Normal Intestinal Transit Research Articles

Colonic Cancer in Occlusion: A Case Report of 70 Patients Experience of the Visceral Surgery Department at the Moulay Ismail Military Hospital in Meknes, Sidi Mohamed Ben Abdallah University in Fez

Occlusive colon cancer is a serious condition, as it combines two very serious pathologies: cancer and acute intestinal obstruction. Colon cancer is a malignant proliferative neoformation developed at the expense of the colonic wall. Colonic obstruction is defined as the interruption of normal intestinal transit, and represents the mode of revelation in 8 to 29% of colon cancers. Occlusion is the most common complication of colonic cancer, either as a result of the disease or as it progresses, accounting for 15-30% of cases. Occluded colon cancer poses a twofold problem:  On the one hand, occlusion and its potential repercussions, particularly of a general or upstream intestinal nature.  On the other hand, it reveals a late diagnosis most often associated with a locally advanced or metastatic tumour. Our study concerns 70 cases of colonic cancer in occlusion diagnosed and treated in the visceral surgery department of the Moulay Ismail Military Hospital in Meknes, over 5 years from 01 January 2019 to 31 December 2023. The aims of our retrospective study are:  Evaluate the proportion of this complication that is indicative of colonic tumour pathology.  To review the range of surgical and non-surgical techniques available.  To establish guidelines for dealing with this type of complication in order to minimise morbidity and mortality. Our series includes 46 men and 24 women with a sex ratio of 1.9 aged between 35 and 86 years, who presented to the emergency department after an average delay of 07 days with extremes of 03 days and 08 days, with an occlusive syndrome (78.6%), sub-occlusive syndrome (21.4%), abdominal pain (95.7%), transit disorders (82.9%), vomiting (75.7%) and rectal bleeding (72.9%). The clinical examination revealed weight loss in 49 patients (70%); abdominal distension in all our patients (100%); and an empty rectal ampulla in all our patients (100%). All our patients underwent PSA, which revealed colonic NHA in 81.4% of cases, .......

Microbiome in Critical Care: An Unconventional and Unknown Ally.

The digestive tract represents an interface between the external environment and the body where the interaction of a complex polymicrobial ecology has an important influence on health and disease. The physiological mechanisms that are altered during hospitalization and in the intensive care unit (ICU) contribute to the pathobiota's growth. Intestinal dysbiosis occurs within hours of being admitted to ICU. This may be due to different factors, such as alterations of normal intestinal transit, administration of various medications, or alterations in the intestinal wall, which causes a cascade of events that will lead to the increase of nitrates and decrease of oxygen concentration, and the liberation of free radicals. This work aims to report the latest updates on the microbiota's contribution to developing sepsis in patients in the ICU department. In this short review, the latest scientific findings on the mechanisms of intestinal immune defenses performed both locally and systemically have been reviewed. Additionally, we considered it necessary to review the literature on the basis of the many studies carried out on the microbiota in the critically ill as a prevention to the spread of the infection in these patients. This review has been written to answer four main questions: 1- What are the main intestinal flora's defense mechanisms that help us to prevent the risk of developing systemic diseases? 2- What are the main Systemic Abnormalities of Dysbiosis? 3- What are the Modern Strategies Used in ICU to Prevent the Infection Spreading? 4- What is the Relationship between COVID-19 and Microbiota? We reviewed 72 articles using the combination of following keywords: "microbiota" and "microbiota" and "intensive care", "intensive care" and "gut", "critical illness", "microbiota" and "critical care", "microbiota" and "sepsis", "microbiota" and "infection", and "gastrointestinal immunity" in: Cochrane Controlled Trials Register, Cochrane Library, Medline and Pubmed, Google Scholar, Ovid/Wiley. Moreover, we also consulted the site ClinicalTrials.com to find out studies that have been recently conducted or are currently ongoing. The critical illness can alter intestinal bacterial flora leading to homeostasis disequilibrium. Despite numerous mechanisms, such as epithelial cells with calciform cells that together build a mechanical barrier for pathogenic bacteria, the presence of mucous associated lymphoid tissue (MALT) which stimulates an immune response through the production of interferon-gamma (IFN-y) and THN-a or or from the production of anti-inflammatory cytokines produced by lymphocytes Thelper 2. But these defenses can be altered following hospitalization in ICU and lead to serious complications, such as acute respiratory distress syndrome (ARDS), health care associated pneumonia (HAP) and ventilator associated pneumonia (VAP), systemic infection and multiple organ failure (MOF), but also to the development of coronary artery disease (CAD). In addition, the microbiota has a significant impact on the development of intestinal complications and the severity of the SARS-COVID-19 patients. The microbiota is recognized as one of the important factors that can worsen the clinical conditions of patients who are already very frail in the intensive care unit. At the same time, the microbiota also plays a crucial role in the prevention of ICU-associated complications. By using the resources that are available, such as probiotics, synbiotics or fecal microbiota transplantation (FMT), we can preserve the integrity of the microbiota and the GUT, which will later help maintain homeostasis in ICU patients.

Antidiarrheal Effect of Zornia brasiliensis Vogel (Leguminosae) on Mice Involves Adrenergic Pathway Activation.

Several secondary metabolites have been isolated from Zornia brasiliensis (Leguminosae), mainly flavonoids. These compounds are known for many pharmacological actions, such as antispasmodic and antidiarrheal. Therefore, we evaluated the antidiarrheal effect of the ethanolic extract obtained from Zornia brasiliensis aerial parts (ZB-EtOHAP), as well as its underlying mechanisms. Castor-oil-induced diarrhea, fluid accumulation, and intestinal transit (normal and castor oil induced) were performed to assess the antidiarrheal, antisecretory, and antipropulsive activities of the extract. The involvement of opioid and adrenergic pathways was also investigated. ZB-EtOHAP inhibited, in a dose-dependent manner, both total defecation frequency and the number of watery stools. The extract showed no effect on fluid accumulation or normal intestinal transit. On the other hand, when the animals were pretreated with castor oil, the extract decreased the distance traveled by the marker in the small intestine. Investigation of the involvement of opioid and adrenergic systems showed that the pharmacological potency of the extract did not change in the presence of naloxone, but it was reduced in the presence of yohimbine. The data indicate that Zornia brasiliensis has an antidiarrheal effect due to inhibition of the intestinal motility through adrenergic pathway activation.

Changes in the parameters of the rectoanal inhibitory reflex in children with functional constipation and large rectum.

BackgroundAbdominal ultrasound and anorectal manometry are part of the investigations used to assess children with functional constipation. This study aimed at assessing the changes in the characteristics of the rectoanal inhibitory reflex (RAIR) in children with functional constipation and correlating them with the dimensions of the rectum, measured by abdominal ultrasound. A secondary objective was to compare the rectum size in children with and without constipation.MethodWe retrospectively reviewed the clinical data and investigations results of 51 children (mean age±standard deviation (SD) = 5.8±3.5 years) with functional constipation who came to our clinic between January 2013 and February 2020. The assessment of these patients included both the assessment of the transverse diameter of the rectal ampulla by abdominal ultrasound and anorectal manometry. The studied parameters of RAIR were: the minimal volume of air necessary to induce RAIR, in all the patients with functional constipation, and in 20 of them, relaxation time, latency and relaxation percentage. A control group was formed of 27 children (mean age±SD = 5.1±4 years) without digestive diseases and with normal intestinal transit, who were assessed by abdominal ultrasound.ResultsThe mean value ±SD of the volume of air necessary to induce RAIR was 21.9±12.1 cm3 air. There was no correlation between the rectum transverse diameter and the minimal air volume that triggered RAIR (r=−0.01, p=0.94). The mean value ±SD of the transverse diameter of the rectum in patients with functional constipation was 39±14 mm, and in children without constipation 26±6 mm (p<0.05). The mean duration of the symptoms in children with functional constipation was 2.8 years.ConclusionsThere were no correlations between the volume of air that induced the RAIR and the transverse diameter of the rectum in children with functional constipation. The transverse diameter of the rectum was increased in children with long-term functional constipation.

Investigation of ethnomedicinal use of Commiphora leptophloeos (Mart.) J. B. Gillett (Burseraceae) in treatment of diarrhea

Ethnopharmacological relevanceCommiphora leptophloeos (Mart.) J.B. Gillett, popularly known as “imburana”, “imburana-de-cheiro” or “imburana-de-espinho”, has been used in folk medicine for the treatment of gastrointestinal diseases, such as diarrhea. The indian tribes “Kairir-Shokó and shokó use the bark to treat diarrhea. However, there is no scientific evidence to justify the therapeutic use of this species. Aim of the studyTo investigate the ethnomedicinal use of Commiphora leptophloeos, with respect to the antimicrobial, antisecretory, antimotility and antispasmodic activities of the crude ethanolic extract obtained from its leaves (CL-EtOHL) and the mechanism underlying this action in rodents. Material and methodsIn the evaluation of antibacterial and antifungal activities was determined the minimum inhibitory concentration (MIC) of the extract, against different strains of bacteria and fungi. All experimental protocols were approved by the Animal Ethics Committee of the Federal University of Paraíba (045/2016). In addition, behavioral screening and acute toxicity assessment of CL-EtOHL were performed in female mice (n = 6). In the investigation of antidiarrheal activity (n = 6), frequency of defecation and number of liquid stools, were classified during 4 h, and intestinal fluid and transit were measured. In addition, the antispasmodic effect on rat ileum (n = 5) was also investigated. ResultsThe ethanolic extract is rich in flavonoids and the main were identified as C-glycosylated flavonoids (isoorientin, orientin, and vitexin). In the evaluation of antimicrobial and antifungal activity, the extract showed moderate efficacy only against the tested strains of Candida krusei ATCC-6258, Candida parapsilosis ATCC-22019 and Candida glabrata ATCC-90030. The extract had no toxic effect until 2000 mg/kg. In castor oil-induced diarrhea, CL-EtOHL inhibited, in a dose-dependent manner, both total defecation frequency (ED50 = 380.4 ± 145.4 mg/kg) and the number of watery stools (ED50 = 151.2 ± 76.3 mg/kg). The extract showed no effect on fluid accumulation or normal intestinal transit. On the other hand, when the animals were pretreated with castor oil, the extract decreased the distance traveled by the activated charcoal (ED50 = 177.0 ± 50.3 mg/kg). In the investigation of antispasmodic effect, CL-EtOHL antagonized the contractions induced by KCl 30 mM (IC50 = 208.2 ± 25.9 μg/mL) and CCh 10−6 M (IC50 = 95. ± 22.0 μg/mL). To verify the participation of muscarinic receptors in this effect, cumulative carbachol curves were performed in the absence and presence of the extract, and a non-competitive pseudo-irreversible antagonism of these receptors was observed. ConclusionThe data indicate that ethanol extract obtained from the leaves of Commiphora leptophloeos has an antidiarrheal effect due to inhibition of the intestinal motility and antispasmodic effect, through the antagonism of muscarinic receptors. In addition, we suggest that flavonoids isolated from CL-EtOHL may be responsible for antidiarrheal activity of this extract. This explains its ethnomedicinal use in the treatment of diarrhea.

Effect of the leaves aqueous extract of Jodina rhombifolia (Hook. & Arn.) Reissek (Santalaceae) on intestinal function and its acute toxicity

Ethnopharmacological relevanceIn Argentine traditional medicine it is recorded the use of Jodina rhombifolia (Hook. & Arn.) Reissek (Santalaceae) leaves for treating various affections that compromise the intestinal normal functioning. Aim of the studyThe aim of this study was to assess the effect of J. rhombifolia leaves lyophilized aqueous extract on the intestinal function by means of in vivo and ex vivo experimental assays for determinate the antidiarrheal and antispasmodic capacity. Furthermore, was to evaluate its acute toxicity potential by oral and intraperitoneal administration of extract. Materials and methodsThe in vivo assays were conducted by the experimental techniques of intestinal transit in mice, intestinal fluid accumulation in rats and Castor oil-induced diarrhea in mice. In the ex vivo assays, isolated rat duodenum and ileum segments were used for to evaluate the antispasmodic activity through contractile concentration-response curves induced by Carbachol and CaCl2. The acute toxicity of the extract was also investigated by oral and intraperitoneal administration. ResultsThe extract intraperitoneal administration at the doses 125, 250 and 500 mg/kg, caused a marked reduction in the normal intestinal transit and in the number of diarrheal episodes in a dose-dependent manner. However, the extract did not produce significant changes in the intestinal fluid accumulation with any of the tested dose. The extract demonstrated a non-competitive inhibitory effect on the contractions of intestinal smooth muscle experimentally provoked by the spasmogenic agents Carbachol and CaCl2 in a dose-dependent manner (IC50 = 10.57 ± 1.38 and 6.29 ± 1.54 mg extract/ml Tyrode solution in the isolated organ bath, respectively). ANOVA indicated a significative effect of treatment (p < 0.001). ConclusionsThe scientific evidence achieved based in the used experimental models allows us to indicate that J. rhombifolia leaves lyophilized aqueous extract manifest an antispasmodic activity on intestinal smooth muscle without observation of apparent toxicity symptoms.

Phytochemical Screening and Toxicological Study of Neptunia oleracea Lour. (Mimosaceae) Extracts, Plant Used in Traditional Medicine

Neptunia oleracea (Lourd.) Mimosaceae is a plant commonly used in traditional medicine for the treatment of several pathologies such as dysentery, jaundice, leucorrhoea, troubles of earache, among others.&#x0D; Aim: The purpose of this study was to carry out preliminary phytochemical screening, acute toxicity studies and to evaluate the effect of the aqueous and hydro-ethanolic extracts of N. oleracea on intestinal motility in vivo.&#x0D; Methodology: Preliminary qualitative phytochemical screening was conducted using standard procedures while acute toxicity studies was performed using OECD method. The effect of N. oleracea extracts on intestinal motility was evaluated using on normal and acetylcholine-induced transits.&#x0D; Results: Preliminary qualitative phytochemical screening of aqueous and hydro-ethanolic extracts of N. oleracea revealed the presence of similar constituents including steroids, triterpenoids, saponins, tannins, flavonoids, anthocyanidins, coumarins and carbohydrates. Alkaloids was absent in both the extracts. The oral median lethal dose (LD50) for both extracts was estimated to be 5000 mg/kg.&#x0D; The effect of extracts on intestinal peristalsis in mice showed that the aqueous and hydro-ethanolic extracts of N. oleracea stimulate normal intestinal transit by 1.29 and 8.54% respectively at the dose of 50 mg/kg body weight, thus there was inhibition at higher doses. These extracts potentiate acetylcholine-induced intestinal transit by 23.9 and 14.39% respectively at 500 mg/kg body weight.&#x0D; Conclusion: The findings of this study showed that the aqueous and hydro-ethanolic extracts of Neptunia oleracea contain bioactive constituents that have practically no toxic effect. This could justify the many forms of use of this plant in traditional medicine.

Antidiarrhoeal and antispasmodic activities of essential oil of &lt;i&gt; Myrtus communis&lt;/i&gt;L. (Myrtaceae))

The use of the essential oil of Myrtus communis L. (myrtle) for different illnesses including diarrohea and dysentery is documented in folklore medicine. However, the scientific bases for this usage are not yet established. The main objective of this study was therefore to investigate the antidiarroheal and antispasmodic activities of the essential oil of M. communis (EOMC) in rodents by using different experimental models. EOMC was evaluated for its antidiarroheal and antispasmodic potential using a host of paradigms, including normal and castor oil-induced intestinal transit in mice; castor oil-induced diarrohea in mice, prostaglandin induced enteropooling in rats, and contractile response using Guinea pig ileum (GPI). Atropine was used in isolated preparation and normal intestinal transit test as a positive control, whereas loperamide was used in the castor oil-induced intestinal transit and castor oil-induced antidiarroheal test. All doses (100, 200 and 400 mg/kg) of EOMC significantly (p&lt;0.05) inhibited normal intestinal transit as well as exhibited significant antidiarroheal and antienteropooling activities, where the effects were comparable with that of the positive controls employed. The oil also displayed significant reductions in acetylcholine-induced contractions of GPI. The agonist-induced contractions of GPI were greatly reduced by both concentrations; 50 μg/ml (p&lt;0.01) and 100 μg/ml (p&lt;0.01), suggesting a good spasmolytic property of the oil. The study suggested that the essential oil of M. communis possesses spasmolytic and antidiarroheal properties, providing support for the traditional use of the plant for stomach pains, and diarrohea. However, further study should be conducted in order to determine the exact mechanism(s) of action of the oil and also to characterize the constituents responsible for the activity observed. Keywords: Myrtus communis, essential oil, antidiarroheal, antispasmodic, antienteropooling

Anti-diarrheal and anti-inflammatory activities of aqueous extract of the aerial part of Rubia cordifolia

BackgroundIn Shaanxi province, China, the aqueous extract of Rubia cordifolia’s aerial part (AERCAP) is traditionally used to manage diarrhea. However, there is no scientific evidence to verify the safety and efficacy of its use. The aim of this study was to investigate the anti-diarrheal and anti-inflammatory effects of AERCAP by using a rodent model.MethodsThe anti-diarrheal effects were studied by senna leaf-induced diarrheal and intestinal transit experiments in mice. The anti-inflammatory activity was investigated by trinitrobenzenesulfonic acid (TNBS)-induced colonic inflammation in rats.ResultsThe results indicated that AERCAP delayed the onset of semi-solid feces, reduced the evacuation index (EI) in senna leaf-induced diarrheal in mice, and inhibited the propulsive movement in castor oil-induced intestinal transit but not in the normal intestinal transit test. The results were compared with the standard anti-diarrheal drug loperamide. Additionally, oral treatment with AERCAP significantly decreased the macroscopic damage area, improved the microscopic structure, and reduced the malondialdehyde (MDA) content, IL-1β and TNF-α levels in colonic tissue compared with the TNBS control group in rats.ConclusionsAERCAP exhibited anti-diarrheal and anti-inflammatory activities in a rodent model. The study validated the traditional use of the plant in Chinese herbal medicine as a valuable natural remedy for the treatment of diarrhea.

Actividad de los extractos acuosos liofilizados de hojas y corteza de Jodina rhombifolia (Hook. &amp; Arn.) Reissek (Santalaceae) sobre el tránsito intestinal en ratones

Introducción: Jodina rhombifolia (Hook. &amp; Arn.) Reissek (Santalaceae) es utilizada en la terapéutica popular para el tratamiento de una gran diversidad de problemas de salud que afectan al metabolismo y al sistema digestivo, respiratorio, músculo-esquelético, cardiovascular y genitourinario. Nuestro objetivo esaportar datos que permitan contribuir a la validación de su uso como antidiarreico. &#x0D; Metodología: conforme a referencias bibliográficas, utilizamos el extracto acuoso de la corteza, el extracto acuoso de las hojas y el empleo conjunto de ambos extractos para ensayar los efectos resultantes sobre la actividad intestinal de ratones Rockland. &#x0D; Resultados: la administración de los extractos de hojas y de corteza por separado no arrojaron valores significativos; sin embargo, la administración conjunta de ambos extractos a las dosis de 125, 250 y 500 mg/kg resultaron en una disminución significativa —y de manera dependiente de la dosis— del tránsito intestinal en ratones Rockland p&lt;0,05; p&lt;0,01 y p&lt;0,01, respectivamente, en comparación con el grupo de control negativo.&#x0D; Conclusiones: los resultados obtenidos nos demuestran que la utilización conjunta del extracto acuoso de las hojas y de la corteza de J. rhombifolia poseen un significante efecto reductor del tránsito intestinal normal en el modelo invivo utilizado y que avala la utilización en la medicina popular argentina.

Evaluation of the anti-diarrheal activity of the hydromethanolic root extract of Rhus tripartita (Ucria) (Anacardiacae).

Rhus tripartita (Anacardiacae) is a plant which is traditionally used for the treatment of ulcer and diarrhea in Tunisia. However, the scientific basis for this usage has not been well established. The core aim of the present study is to evaluate the antidiarrheal activity of Rhus tripartita root methanolic extract (RRE). The antidiarrheal activity of RRE oral doses (50, 100, 200 and 300mg/kg) was evaluated using the castor oil-induced diarrhea, the intestinal fluid emptying method and the normal intestinal transit test. The antibacterial activity was tested against four pathogenic bacteria using two methods. The RRE was also phytochemical studied. Diarrhea experiments showed a protective effect of the RRE which produced a significant (p<0.05) and dose-dependent reduction of all the diarrhea parameters. It delayed the onset of diarrhea, produced a significant decrease in the frequency of defecation and the diarrhea score severity and decreased the volume of intestinal fluid induced by castor oil as well as the propulsion intestinal transit. The effect of the extract at the highest dose (300mg/kg) was similar to that of loperamide, the standard anti-diarrheal drug (10mg/kg). The anti-bacterial activity test showed that RRE exhibited a great inhibition activity against four pathogenic bacteria strains (Esherichia coli, Salmonella typhimurium, Salmonella argenosa, Staphylococcus aureus). Oral administration of the extract up to 3g/kg did not produce any acute toxicity in rats. The preliminary phytochemical screening of the RRE revealed the presence of flavonoids, tannins, and polyphenols. Results showed that RRE at 300mg/kg possesses the highest anti-diarrheal activity possibly mediated by the inhibitory effects on gastrointestinal propulsion and intestinal fluid accumulation.

Regional gastrointestinal transit times in severe ulcerative colitis.

Gastrointestinal (GI) dysmotility may present secondary to inflammatory bowel disease. The main aim of this study was to investigate GI motility in ulcerative colitis (UC) patients during severe disease activity. Twenty patients with severe UC were studied with a novel telemetric capsule system (3D-Transit) designed for minimally invasive, ambulatory assessment of total and regional GI transit times. Ten patients were available for follow-up during remission. Data were compared to those of 20 healthy subjects (HS). Total GI transit time was significantly longer in patients with severe UC (median 44.5 h [range 9.9-102.7 h]) than in HS (median 27.6 h [range 9.6-56.4 h]) (p = 0.032). Additionally, during severe UC, transit time was prolonged through the proximal colon (p = 0.003) and there were strong trends toward longer than normal small intestinal transit time (HS: median 4.9 h [range 3.4-8.3 h] vs severe UC patients: median 5.9 h [range 3.9-11.9 h]; p = 0.053) and colorectal transit times (HS: median 18.2 h [range 1.5-43.7] vs severe UC patients: median 34.9 h [range 0.4-90.9 h]; p = 0.056). Our data further indicate that total GI and colorectal transit times may be prolonged in UC during early remission. Total GI transit times are significantly prolonged during severe UC.

Short‐chain fructooligosaccharides from sucrose and maintenance of normal defecation: evaluation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006

Following an application from Beghin-Meiji and Tereos Syral, submitted for authorisation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of France, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA Panel) was asked to deliver an opinion on the scientific substantiation of a health claim related to short-chain fructooligosaccharides (scFOS) from sucrose and maintenance of normal defecation. The food constituent that is the subject of the health claim is scFOS from sucrose. The Panel considers that scFOS from sucrose is sufficiently characterised. The claimed effect proposed by the applicant is ‘maintaining normal intestinal transit regularity by increasing stool frequency’. The target population proposed by the applicant is the general population. Upon a request from EFSA, the applicant confirmed that the proposed claimed effect refers to maintenance of normal defecation. The Panel considers that maintenance of normal defecation is a beneficial physiological effect. The Panel considers that one human intervention study did not show an effect of scFOS from sucrose at a dose of 5.7 g/day for 4 weeks on defecation frequency, consistency of stools or dry faecal mass and that in two other human intervention studies 10 g/day of scFOS increased faecal bulk, whereas higher amounts (12.5 g/day) consumed for shorter period did not. Although a number of studies provided some evidence that scFOS are fermented in the colon and increase bacterial mass and faecal bulk, the information provided does not demonstrate that the changes in short-chain fatty acids (SCFA) or bile acids induced by scFOS lead to significant changes in the frequency of stools. The Panel concludes that a cause and effect relationship has not been established between the consumption of scFOS from sucrose and maintenance of normal defecation under proposed conditions of use.

Effects of Mesalamine Treatment on Gut Barrier Integrity After Burn Injury.

Gut barrier disruption is often implicated in pathogenesis associated with burn and other traumatic injuries. In this study, the authors examined whether therapeutic intervention with mesalamine (5-aminosalicylic acid [5-ASA]), a common anti-inflammatory treatment for patients with inflammatory bowel disease, reduces intestinal inflammation and maintains normal barrier integrity after burn injury. Male C57BL/6 mice were administered an approximately 20% TBSA dorsal scald burn and resuscitated with either 1 ml normal saline or 100 mg/kg of 5-ASA dissolved in saline. The authors examined intestinal transit and permeability along with the levels of small intestine epithelial cell proinflammatory cytokines and tight junction protein expression 1 day after burn injury in the presence or absence of 5-ASA. A significant decrease in intestinal transit was observed 1 day after burn injury, which accompanied a significant increase in gut permeability. The authors found a substantial increase in the levels of interleukin (IL)-6 (by ~1.5-fold) and IL-18 (by ~2.5-fold) in the small intestine epithelial cells 1 day after injury. Furthermore, burn injury decreases the expression of the tight junction proteins claudin-4, claudin-8, and occludin. Treatment with 5-ASA after burn injury prevented the burn-induced increase in permeability, partially restored normal intestinal transit, normalized the levels of the proinflammatory cytokines IL-6 and IL-18, and restored tight junction protein expression of claudin-4 and occludin compared with that of sham levels. Together these findings suggest that 5-ASA can potentially be used as treatment to decrease intestinal inflammation and normalize intestinal function after burn injury.

Antidiarrhoeal activity of aqueous leaf extract of Caladium bicolor (Araceae) and its possible mechanisms of action

Ethnopharmacological relevanceCaladium bicolor (Araceae) is a horticulture plant also used by some traditional medicine practitioners in the treatment of diarrhoea and other gastrointestinal disorders. This study was conducted to evaluate the antidiarrhoeal activity of the aqueous leaf extract of C. bicolor and its possible mechanisms of action in rodents. Materials and methodsNormal and castor oil-induced intestinal transit and castor oil-induced diarrhoea tests were carried out in mice while gastric emptying and enteropooling tests were conducted in rats following the administration of distilled water (10ml/kg, p.o.), C. bicolor extract (1–50mg/kg, p.o.) and loperamide (5mg/kg, p.o.). The probable mechanisms of action of C. bicolor was investigated following pre-treatment with yohimbine (10mg/kg, s.c.; α2-adrenoceptor antagonist), pilocarpine (1mg/kg, s.c.; non-selective muscarinic receptor agonist), prazosin (1mg/kg, s.c.; α1-adrenoceptor antagonist) and propranolol (1mg/kg, i.p.; non-selective β-adrenoceptor antagonist) 15min prior to administration of C. bicolor extract (50mg/kg, p.o.). After 30min of pre-treatment with these drugs, the mice were subjected to the castor oil-induced intestinal transit test. ResultsC. bicolor extract did not produce significant (p>0.05) effect on normal intestinal transit unlike loperamide which caused significant (p<0.001) inhibition (61.57%). The extract caused significant (p<0.001) dose-dependent inhibition of castor oil-induced intestinal transit with peak effect, 100% inhibition, elicited at the dose of 50mg/kg compared to 86.97% inhibition for loperamide. Yohimbine and pilocarpine most significantly (p<0.001) reversed this effect of the extract. In the castor oil-induced diarrhoea test, the extract (1mg/kg) and loperamide significantly (p<0.05, 0.01) delayed the onset of diarrhoea. For diarrhoea score, the extract (1 and 50mg/kg) inhibited diarrhoea development (47.53% and 43.83% inhibition, respectively) like loperamide (5mg/kg; 54.94%). The in vivo antidiarrhoeal index of the extract at 1 and 50mg/kg was 50.07% and 42.81% respectively compared to 58.15% for loperamide. ConclusionsThe results obtained in this study suggest that the aqueous leaf extract of C. bicolor possess antidiarrhoeal activity due to its anti-motility effect possibly via antagonist action on intestinal muscarinic receptors and agonist action on intestinal α2-adrenoceptors. This justifies the use of the extract in traditional medicine for the treatment of diarrhoea.

Toxicological, Antidiarrheal and Spasmolytic Activities of Solanum paniculatum.

Solanum paniculatum is popularly known as "jurubeba-verdadeira". In folk medicine, its roots, stems, and leaves are used as tonics, anti-inflammatories, carminatives, diuretics, and for gastrointestinal disorders. This species is listed in the Brazilian Pharmacopoeia and belongs to the "Relação Nacional de Plantas Medicinais de Interesse ao SUS". Based on folk medicine data of the Solanum genus, we decided to investigate whether the crude ethanol extract from S. paniculatum aerial parts presents toxicological, antidiarrheal, and spasmolytic activities. The crude ethanol extract from S. paniculatum aerial parts did not produce in vitro or in vivo toxicity and showed dose-dependent antidiarrheal activity, inhibiting equipotently both the defecation frequency (ED50 = 340.3 ± 35.1 mg/kg) and liquid stool formation (ED50 = 370.1 ± 19.4 mg/kg) in mice. Conversely, the crude ethanol extract from S. paniculatum aerial parts did not inhibit normal intestinal transit, even though it has shown a dose-dependent reduction of both the castor oil-induced intestinal transit (Emax = 36.9 ± 1.3 %, ED50 = 242.0 ± 8.6 mg/kg) and intestinal fluid content (Emax = 74.8 ± 2.4 %, ED50 = 328.9 ± 15.9 mg/kg). Additionally, the crude ethanol extract from S. paniculatum aerial parts was approximately 2-fold more potent in antagonizing the phasic contractions induced with histamine (IC50 = 63.7 ± 3.5 µg/mL) than carbachol 10(-6) M (IC50 = 129.3 ± 14.1 µg/mL). Therefore, we concluded that the crude ethanol extract from S. paniculatum aerial parts presents antidiarrheal activity in mice related to the inhibition of small intestinal motility and secretion as well as nonselective spasmolytic activity on the guinea pig ileum.

Cissampelos sympodialis Eichl. (Menispermaceae), a medicinal plant, presents antimotility and antidiarrheal activity in vivo.

BackgroundCissampelos sympodialis (Menispermaceae), known as “Milona” has a specific verified medicinal use for the treatment of diarrhea and respiratory tract diseases. This work aims to evaluate the antimotility and antidiarrheal activity of crude ethanolic extract (EtOHE-Cs), and the total alkaloid fraction (TAF-Cs) obtained from aerial parts of C. sympodialis.MethodsNormal intestinal transit and gastric emptying were used to evaluate antimotility activity. Castor oil-induced diarrhea and castor oil-induced enteropooling were used to evaluate antidiarrheal activity.ResultsThe results indicated that EtOHE-Cs has no antimotility activity, but did demonstrate antidiarrheal activity (at 500 mg/kg), and this activity is related to reduction of intestinal fluid accumulation. The TAF-Cs (at 250 and 500 mg/kg) showed antidiarrheal activity by reducing gastrointestinal motility (gastric emptying and normal intestinal transit).ConclusionsThe antidiarrheal activity of C. sympodialis can be attributed to the chemical compounds already isolated and quantified in this species, mainly alkaloids.

Antidiarrheal Mechanism And Ionic Profile Of &lt;i&gt;Carpolobia Lutea&lt;/i&gt; Ethanolic Stem-Bark Extract In Rats.

The stem-bark extract of Carpolobia lutea (Polygalaceae), used in ethno-medicine as anti-diarrhea was pharmacologically evaluated. This was the first report of assessment of the ethanolic stem extract (ESE), of C. lutea as anti-diarrhoeal agent in rats. The anti-diarrhoeal effects, acute toxicity and ionic profile are investigated and reported. The acute toxicity was established using Lock's method. The anti-diarrhoeal effects were demonstrated using castor oil-induced diarrheal and fluid accumulation and its effect on normal intestinal transit. The mechanism elucidated using yohimbine, isosorbide dinitrate, and diphenoxylate. The elemental and ionic profile of ESE was established using inductively coupled argon-plasma emission spectrometer and potentiometric titration respectively. The finger print of ESE was revealed by Jasco (Tokyo, Japan), HPLC and active compounds by phytochemical screening using standard procedure. The LD50 obtained is 866.025 mg/kg (i.p). The doses of 43.3, 86.6, and 173.2 mg/kg of ESE showed inhibition of castor oil-induced diarrheal (p<0.05 -0.001). The most abundant cations in the extract are potassium and phosphorus (1.00 ±0.01 and 0.80 ± 0.030 mg/g respectively); while the most abundant anions are phosphate and sulphate (33.50±7.09 and 7.19±3.29 mg/g respectively). The HPLC fingerprint of ESE revealed UV spectra of biomolecules. Phytochemical screening revealed presence of saponins, polyphenols and glycosides. These investigations indicate presence of bioactive and elemental substances which could play major role in diarrheal management. This investigation justifies the use of stem-bark of C. lutea in illicit gin (akpatashi), among the Effiks in Nigeria as antidiarrheal.

Evaluation of the antidiarrhoeal activity of the hydroethanolic leaf extract of Pupalia lappacea Linn. Juss. (Amaranthaceae)

Ethnopharmacological RelevancePupalia lappacea is a medicinal plant found in savannah and woodland localities and forest path sides from Senegal to Southern Nigeria. It has been used in the management of diarrhoea in Nigerian traditional medicine. This study was designed to evaluate the antidiarrhoeal activity of the hydroethanolic leaf extract of Pupalia lappacea (PL). Materials and methodsThe antidiarrhoeal activity of PL was evaluated using the normal and castor oil-induced intestinal transit, castor oil-induced diarrhoea, gastric emptying and intestinal fluid accumulation tests in rodents. ResultsPL (100–400mg/kg, p.o.) produced a significant dose-dependent decrease in normal and castor oil-induced intestinal transit compared with the control group (distilled water 10ml/kg, p.o.). This effect was significantly (P<0.05) inhibited by pilocarpine (1mg/kg, s.c.) but not by yohimbine (10mg/kg, s.c.), prazosin (1mg/kg, s.c.), or propranolol (1mg/kg, i.p.). The extract produced a dose-dependent and significant increase in the onset of diarrhoea. PL (100–400mg/kg) also reduced the diarrhoea score, number and weight of wet stools. The in-vivo antidiarrhoeal index (ADIin vivo) of 56.95% produced by the extract at the dose of 400mg/kg was lower compared to that produced by loperamide 5mg/kg (77.75%). However, PL (400mg/kg) significantly increased gastric emptying in rats but significantly reduced the volume of intestinal content in the intestinal fluid accumulation test. Phytochemical analysis of the extract revealed the presence of alkaloids, saponins, and fixed oils and fats. The acute toxicity studies revealed that the extract is relatively safe when given orally; no death was recorded at a dose of 10g/kg. ConclusionResults showed that the hydroethanolic leaf extract of Pupalia lappacea possesses antidiarrhoeal activity possibly mediated by antimuscarinic receptor activity.

Dimethoxyflavone isolated from the stem bark of &lt;i&gt;Stereospermum kunthianum&lt;/i&gt; possesses antidiarrhoeal activity in rodents

This study was undertaken to evaluate the antidiarrhoeal activity of 3, 7, 4'-trihydroxy-3'-(8″-acetoxy-7″-methyloctyl)-5, 6-dimethoxyflavone, a flavonoid isolated from the stem bark of Stereospermum kunthianum. The antidiarrhoeal activity was evaluated using rodent models with diarrhoea. The normal intestinal transit, castor oil-induced intestinal transit and castor oil-induced diarrhoea tests in mice as well as castor oil-induced intestinal fluid accumulation in rats were employed in the study. The animals were pretreated with distilled water (10 ml/kg for mice, 5 ml/kg for rats), dimethoxyflavone (25 mg/kg or 50 mg/kg), morphine (10 mg/kg), or indomethacin (10 mg/kg) before induction of diarrhoea with castor oil (0.2ml for mice and 2ml for rats). Dimethoxyflavone dose dependently and significantly reduced (P<0.05) castor oil-induced intestinal motility. Its antimotility effect at the dose of 50 mg/kg was higher compared to that of morphine (10 mg/kg). Dimethoxyflavone (25 mg/kg and 50 mg/kg) caused a delay in the onset of diarrhoea reduction in the number and weight of wet stools and total stools in mice with castor oil-induced diarrhoea compared to the distilled water treated mice. Treatment with dimethoxyflavone (25 mg/kg or 50 mg/kg) did not produce any remarkable effect on castor oil-induced intestinal fluid accumulation in rats and normal intestinal transit in mice. The results indicate that dimethoxyflavone possesses antidiarrhoeal activity due to its intestinal antimotility effect and inhibition of other diarrhoeal pathophysiological processes. In conclusion, dimethoxyflavone reduced the frequency and severity of diarrhoea in the diarrhoeal models studied.