of R. semialata possesses significant anti-diarrhoeal effect and substantiated the use of this herbal remedy as a non-specific treatment for diarrhoea in folk medicine.
PubMed: 20162061
DOI: No ID Found -
Hong Kong Medical Journal = Xianggang... Dec 2005We report two cases of unintentional poisoning with anticholinergic agents. The first patient, a 7-year-old girl, was prescribed four different medications by a general...
We report two cases of unintentional poisoning with anticholinergic agents. The first patient, a 7-year-old girl, was prescribed four different medications by a general practitioner for treatment of abdominal colic and diarrhoea. All drugs had anticholinergic properties. The second patient, a 16-month-old boy, ingested his mother's cyproheptadine tablets. Both children presented with central and peripheral symptoms and signs compatible with acute anticholinergic syndrome. They recovered spontaneously following intravenous fluid replacement and close observation. Gastric lavage was also performed on the boy. Poisoning with cholinergic antagonists in children is a potentially serious hazard in Hong Kong. It may be avoided by careful prescribing on the part of general practitioners and safe storage of all medicinal products in the home environment.
Topics: Antidiarrheals; Atropine; Child; Cholinergic Antagonists; Colic; Cyproheptadine; Diphenoxylate; Drug Combinations; Drug Overdose; Drug Therapy, Combination; Female; Gastric Lavage; Hong Kong; Humans; Infant; Male; Medication Errors; Radiography
PubMed: 16340032
DOI: No ID Found -
BMC Complementary and Alternative... Jul 2004Diarrhoea is a major health problem for children worldwide, accounting for 5-8 million deaths each year. Arque-Ajeeb (AA) is a compound formulation of Unani medicine. It...
BACKGROUND
Diarrhoea is a major health problem for children worldwide, accounting for 5-8 million deaths each year. Arque-Ajeeb (AA) is a compound formulation of Unani medicine. It is reputed for its beneficial effects in the treatment of diarrhoea and cholera, but the claim of its efficacy is yet to be tested. Therefore the present study has been planned to investigate the real efficacy of this drug in rats.
METHODS
The effect of Arque-Ajeeb was investigated for antidiarrhoeal activity against charcoal-induced gut transit, serotonin-induced diarrhoea and PGE2-induced small intestine enteropooling in rats. The control, standard and test groups of experimental animals were administered with normal saline (p.o.), diphenoxylate hydrochloride (5 mg/kg, p.o.) and Arque-Ajeeb (0.07 ml and 0.14 ml/kg, p.o.) respectively except the control group of PGE2-induced small intestine enteropooling which received only 5% ethanol in normal saline (i.p.). Charcoal (10 ml/kg, p.o.) and serotonin (600 micrograms/kg, i.p.) were administered after 30 min, while PGE2 (100 micrograms/kg, p.o.) was administered immediately afterwards. The distance traveled by charcoal in small intestine was measured after 15 and 30 min of charcoal administration, diarrhoea was observed every 30-min for six hour after serotonin administration and the volume of intestinal fluid was measured after 30 min of PGE2 administration.
RESULTS
Arque-Ajeeb (0.07 ml and 0.14 ml/kg) significantly inhibited the frequency of defaecation and decreased the propulsion of charcoal meal through the gastrointestinal tract, reduced the wetness of faecal droppings in serotonin-induced diarrhoea and also reduced the PGE2-induced small intestine enteropooling.
CONCLUSION
Arque-Ajeeb may have potential to reduce the diarrhoea in rats. Thus the drug may prove to be an alternate remedy in diarrhoea.
Topics: Animals; Antidiarrheals; Apiaceae; Camphor; Charcoal; Diarrhea; Dinoprostone; Ethanol; Female; Gastrointestinal Transit; Male; Mentha; Phytotherapy; Plant Extracts; Rats; Rats, Wistar; Seeds; Serotonin
PubMed: 15238156
DOI: 10.1186/1472-6882-4-8 -
American Family Physician Jun 2003Pregnant women commonly use over-the-counter medications. Although most over-the-counter drugs have an excellent safety profile, some have unproven safety or are known... (Review)
Review
Pregnant women commonly use over-the-counter medications. Although most over-the-counter drugs have an excellent safety profile, some have unproven safety or are known to adversely affect the fetus. The safety profile of some medications may change according to the gestational age of the fetus. Because an estimated 10 percent or more of birth defects result from maternal drug exposure, the U.S. Food and Drug Administration has assigned a risk category to each drug. Many drugs have not been evaluated in controlled trials and probably will not be because of ethical considerations. Of the commonly used over-the-counter medications, acetaminophen, chlorpheniramine, kaolin and pectin preparations, and most antacids have a good safety record. Other drugs, such as histamine H2-receptor blockers, pseudoephedrine, and atropine/diphenoxylate should be used with caution. If use of smoking cessation products is desired, the intermediate-release preparations minimize the amount of nicotine while maintaining efficacy. With all over-the-counter medications used during pregnancy, the benefit of the drug should outweigh the risk to the fetus.
Topics: Female; Fetus; Humans; Maternal-Fetal Exchange; Nonprescription Drugs; Pregnancy; Risk Factors
PubMed: 12825840
DOI: No ID Found -
Medical Principles and Practice :... 2002Irritable bowel syndrome (IBS) comprises a major proportion of gastrointestinal and primary care practice worldwide. The past several years have seen the rapid evolution... (Review)
Review
Irritable bowel syndrome (IBS) comprises a major proportion of gastrointestinal and primary care practice worldwide. The past several years have seen the rapid evolution of a new and comprehensive model of IBS based on alterations in brain-gut interactions. Alterations in the bidirectional communication between the enteric nervous system and the central nervous system are implicated in the pathogenesis of IBS. 5-Hydroxytryptamine (5-HT; serotonin), a major neurotransmitter in the gastrointestinal tract, and its receptors 5-HT3 and 5-HT4 are involved in the control of gastrointestinal function. A number of abnormal motor and sensory patterns have been reported in patients with IBS. However, it is not known whether these abnormalities are related to symptoms or have a role in establishing a diagnosis of functional gastrointestinal disorders. Visceral hyperalgesia in IBS patients can be secondary to altered receptor sensitivity at the viscus itself and altered central modulation of sensation involving psychological influences in the interpretation of these sensations. The development of diagnostic criteria for IBS helps to avoid unnecessary and costly investigations. A detailed history allows us to diagnose IBS and search for another cause if warning symptoms are present. The Rome criteria are presently used to define IBS and are currently the most widely applied criteria used in clinical diagnosis and research purposes. Abdominal pain or discomfort associated with chronic altered bowel habits are the mainstay in diagnosis, while the supportive criteria may be used to further classify IBS patients into diarrhea-predominant or constipation-predominant subgroups. Minimal diagnostic tests have been advocated in the initial diagnostic approach to patients with suspected IBS, depending on the predominant symptom. The therapeutic goals in IBS must focus on the overall well-being of the patient, including abdominal symptoms and the accompanying nonbowel symptoms and affective disorders. It is important to establish an effective physician-patient relationship and to reassure the patient once the diagnosis of IBS is made. Dietary modification may be of value in some patients with IBS. Dietary fiber is frequently recommended for patients with constipation-predominant IBS. Two novel serotonin agonists are currently under development for constipated IBS patients, tegaserod and prucalopride. Antidiarrheal agents, including loperamide and diphenoxylate, may help patients with diarrhea-predominant IBS. 5-HT3 receptor antagonists may play a role in the management of such patients in the future. Psychological treatment and antidepressants should be considered when IBS symptoms are severe or refractory or associated with psychological distress and impaired quality of life.
Topics: Abdominal Pain; Autonomic Nervous System; Colonic Diseases, Functional; Constipation; Diarrhea; Female; Humans; Male; Psychophysiologic Disorders; Psychotherapy; Sensation Disorders
PubMed: 12116690
DOI: 10.1159/000048654 -
The National Medical Journal of India 1995
Topics: Antidiarrheals; Atropine; Diphenoxylate; Drug Combinations; Female; Furazolidone; Humans; Infant
PubMed: 7549862
DOI: No ID Found -
Gut Jun 1989The aim of the present study was to determine whether changes in orocaecal transit time (OCTT) affect the magnitude of the breath hydrogen (H2) excretion after ingestion... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
The aim of the present study was to determine whether changes in orocaecal transit time (OCTT) affect the magnitude of the breath hydrogen (H2) excretion after ingestion of unabsorbable carbohydrate. We studied eight healthy subjects by interval sampling of end expiratory H2 concentration for 12 hours after ingestion of: (1) 10 g lactulose (L); (2) 10 g L with 20 mg metoclopramide (M) as tablets; (3) 20 g L, and (4) 20 g L with 7.5 mg diphenoxylate (D) as tablets, in random order. In spite of significant changes in OCTT after M and D, there were no significant changes, compared for the same dose of lactulose, with respect to area under the breath H2 excretion curves, peak increments of H2 concentration or timing of the peak increment. We conclude that, within the ranges observed, the OCTT does not significantly affect the shape of the H2 concentration versus time curves. In comparative studies estimates of the degree of carbohydrate malabsorption on the basis of breath H2 concentration may be valid in spite of differences in OCTT.
Topics: Adult; Breath Tests; Cecum; Disaccharides; Female; Gastrointestinal Transit; Humans; Hydrogen; Intestinal Absorption; Lactulose; Male
PubMed: 2753406
DOI: 10.1136/gut.30.6.811 -
British Journal of Clinical Pharmacology Nov 1985The purpose of the study was to evaluate the validity of a model where intestinal transit is increased and decreased by motility modifying drugs. The measurement of...
The purpose of the study was to evaluate the validity of a model where intestinal transit is increased and decreased by motility modifying drugs. The measurement of breath hydrogen concentrations after ingestion of lactulose was used to estimate small intestinal transit time. After obtaining base-line values, eight healthy volunteers were pretreated on separate occasions with loperamide, diphenoxylate, metoclopramide and cisapride. Diphenoxylate caused a significant increase in small bowel transit time, whereas both metoclopramide and cisapride significantly shortened it. The H2 breath test therefore seems to accurately reflect the expected transit time. Loperamide did not alter significantly intestinal transit. Possibly this drug counteracts its own delaying influence on small bowel transit by hurrying gastric emptying. Alternatively, not enough time was allowed for it to exert its full effect.
Topics: Adult; Breath Tests; Cisapride; Diphenoxylate; Female; Gastric Emptying; Gastrointestinal Motility; Humans; Hydrogen; Lactulose; Loperamide; Male; Metoclopramide; Piperidines; Random Allocation
PubMed: 4074618
DOI: 10.1111/j.1365-2125.1985.tb05101.x