ACUTE DIARRHOEA AND CHRONIC BOWEL DISORDERS

ACUTE DIARRHOEA

The priority in acute diarrhoea, as in gastro-enteritis, is the prevention or reversal of fluid and electrolyte depletion.

Antimotility drugs relieve symptoms of acute diarrhoea. They are used in the management of uncomplicated acute diarrhoea in adults, fluid and electrolyte replacement may be necessary in case of dehydration.

1. Absorbents and bulk-forming drugs:

- Kaolin, light.

2. Antimotility drugs:

- Codeine phosphate

- Co-phenotrope

- Loperamide Hydrochloride (Loperamide, Imodium).

CHRONIC BOWEL DISORDERS

Inflammatory bowel disease (Ulcerative colitis and Crohn´s disease):

-Ulcerative colitis (UC) is a disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. It is one of a group of diseases called inflammatory bowel disease.

UC can happen at any age, but it usually starts between the ages of 15 and 30. It tends to run in families. The most common symptoms are pain in the abdomen and blood or pus in diarrhea. Other symptoms may include:

-Anemia

-Severe tiredness

-Weight loss

-Loss of appetite

-Bleeding from the rectum

-Sores on the skin

-Joint pain

-Growth failure in children

About half of people with UC have mild symptoms.

Email this page to a frienShare on facebook

Bookmark & SPrinter-friendly versSubscribe to 

-Crohn's disease causes inflammation of the digestive system. Crohn's can affect any area from the mouth to the anus. It often affects the lower part of the small intestine called the ileum.

The cause of Crohn's disease is unknown. It may be due to an abnormal reaction by the body's immune system. It also seems to run in some families. It most commonly starts between the ages of 13 and 30.

The most common symptoms are pain in the abdomen and diarrhea. Other symptoms include

-Bleeding from the rectum

-Weight loss

-Fever

Crohn's can cause complications, such as intestinal blockages, ulcers in the intestine, and problems getting enough nutrients. People with Crohn's can also have joint pain and skin problems. Children with the disease may have growth problems.

There is no cure for Crohn's. Treatment can help control symptoms, and may include medicines, nutrition supplements, and/or surgery. Some people have long periods of remission, when they are free of symptoms.

Other disorders:

-Clostridium difficile infection.

-Malabsorption syndromes.

PHARMACOLOGY

1. Aminosalicylates:

- Balsalazide sodium (Colazide), indicated for treatment of mild to moderate ulcerative colitis and maintenance of remission.

- Mesalazine (Asacol, Ipocol, Mesren, Mezavant, Pentasa, Salofalk), indicated for treatment of mild to moderate ulcerative colitis and maintenance of remission.

- Olsalazine sodium (Dipentum), indicated for treatment of mild ulcerative colitis and maintenance of remission.

- Sulfasalazine (Salazopyrin), indicated for treatment of mild to moderate and severe ulcerative colitis and maintenance of remission and active Crohn´s disease.

2. Corticosteroids:

-Beclometasone dipropionate (Clipper)

-Budesonide (Budenofalk, Entocort)

-Hydrocortidone (Colifoam)

-Prednisolone (Predenema, Predfoam, Predsol)

3. Drugs affecting the immune response, may benefit patients with unresponsive or chronically active Crohn´s disease.

-Azathioprine

-Ciclosporin

-Mercaptopurine

-Methotrexate

*Cytokine modulators, they should be used under specialist supervision:

-Adalimumab

-Infliximab, it is licensed for the management of severe active Crohn´s disease and moderate to severe ulcerative colitis in patients whose condition has not responded adequately to treatment  with a corticosteroid and a conventional immunosuppressant or who are intolerant of them.

4. Food allergy, allergy with classical symptoms of vomiting, colic and diarrhoea caused by specific foods, such as shellfish, should be managed by strict avoidance. Sodium cromoglicate (Nalcrom) may be helpful as an adjunct to dietary avoidance.

Sources:

-http://www.nlm.nih.gov/medlineplus/

-BNF 57 March 2009