Treatment Of Chronic Diarrhea Research Articles

Metabolomic Analysis, Fast Isolation of Phenolic Compounds, and Evaluation of Biological Activities of the Bark From Weinmannia trichosperma Cav. (Cunoniaceae).

Weinmannia trichosperma Cav. (Cunoniaceae) (local name, tineo; Mapuche names, madén, mëdehue) is an endemic species of Chile and Argentina used in Mapuche traditional medicine in the treatment of chronic diarrhea, inflammation, and wound healing. This study focused on the isolation, analysis, and characterization of the biological activity of compounds and bark extracts from this plant for the first time. The infusion and tincture of the bark were characterized regarding antioxidant and important enzyme inhibitory activities, phenolics, and flavonoids content and UHPLC-ESI-OT-MS metabolite profiling. Twenty-five metabolites were detected in the medicinal infusion of W. trichosperma, three flavonols were isolated: isoastilbin, neoisoastilbin, and neoastilbin ((2R,3S)-, (2S,3R)-, and (2S,3S)-dihydroquercetin 3-O-alpha-l-rhamnoside) by countercurrent chromatography, and the isomers were quantified in the bark using a validated analytical HPLC methodology. The antioxidant properties were measured by ABTS, DPPH, FRAP, ORAC, and TEAC methods. The infusion displayed a strong DPPH and ABTS scavenging activity (IC50 = 20.58 and 3.070 µg ml−1, respectively) while a moderated effect was observed in the FRAP, ORAC, and ABTS assays. The infusion showed a content of phenolic and flavonoid compounds of 442.1 mg GAE g−1 and 15.54 mg QE g−1, respectively. Furthermore, the infusion showed a good and promissory inhibitory activity (33.80%, 33.12%, and 82.86% for AChE, BuChE, and 5-hLOX, respectively) and isoastilbin (51.70%, 50.10%, and 34.29–80.71% for AChE, BuChE, and 5-hLOX, respectively). The biomolecules identified in this study support the traditional uses of this bark and the potential industrial interest from this Valdivian plant species.

Professor YANG Jun's clinical characteristics in the treatment of chronic diarrhea with acupuncture and herbal medicine based on qi activity theory in Huangdi Neijing

Professor YANG Jun believes that chronic diarrhea is located in the "intestine" and its pathogenesis focuses on the dysfunction of the spleen and the stomach which results in the impairment of qi activity. In the treatment, the comprehensive therapy is adopted, including acupuncture, moxibustion, herbal medicine, cupping method, etc. Regarding acupuncture therapy, Tianshu (ST 25) is selected specially for regulating the spleen and stomach function, Xiabai (LU4) for dispersing the lung qi to stop diarrhea, as well as Yintang (GV 29), Shuigou (GV 26), Chengjiang (CV 24), Qihai (CV 6), Guanyuan (CV 4) and Zhongwan (CV 12) for promoting the circulation of the conception vessel and the governor vessel. Regarding moxibustion therapy, moxibustion is exerted at the abdominal region to regulate qi and blood circulation and unblocking the meridians. Moreover, the retained cupping method is used at Shenque (CV 8) to consolidate the primary qi and the modified sijunzi tang, the herbal decoction is supplemented to tonify the acquired foundation for assisting the congenital one. All of these therapies co-work on promoting and regulating qi activity so as to stop diarrhea.

Diagnostic and Therapeutic Management of Post-Gastric Bypass Chronic Diarrhea: a Systematic Review.

There is a lack of recommendation regarding exploration and treatment of chronic diarrhea following gastric bypass, while it is a common side effect of this surgery. The electronic databases MEDLINE and EMBASE were searched until July 2018. Of the 553 articles identified, 35 articles were included. Intestinal bacterial overgrowth and pancreatic exocrine insufficiency are the main etiologies of diarrhea following gastric bypass. The diagnostic approach must begin by eliminating infectious causes of diarrhea. Exocrine pancreatic insufficiency can be diagnosed with fecal fat quantification or fecal elastase 1 level evaluation. A positive lactulose breath test confirms suspicion of small intestine bacterial overgrowth. In conclusion, we propose sequential exploration and treatment of the possible etiologies of diarrhea depending on clinical symptoms.

Chemical Constituents and Antimicrobial Activities of Combretumpaniculatum

Combretumpaniculatum(combretaceae), has been used widely in ethno medicine in the treatment of chronic diarrhea and dysentery, flatulence, vomiting, colic, and enlarge spleen and liver. The leaf and root of Combretumpaniculatum were pulverized and extracted by serial exhaustive method with solvents: chloroform, ethyl acetate and ethanol in order of increasing polarity, the chemical composition and the antimicrobial activities were investigated using Gas Chromatography- Mass Spectrometry (GC-MS) and Agar-well Diffusion methods respectively. The GC-MS analysis carried out on the leaves and roots extracts of Combretumpaniculatum afforded fifty compounds with the prevailing compounds as Thiirane, Urea, 1,5- Heptadiene, Carbonyl sulfide, Hydrazine, Propanamide, Guanidine, Isobutylamine, Acetic acid, Hexanoic acid, Inositol, Ethane, 5-Chlorovaleric acid and 1-Propanol. These active constituents have been reported to be responsible for many biological activities. The antibacterial analysis of the extracts revealed high activity against the tested pathogens except Pseudomonas aeruginosa staphylococcus aureus (ethylacetate leaf and root extract) and candida albicans (ethanol root). The Minimum Inhibitory Concentration of the extracts were recorded as low as 0.0078mg/ml, the results obtained confirmed that the extracts were highly bactericidal and fungicidal at low concentration. The plant Combretumpaniculatum therefore can be explored in the development of potent antibiotics.

Diagnosis and treatment of chronic diarrhea

慢性腹泻是消化系统常见疾病之一，其病因复杂，发病人群分布广泛。慢性腹泻影响患者的体力、精神状态、营养吸收、日常工作，大大降低患者的生命质量，造成较大的社会负担。通过阐述成人慢性腹泻的发病机制、分型、诊断和治疗,旨在提高临床医生对慢性腹泻的认识和诊治水平。

Phytochemical composition, antilipidemic and antihypercholestrolemic perspectives of Bael leaf extracts

BackgroundIn recent times, focus on plant research has improved all over the world and essential parts of plants provide bioactive compounds in human diet. The bael (Aegle marmelos) has enormous traditional uses in the treatment of chronic diarrhea, dysentery, peptic ulcers and as a laxative. The main focus of this study was characterization of bael leaf extract for its bioactive constituents, antihypercholestrolemic and antilipidemic perspectives.MethodsAfter proximate composition of bael powder, the aqueous extract of bael leaf was used for phytochemical profiling (alkaloids, total phenolic content and total flavonoid content). Afterwards, normal rats group G0 was administrated basal diet while G1 and G2 normal rat groups were fed diets containing bael leaf extract 125 mg and 250 mg, respectively for consecutive 60 days. In a similar way, hyperlipidemic rats group Gh0 was administrated basal diet while Gh1 and Gh2 hyperlipidemic rat groups were fed diets containing bael leaf extract 125 mg and 250 mg, respectively for consecutive 60 days. The blood drawn on day 0, day 30 and day 60 was analyzed for serum parameters, such as total cholesterol, high-density lipoprotein cholesterol, low–density lipoprotein cholesterol, triglycerides concentration and free and ester cholesterol.ResultsBael leaf powder is a rich source of crude fiber (14.50 ± 0.10 g/100 g). Aqueous extract of bael leaf contains alkaloids (15.58 ± 0.05 mg/g), flavonoids (64.00 ± 0.05 mg/g), phenolics (30.34 ± 0.01 GAEmg/g). From the In vivo studies, the lowest weight gain was observed in group G2 and in Gh2 as compared to control of both groups. The decrease in serum TC for G1–15.06%, G2–17.27% while in Gh1–22.46% and Gh2–34.82% after day 60, respectively. The maximum decrease was observed in group G2 (− 14.33%) and in Gh2 (− 24.79%) for triglycerides after 60 days. For HDL-cholesterol, significant increase (11.20%) in G2 and (49.83%) in Gh2 was observed of after 60 days. A trend in decrease of serum LDL–cholesterol in G2 (− 9.63%) and in Gh2 (− 44.65%) was also observed at day 60, and − 19.05% and − 30.06% decrease was noted in G2 and Gh2, respectively and decreasing trend was observed in free and total cholesterol − 22.30% and − 81.49% for groups G2 and Gh2 after day 60.ConclusionsThe results of the present study demonstrated that the extract contents of bael leaf provide protective role against hypercholesterolemic and hyperlipidemic conditions.

Pharmacologic Agents for Chronic Diarrhea.

Chronic diarrhea is usually associated with a number of non-infectious causes. When definitive treatment is unavailable, symptomatic drug therapy is indicated. Pharmacologic agents for chronic diarrhea include loperamide, 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists, diosmectite, cholestyramine, probiotics, antispasmodics, rifaximin, and anti-inflammatory agents. Loperamide, a synthetic opiate agonist, decreases peristaltic activity and inhibits secretion, resulting in the reduction of fluid and electrolyte loss and an increase in stool consistency. Cholestyramine is a bile acid sequestrant that is generally considered as the first-line treatment for bile acid diarrhea. 5-HT3 receptor antagonists have significant benefits in patients with irritable bowel syndrome (IBS) with diarrhea. Ramosetron improves stool consistency as well as global IBS symptoms. Probiotics may have a role in the prevention of antibiotic-associated diarrhea. However, data on the role of probiotics in the treatment of chronic diarrhea are lacking. Diosmectite, an absorbent, can be used for the treatment of chronic functional diarrhea, radiation-induced diarrhea, and chemotherapy-induced diarrhea. Antispasmodics including alverine citrate, mebeverine, otilonium bromide, and pinaverium bromide are used for relieving diarrheal symptoms and abdominal pain. Rifaximin can be effective for chronic diarrhea associated with IBS and small intestinal bacterial overgrowth. Budesonide is effective in both lymphocytic colitis and collagenous colitis. The efficacy of mesalazine in microscopic colitis is weak or remains uncertain. Considering their mechanisms of action, these agents should be prescribed properly.

Mo1570 Fecal Microbiota Transplantation, by Means of Push Enteroscopy. a Novel Endoscopic Technique, for the Treatment of Chronic Diarrhea Associated With Clostridium difficile -a Pilot Study

Mo1570 Fecal Microbiota Transplantation, by Means of Push Enteroscopy. a Novel Endoscopic Technique, for the Treatment of Chronic Diarrhea Associated With Clostridium difficile -a Pilot Study

Pancreatic insufficiency in patients with HIV infection: role of didanosine questioned

The aim of the study was to identify possible causes of pancreatic insufficiency in patients with HIV infection. A retrospective analysis of 233 HIV-positive patients for whom faecal elastase measurement was available was performed to investigate potential associations with core demographic data, HIV infection characteristics, degree of immunosuppresion, exposure to antiretroviral therapy (ART), alcohol misuse, diabetes, hepatitis C virus (HCV) infection, triglyceride and cholesterol levels and symptomatology. The response to pancreatic enzyme replacement for patients with evidence of insufficiency was also evaluated. Of 233 patients, 104 (45%) had evidence of pancreatic exocrine insufficiency (faecal elastase < 200 mcg/g). A positive association with exocrine pancreatic insufficiency was found for HCV infection (P = 0.007), previous or current HCV treatment (P = 0.003), alcohol misuse history (P = 0.006) and the presence of steatorrhoea (P = 0.03). There was no demonstrated association between exocrine pancreatic insufficiency and didanosine (ddI) exposure (P = 0.43) or stavudine (d4T) exposure (P = 0.62). Seventy-seven per cent of patients who were treated with pancreatic enzymatic supplementation reported a subjective improvement in symptoms. Faecal elastase sampling should form part of the routine work-up for HIV-positive patients with chronic diarrhoea even in the absence of 'traditional' risk factors such as ddI exposure. In particular, if the patient has steatorrhoea, a history of alcohol exposure or their HCV serology is positive, they should be considered for investigation. Treatment with pancreatic enzyme supplementation appears to be effective in the treatment of chronic diarrhoea caused by pancreatic insufficiency in the majority of patients.

Update on Chronic Diarrhea: A Run-Through for the Clinician

Chronic diarrhea is a common patient complaint, with an estimated prevalence of 5%. Diarrhea is defined as >200g/day of stool with decreased consistency, and chronic diarrhea is defined as lasting more than 4weeks. The purpose of this review is to guide the clinician's diagnostic evaluation and management of chronic diarrhea, rather than providing a textbook comprehensive review of the subject, focusing on the patient in developed countries and excluding the immune suppressed patient. While the investigation and treatment of chronic diarrhea can be challenging due to its myriad causes, when the clinician employs a practical approach, dividing chronic diarrhea into bloody, fatty, and watery causes, it simplifies and streamlines the work-up and management plan and leads to improved patient outcomes.

Approach for Diagnostic and Treatment of Chronic Diarrhea Caused by Hookworm Infection

Chronic diarrhea has various etiologies. One of the causes includes parasitic infection, such as hookworm. Human hookworm infections are caused by the blood-feeding intestinal nematodes (Ancylostoma duodenale and Necator americanus). A 54-year-old male was admitted to Cipto Mangunkusumo Hospital with a chief complaint of diarrhea since one month before hospital admission. He experienced diarrhea more than five times a day, without blood and mucus. The stool appearance was yellow without bubbles. He also noted decreased appetite and weight loss. The remarkable physical finding was pain in whole abdomen. Laboratory results showed leukocytosis; while the feces analysis showed bacteria, leukocytes and Gram-negative bacilli. Colonoscopy examination revealed a lot of worms in the colon with multiple ulcers. Histopathological findings indicated colitis with plasma and eosinophils cells in the lamina propia. Parasitology analysis confirmed the hookworms (Necator americanus). The patient was given intravenous fluid, albendazole 400 mg in three consecutive days. The patient’s clinical condition was improved and he was subsequently discharged after seven days of hospitalization. During the follow up at outpatient clinic, the patient was in healthy condition. This is a demonstrative case of human hookworm infection that cause chronic diarrhea. Colonoscopy plays important role for evaluating and finding the etiology of chronic diarrhea. Proper treatment with albendazole has been proven to be effective in eradicating hookworm infection. Keywords: diarrhea, parasite, hookworm

Evidence behind the WHO Guidelines: Hospital Care for Children: What is the Aetiology and Treatment of Chronic Diarrhoea in Children with HIV?

This clinical review aims to address the issue of appropriate treatment for chronic diarrhea in children with HIV and evaluates the scientific evidence behind WHOs recommendations for this matter. It finds that highly active antiretroviral therapy (HAART) substantially reduces diarrhea increases the effectiveness of antimicrobial agents and improves weight gain.

Review article: small intestinal bacterial overgrowth, bile acid malabsorption and gluten intolerance as possible causes of chronic watery diarrhoea

Chronic watery diarrhoea is one of the most common symptoms prompting GI evaluation. Recently, new diagnostic considerations have emerged as possible factors in chronic diarrhoea. To review available data regarding diagnosis and treatment of chronic diarrhoea with an emphasis on bacterial overgrowth and bile acid malabsorption. A systematic search of the English language literature of chronic diarrhoea was performed focused on three possible aetiologies of diarrhoea: small intestinal bacterial overgrowth (SIBO), idiopathic bile salt malabsorption (IBAM), gluten responsive enteropathy. Recent studies suggest that SIBO and bile acid malabsorption may have been underestimated as possible causes of chronic watery diarrhoea. Gluten intolerance with negative coeliac serology is a contentious possible cause of watery diarrhoea, but requires further research before acceptance as an entity. In patients with otherwise unexplained chronic watery diarrhoea, small intestinal bacterial overgrowth and bile salt malabsorption should be considered and investigated.

Therapy Insight: drugs for gastrointestinal disorders in pregnant women

The management and treatment of gastrointestinal ailments in pregnant women requires special attention and expertise, since the safety of the mother, fetus and neonate remains the primary focus. Nausea and vomiting during pregnancy is common, as is symptomatic gastroesophageal reflux disease. Peptic ulcer disease occurs less frequently and with fewer complications. Gastroenterologists and obstetricians should be familiar with safe treatment options for these conditions, because they can profoundly impair the quality of life of pregnant women. During pregnancy, constipation can develop de novo, or chronic constipation can increase in severity. Given the array of therapies for constipation, physicians must apprise themselves of drugs that are safe for both mother and fetus. Management of acute, self-limited diarrhea should focus on supportive therapy, dietary changes and maintenance of hydration. Treatment of chronic diarrhea should be considered in the context of therapy for the underlying disorder. Inflammatory bowel disease and irritable bowel syndrome present a unique therapeutic challenge--to control the disease while minimizing toxicity to the fetus and mother. Initiation and alteration of medical therapy for gastrointestinal disorders during pregnancy must be undertaken after discussion with the patient's obstetrician.

Double-Blind Pilot Study of Mesalamine vs. Placebo for Treatment of Chronic Diarrhea and Nonspecific Colitis in Immunocompetent HIV Patients

Chronic diarrhea and colitis are common in patients positive for human immunodeficiency virus (HIV) under highly active antiretroviral treatment (HAART). This prospective double-blind study explores the effect of mesalamine vs. placebo in HIV-positive patients. Thirteen HIV-infected patients with noninfectious chronic diarrhea and > 250 CD4+ cells/mm(3) were randomized to mesalamine (2.4 g/day; n = 9) or placebo (n = 4) for 6 weeks. Colonoscopy was performed at baseline and week 6, and biopsies were obtained to calculate the Biopsy Activity Index (BAI). Diarrhea was assessed at baseline and end of treatment using the Disease Activity Index (DAI). Patients and clinicians completed Patient Global Improvement index (PGI) and Clinical Global Improvement index (CGI) at weeks 2 and 6. Comparisons at week 6 were statistically significant between mesalamine and placebo groups for BAI (P = 0.03), DAI (P = 0.007), PGI (P = 0.008), and CGI (P = 0.008). Furthermore, major improvements were documented in the mesalamine group at week 6 compared to baseline for all variables, whereas the placebo group did not have any. Mesalamine was effective for treatment of chronic diarrhea and moderate nonspecific colitis in HIV patients.

Treatment of chronic diarrhea with point-irradiation of He−Ne laser in 50 cases

To treat 50 cases of chronic diarrhea by laser point-radiation on Shenque (CV 8), Tianshu (ST 25), Zusanli (ST 36) and Point Anti-diarrhea with low power He−Ne laser. The total effective rate was 96%.

Multicenter randomized controlled trial of heat‐killed Lactobacillus acidophilus LB in patients with chronic diarrhea

OBJECTIVE: Chronic diarrhea is a common bowel disorder, and disturbance of intestinal microorganisms may play a role in its pathogenesis. The aim of this study was to assess the clinical efficacy of lyophilized heat‐killed Lactobacillus acidophilus LB compared with living lactobacilli in the treatment of chronic diarrhea.METHODS: One hundred and thirty‐seven patients with chronic diarrhea were randomly allocated to receive either a 4‐week course of two capsules of Lacteol Fort twice a day as the Lacteol group (69 patients completed the course) or a 4‐week course of five chewable tablets of Lacidophilin three times a day as the Lacidophilin group (64 patients completed the course). The frequency of stools was recorded quantitatively and the semiquantitative parameters such as stool consistency, abdominal pain, distension and feeling of incomplete evacuation were evaluated.RESULTS: At the second and fourth week of the treatment, the mean bowel frequency was significantly lower in the Lacteol group than in the Lacidophilin group (1.88 ± 1.24 vs 2.64 ± 1.12, 1.39 ± 0.92 vs 2.19 ± 1.05, respectively; P &lt; 0.05). At the end of the treatment, the clinical symptoms were markedly improved in the Lacteol group.CONCLUSIONS: Lactobacillus acidophilus LB is more effective than living lactobacilli in the treatment of chronic diarrhea.

Primary Health Care Response to the Treatment of Chronic Diarrhoea in Aboriginal Children

This paper explores the issue of chronic diarrhoea in Australian Aboriginal children from a primary health care perspective. It discusses the nature of the problem and factors which influence its perpetuation as a dominant health issue for this population. A variety of primary health care solutions are suggested, including those in relation to basic sanitation, improvements to local environmental conditions, education, collaborative health care planning, resourcing implications and the empowerment of local communities.

Home-made modular diet versus semi-elemental formula in the treatment of chronic diarrhoea of infancy: a prospective randomized trial

Home-made modular diet versus semi-elemental formula in the treatment of chronic diarrhoea of infancy: a prospective randomized trial

Diagnosis and treatment of chronic diarrhea.

Diagnosis and treatment of chronic diarrhea.