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Nature's Quick Constipation Cure

The First Step-by-step Plan To Cure Constipation Using A Combination Of Unique All-natural Remedies. This plan uses a strategically organized and ordered combination of the safest and most effective natural remedies for constipation. Everything used in this plan is from natures garden. No use of harmful laxatives. People who have used these swear they work Better than over-the-counter laxatives! Every strategy is carefully researched for safety and effectiveness. Each remedy builds on the last while helping out the next. The plan takes into account human physiology, anatomy, nutrition, metabolic needs and deficiencies while using specific dietary remedies and the almost always neglected but extremely powerful, mechanical remedies. All of these have been carefully planned and refined to provide you the most powerful, synergistic constipation relief plan that will relieve you of even the most stubborn of constipation episodes within as quick as 15 minutes and less than 24 Hours. Read more here...

Natures Quick Constipation Cure Summary

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Natural Remedies For Constipation

Here is a comprehensive constipation e-book that cover all aspects of colon health. If ever you wanted to find answers on how to keep your colon healthy, how to elminated constipation, or follow a health lifestyle, then this is an e-book you should read. It just not for constipation, but for gaining your health back when you hav an illness. This e-book is about how to eliminate constipation, how to keep regular by maintaining a healthy colon, and how to prevent constipation in the future. Here's what you will discover in, Constipation Natural Cures: Why drugstore laxatives will kill you if you continue to use them (page 26 27) Which drugstore laxative is the safest to use (page 28) How many bowels movements should you have each day (page 19) How to tell if you are constipated (page 20) How long does it take for food you eat to come out the rectum (page 18) One thing that will keep your colon healthy and keep you from having constipation (page 46) Two areas that you need to massage to keep your stools moving in the right direction (page 40) The best good bacteria supplement you should take (page 45, 46) What you can feed your good bacteria so that the bad bacteria doesn't take over (page 46 and 47) What happens when bad bacteria in your colon takes over (page 49) Read more here...

Natural Remedies For Constipation Summary

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Author: Rudy Silva
Official Website: www.remedies-for-constipation.com
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Treatment Of Constipation

Rationale for IBS and non-IBS constipation - According to ROME II criteria, Irritable Bowel Syndrome (IBS) is subdivided into 3 major subsets of patients exhibiting either diarrhea (IBS-D), constipation (IBS-C) or alternating constipation and diarrhea (IBS-A) representing 30, 50 and 20 of all IBS patients respectively. However chronic constipation may occur in patients not exhibiting abdominal pain and consequently not included in IBS-C patients. Chronic constipation as IBS-C is often associated with slow colonic transit or rectal retention with impared rectal sensitivity and or motility reflex. Chronic constipation is a common complaint for which pharmacological therapy has not had a dramatic impact, evidenced by the absence of any good controlled trials demonstrating efficacy. Metoclopramide appears to be ineffective in the treatment of chronic constipation (30) and bulking agents have some demonstrated efficacy but many they generate abdominal bloating. Classical laxatives...

Problemsspecial considerations

The main risk of ectopic pregnancy is sudden severe haemorrhage, which may be intra-abdominal and thus concealed until rapid decompensation and collapse occur. A common theme in deaths associated with ectopic pregnancy is the failure to consider the diagnosis before collapse. Ectopic pregnancy may present with non-specific abdominal signs including diarrhoea or constipation, thus mimicking other intra-abdominal conditions (e.g. appendicitis), although with serial measurement of plasma human chorionic gonadotrophin (hCG doubles every 2-3 days in normal pregnancy) and use of pelvic ultrasonography this should be unusual. The potential severity of the condition is not always appreciated by other hospital staff, the patient herself or her relatives. Ectopics outside the Fallopian tubes are more likely to be associated with massive haemorrhage, with abdominal pregnancies the most hazardous, especially when the placenta is removed.

Predisposing Conditions And Pathophysiology

Excretion of the organism has persisted for as long as 158 days after the onset of constipation, well after clinical recovery had occurred. The syndrome has occurred in both breast-fed and bottle-fed infants, and the role of type of feeding is yet unsettled (16). Risk factors for IB are multifactorial and include breastfeeding, and the introduction of first-formula feeding, consumption of honey, and residence in a region of high spore density and soil disruption (13). Constipation appears to be a risk factor but also is an early manifestation of intoxication (17). Preformed toxin has not been identified in food ingested by the infants, but the organism has been identified in honey, vacuum cleaner, dust, and soil. C. botulinum organisms, but no preformed toxin, were identified in six different honey specimens fed to three California patients with IB, as well as from 10 (9 90) of honey specimens studied (23). By food exposure history, honey was significantly associated with type B IB....

Clinical Manifestation

The onset ranges from insidious to abrupt. The syndrome is characterized by a history of constipation (defined as three or more days without bowel movement) followed by a subacute progression of bulbar and extremity weakness (within four to five days) manifest in inability to suck and swallow, weakened voice, ptosis, hypotonia, that may progress to generalized flaccidity and respiratory compromise. There is, however, a broad clinical spectrum of IB. The mild end of the spectrum appears to be represented by infants who never require hospitalization but who have feeding difficulties, mild hypotonia, and floppy neck, and failure to thrive, while the severe end of the spectrum may be characterized by a presentation resembling sudden infant death syndrome (SIDS) (26), and these patients require hospitalization for treatment of their respiratory and feeding difficulties. The main clinical feature of the syndrome is constipation which occurs in about 95 of patients (16,27). Botulism is...

Centrally Acting Agents

Opioids - Studies detailing the selective 8 opioid receptor agonist SB 227122 (1) have recently been described (12). Compound 1 binds to the human 8 receptor with high affinity (K, 6.9 nM) while its activity at the p and k opioid receptors is significantly weaker (K, 2030 nM and 5000 nM respectively). In vivo, 1 dose-dependently inhibited citric acid induced cough in the guinea pig with an ED5o 7.3 mg kg when administered parenterally. This compares favorably with the activity of codeine (a n receptor agonist) and BRL 52974 (a k receptor agonist) in the same model (ED50 5.2 and 5.3 mg kg respectively). Activation of the n and k receptors is associated with many of the side effects seen with the opioid antitussives such as respiratory depression, constipation and dependence (n receptor), and diuresis and

Site Of Action Of Antitussive Drugs

Opioids - Studies detailing the selective 8 opioid receptor agonist SB 227122 (1) have recently been described (12). Compound binds to the human 5 receptor with high affinity (K, 6.9 nM) while its activity at the n and k opioid receptors is significantly weaker (Kj 2030 nM and 5000 nM respectively). In vivo, 1 dose-dependently inhibited citric acid induced cough in the guinea pig with an ED5o 7.3 mg kg when administered parenterally. This compares favorably with the activity of codeine (a n receptor agonist) and BRL 52974 (a k receptor agonist) in the same model (ED50 5.2 and 5.3 mg kg respectively). Activation of the and k receptors is associated with many of the side effects seen with the opioid antitussives such as respiratory depression, constipation and dependence (n receptor), and diuresis and sedation (k receptors). Therefore, it may be expected that a selective 5 receptor agonist might be devoid of such side effects.

Opioid receptors and GI pharmacology

The G protein-coupled opioid receptors, m (MOR), S (DOR), and k (KOR), are expressed in both the central nervous system (CNS) and a variety of peripheral tissues 1 . Opioid analgesics such as morphine, fentanyl, and oxycodone induce analgesia, miosis, and respiratory depression via activation of MOR in the CNS. However, these drugs also have significant inhibitory effects on GI function, including motility, secretion, absorption, and blood flow via MOR expressed in the enteric nervous system (ENS) in the gut 2 . Indeed, opioid-induced constipation (OIC) is an

Opioidinduced GI dysfunction

OIC is a common and often debilitating side effect of opioid analgesics occurring in 40-95 of patients treated with opioids 22 . Unlike many of the other side effects of opioids (respiratory suppression, sedation, nausea), OIC is unlikely to improve over time 23 . A recent report on the results of a US and European patient survey on the prevalence, severity, and impact of OBD revealed that 81 of 322 patients on oral opioid drugs for pain reported the highest level of bothersomeness for constipation, a condition that persisted despite the fact that all the patients were taking laxatives 22 . Another recent study with more than 800 patients suffering from OIC showed that patients with constipation had substantially higher total medical costs arising from significantly higher care requirements (i.e., inpatient, hospice, outpatient, emergency, nursing home care, etc.) compared with control patients 24 .

Pharmacodynamic activity

Owing to the distribution of 5-HT4 receptors throughout the GI tract and the selectivity of tegaserod as an agonist at these receptors, the compound acts as a promotile drug throughout the GI tract 28,29 . Stimulatory effects are observed on both normal and impaired gastric emptying in mice, rats and dogs, on small intestinal motility in dogs, on colonic transit and motility in mice and dogs 28,36-38 , and on motility in healthy horses 39 . In a model of constipation in dogs using morphine, tegaserod normalized the reduced number of bowel movements and the quantity of stools. Furthermore, treatment with tegaserod significantly improved stool consistency 40 . Tegaserod does not affect gastric (acid) secretion (Figure 1). Figure 1 Effects of tegaserod in a constipation model in conscious dogs. Tegaserod normalizes stool frequency, stool quantity and softens stool consistency. Mean + SEM (n 8) *p 0.05 versus Vehicle p 0.05 versus Morphine. From Weber et al., Gastroenterology (2003), 124...

Clinical Phase Iiiii Studies

The clinical efficacy of tegaserod in female patients with constipation-predominant IBS was established in two prospective well-controlled studies, with supportive efficacy obtained in a third study. The drug dosed at 6 mg b.i.d. for 3 months showed a consistent pattern of improvement across multiple efficacy variables and study time points in all three studies. Higher response rates were observed for the tegaserod-treated group than the placebo group on a global validated measure of IBS symptom relief (Subject's Global Assessment (SGA) of Relief) 49 for each month in all three studies. In particular, tegaserod had a rapid onset of action with a therapeutic gain of 13-14 during month 1 vs. placebo. At study completion, the therapeutic gain ranged from 7 to 14 . The onset of action of tegaserod, as measured by SGA of relief, was observed as early as 1 week. Clinical efficacy persisted throughout the 12-week treatment period. Upon discontinuing tegaserod, symptoms returned within one...

What foods can I eat to assure that Im getting enough calcium

For example, too much fiber in your diet can slow the rate at which calcium is absorbed by your body. However, a high-fiber diet has also been associated with healthful changes, such as decreased risks of breast and colon cancer. Increasing fiber in your diet can also decrease the constipation associated with calcium carbonate. Dividing the amount of calcium that you need into smaller doses to take throughout the day may provide better absorption and fewer side effects of bloating and gas.

Disorders of the Large Intestine and Rectum

Irritable bowel syndrome is a group of symptoms that includes cramping pain, gas, bloating, and alternating bouts of constipation and diarrhea. Sometimes people with irritable bowel syndrome pass mucus with their bowel movements. Irritable bowel syndrome is also called irritable colon, spastic colon, spastic bowel, mucous colitis, and functional bowel disease. Diagnosis of irritable bowel syndrome is usually made by ruling out other possible causes of the symptoms. Irritable bowel syndrome does not cause permanent damage to the intestines and does not increase the risk of colon cancer. Diverticula are small bulges or pouches that develop in the colon. These pouches form when the colon strains to move hard stool, and the increased pressure pushes through weak spots in the lining of the colon. This condition may result from eating a diet that is low in fiber. If there are no symptoms or mild symptoms, the condition is called diverticulosis. If the pouches become infected or inflamed...

Opioid receptor antagonists

Activation of peripheral m-opioid receptors present in the enteric nervous system increases tone and phasic contractility leading to compromised motility throughout the GI tract. Opioid-induced bowel dysfunction is a condition for which no adequate treatment is currently available and, moreover, activation of opioid receptors might be a contributory factor to the development of post-operative ileus (POI). A peripheralized opioid receptor antagonist, which does not interfere with analgesia represents a possible treatment for these conditions. Methylnaltrexone 11 is a quaternary analogue of the m-opioid antagonist naltrexone, which does not cross the blood-brain barrier and has limited oral absorption. After parenteral administration, methylnaltrexone reversed motility impairments caused by opioids in healthy volunteers and chronic methadone users 30 . The compound is presently in clinical development for various conditions associated with opioid-induced constipation. Alvimopan 12 is a...

Results from Clinical Trials with cf1520 OnyxOl 5 or CI1042

Intraperitoneal, intraarterial, and intravenous administration were also remarkably well tolerated in general. Intraperitoneal administration was feasible at doses up to 1013 particles divided over 5 days 50 . The most common toxicites included fever, abdominal pain, nausea vomiting, and bowel motility changes (diarrhea, constipation). The severity of the symptoms appeared to correlate with tumor burden. Patients with heavy tumor burdens reached a maximally tolerated dose at 1012 particles (dose-limiting toxicities were abdominal pain and diarrhea), whereas patients with a low tumor burden tolerated 1013 without significant toxicity.

PNS of the Peripheral Nervous System

Finally, autonomic dysfunction is a common feature of LEMS with and without malignant disease. In LEMS patients, the most frequent symptoms are cholinergic, including dry mouth, erectile failure, constipation, blurred vision, and impaired sweating, suggesting that major involvement is the parasympathetic nerves 109 .

Rimantadine hydrochloride amethyl1adamantanemethylamine hydrochloride

High fever and constipation followed by diarrhea. Mortality may exceed 90 . Inflammation and ulceration of the whole alimentary tract is the main pathological lesion, but patchy pneumonia may occur. Transmission is by direct contact and outbreaks usually start by the introduction of an infected animal with up to 100 infection of the affected herd. Control is by slaughter and use of tissue-culture-attenuated vaccines, which generate life-long immunity. The virus is closely similar in structure to Measles and Canine distemper virus and contains cross-reacting antigens. Serum from rinderpest virus-infected cattle prevents hemagglu-tination by Measles virus. Several live virus-attenuated vaccines are available and a global rinderpest eradication campaign coordinated by the Food and Agriculture Organization of the United Nations (FAO) is underway. Synonyms cattle plague virus peste bovina peste bovine.

Management And Prognosis

Maintenance of adequate nutrition and hydration is of outmost importance. Parenteral nutrition is usually required because of the likely length of the disease and the undesirability of oral or nasogastric feedings. Adequate nutritional support can minimize weight loss, maintain electrolyte balance, and improve management of arrhythmias. Attention must be paid to skin care, and excretory functions must be monitored closely for urinary retention or serious constipation. Patients must be immunized with tetanus toxoid to prevent further disease. Tracheostomy may be required to prevent laryngospasm, which greatly increases the mortality rate of the disease.

Multiple Endocrine Neoplasia Type

In addition, at about the same time that the MEN2-associated locus was discovered, the gene for an autosomal dominant condition called Hirschsprung disease (aganglionic megacolon), which affects about 1 in 5000 individuals, was mapped to chromosome 10q11.2. The principal phenotype of this noncancerous disorder is the absence of nerve cells (intrinsic ganglion cells) from a section of the terminal portion of the colon. Because there is no peristaltic movement in an aganglionic segment of a colon, waste material accumulates. In mild forms of Hirschsprung disease, a short segment of the colon is aganglionic, and constipation occurs. In severe cases, where a long segment of the colon lacks nerve cells, there may be complete colonic obstruction and abdominal distension. Often, with extreme colonic blockage, many small fissures develop and become infected. If untreated, the severe form is fatal when the colon ruptures. However, surgical removal of the aganglionic portion of the colon...

Indisetron Antiemetic [5862

Indisetron, a 5-HT3 5-HT4 antagonist, has, therefore, been launched in Japan as an anti-emetic. Since 5-HT4 is implicated in intestinal motility, dual antagonism should improve the anti-emetic effect, although this remains to be demonstrated. The diazabicycloamine portion of indisetron is prepared in four steps starting with methylamine and bromoacetaldehyde dimethylacetal. Coupling to the indazole core is accomplished via the acid chloride of lH-indazole-3-carboxylic acid. In vitro, indisetron displaced 3H GR-65630 binding to the 5-HT3 receptor in rat brain membranes in a concentration-dependent manner with a pK value of 8.77, which is comparable to the activities of other 5-HT3 antagonists such as granisetron and on-dansetron. In animal models (ferrets and dogs), indisetron reduced the number and duration of cisplatin-induced emetic episodes when administered orally at O.l-l mg kg prior to cisplatin treatment. Compared to granisetron and ondansetron, there were...

Darifenacin Urinary Incontinence [1518

Darifenacin demonstrates greater effect on tissues in which the predominant receptor type is M3 rather than Ml or M2. In vitro darifenacin inhibits carbachol-induced contractions with greater potency in isolated guinea-pig bladder (M3) than in guinea-pig atria (M2) or dog saphenous vein (Ml). In animal models, it shows greater selectivity for inhibition of detrusor contraction over salivation or tachycardia. The synthesis of darifenacin involves the coupling of 5-(2-bromoethyl)-2, 3-dihydrobenzofuran with as a key step. The latter intermediate is prepared from 3-(R)-hydroxypyrrolidine in a five-step sequence involving N-tosylation, Mitsunobu reaction to introduce a tosy-loxy group in the 3-position with stereochemical inversion, anionic alkylation with diphenylacetonitrile, cleavage of the N-tosyl protecting group with HBr, and conversion of the cyano group to a carboxamide. Darifenacin is supplied as a controlled release formulation, and the recommended dosage is 7.5 mg once, daily....

Nonstimulant Medications for ADHD

Timothy Wilens and colleagues (2002) recommended that dosing with TCAs should start with 25 mg daily with a gradual increase to a maximum of 5 mg per kg of patient weight per day, except for nortriptyline, whose dosing should be limited to a maximum of 2 mg per kg per day. Often responses to TCA treatment are not very noticeable until the regimen has been continued for three to five weeks. Adverse effects with TCAs may include sedation, weight gain, dry mouth, constipation, and sexual dysfunction. Usually nortriptyline produces fewer adverse effects than do the other TCAs.

Prokinetic Agent Target Classes 21 Dopamine D2 receptor antagonists

Prucalopride 5 is a selective 5-HT4 agonist which when dosed once daily for 4 weeks showed significant improvements compared to placebo in stool softening, decreased straining and time to first stool in patients with chronic constipation, who were refractory to laxatives. However, further development of this compound is on hold due to carcinogenicity issues 12 . Tegaserod 6 is a 5-HT4 receptor agonist which has been approved by the FDA for IBS-C and chronic idiopathic constipation and is marketed in the US and elsewhere. Tegaserod is rapidly absorbed in man and shows linear pharmacokinet-ics in a 2-12 mg oral dose range, with no significant differences found between healthy volunteers, young or elderly IBS patients 13 . In clinical phase III studies for IBS-C conducted in predominantly female patients, tegaserod b.i.d. at 6mg for 12 weeks compared to placebo demonstrated significant improvements in self-reported symptom scores including abdominal pain, bloating and bowel function....

Clinical Presentation

Ulcerative colitis typically begins in the rectum and extends proxi-mally. Symptoms tend to develop gradually, with the predominant symptom of diarrhea, accompanied by blood. Occasionally it may begin with infrequent stools but pure rectal bleeding, secondary to the significant rectal inflammation, resulting in a functional right-sided constipation. The course is usually chronic, characterized by remission with intermittent episodes of relapse (7). Less commonly, the course may be continuous, with unrelenting symptoms and eventual surgery. The severity of the symptoms tends to parallel the severity of the inflammation, not necessarily the extent. In other words, a limited extent does not guarantee a more benign course. Symptoms range from occasional rectal bleeding even without diarrhea to profuse purulent bloody diarrhea. Patients may experience lower abdominal pain, urgency, tenesmus, and incontinence. With more severe inflammation, patients also have systemic complaints such as...

What is the significance of autonomic dysfunction How might you tell if a patient has autonomic dysfunction

Patients with autonomic dysfunction tend to have severe hypotension intraoperatively. Evaluation of changes in orthostatic blood pressure and heart rate is a quick and effective way of assessing autonomic dysfunction. If the autonomic nervous system is intact, an increase in heart rate of 15 beats min and an increase of 10 mm Hg in diastolic blood pressure are expected when changing position from supine to sitting. Autonomic dysfunction is suggested whenever there is a loss of heart rate variability, whatever the circumstances. Autonomic dysfunction includes vasomotor, bladder, bowel, and sexual dysfunction. Other signs include blurred vision, reduced or excessive sweating, dry or excessively moist eyes and mouth, cold or discolored extremities, incontinence or incomplete voiding, diarrhea or constipation, and impotence. Although there are many causes, it should be noted that people with diabetes and chronic alcoholics are patient groups well known to demonstrate autonomic dysfunction.

Recent Advances in Development of Novel Analgesics

Introduction - Nonsteroidal anti-inflammatory drugs (NSAIDs, e.g. aspirin, ibuprofen and naproxen), opioids (e.g. morphine) and a variety of adjuvant agents (e.g. tricyclic antidepressants, lidocaine and certain anticonvulsant agents) have been mainstays of pain therapy for decades. All these agents suffer from drawbacks in clinical use. The NSAIDs are associated with gastrointestinal side effects, increased bleeding time and do not effectively ameliorate severe pain. The opioids can produce tolerance and dependence, constipation, respiratory depression and sedation. Adjuvant agents, which non-selectively block sodium channels, are associated with CNS and cardiovascular side effects. Currently available analgesics also have limited utility in treatment of neuropathic pain (pain arising from nerve injury). Thus, there is a significant unmet medical need for safer and more effective analgesic agents, and this need is likely to be met by identification of novel ligands for newly...

Adenosine Deaminase Narcolepsy Ear Infections

Cardiovascular disease is a prevalent component of WS that often entails the narrowing of arteries, especially the aortic artery above the aortic valve (supervalvar aortic stenosis, SVAS). Connective tissue abnormalities are common and include hoarse voice abnormal joint movement soft, flexible skin groin and abdominal ruptures and protrusions (diverticulae) of the bladder and bowel that extend through the surrounding layers. There is excess calcium in the blood and urine. Feeding problems, colic, and constipation curtail growth and weight gain during the first 4 years after birth. The facial features (facies) are distinctive with a broad forehead narrowing at the temples epicanthal folds crossed eyes (strabismus) full cheeks and lips a rounded tip of the nose puffiness around the eyes prominent ear lobes small chin and jaw small, widely spaced teeth a longer than normal groove (philtrum) in the midline of the upper lip and a starlike pattern in the iris (Figure...

Solitary Rectal Ulcer

Solitary rectal ulcer syndrome typically presents in a patient with a history of constipation, incomplete evacuation, and chronic straining at stool who may also use digital maneuvers to empty the rectum (94). Rectal bleeding and associated mucus passage is usually scanty with coating of the stool or tissue. Severe bleeding is rare (95). The diagnosis is made by endoscopy, by which classically, a shallow, discrete, 1-cm punched-out ulcer with a hyperemic margin 710 cm from the anal verge on the anterior rectal wall is identified. The term solitary rectal ulcer is somewhat of a misnomer, however, because endoscopic examination may show several small clustered ulcers or may reveal no ulcer at all. Instead, a localized hyperemic patch of tissue or a polypoid mass initially suggestive of a malignancy may be appreciated. Treatment is primarily aimed at improving defecation habits. The combination of education, the liberal use of fiber and or laxatives, and bowel habit retraining has...

Neurophysiological Techniques

Also helps to identify patients in whom incontinence may develop or worsen following surgery. Anal sphincter EMG is generally better tolerated, and yields identical results (50). In at least 80 of patients with MSA, EMG of the external anal sphincter reveals signs of neuronal degeneration in Onuf's nucleus with spontaneous activity and increased polyphasia (103-105). However, these findings do not reliably differentiate between MSA and other forms of APD. An abnormal anal sphincter examination was present in 5 of 12 (41.6 ) PSP patients (106). Furthermore, neurogenic changes of external anal sphincter muscle have also been demonstrated in advanced stages of PD by several investigators (107,108). Also chronic constipation, previous pelvic surgery, or vaginal deliveries can be confounding factors to induce nonspecific abnormalities (109). In summary, in patients with probable MSA, abnormal sphincter EMG, as compared to control subjects, has been found in the vast majority of patients,...

Management options

Initial management includes simple analgesics such as paracetamol and nonsteroidal anti-inflammatory drugs. Constipation (which causes straining) should be prevented if possible by avoiding opioids such as codeine or by offering lactulose. Although dehydration can exacerbate the headache, there is no evidence that overhydration has a beneficial effect. Other medical management includes oral caffeine 150-300 mg 6-8 hourly, which has been shown to improve the symptoms although not cure them. Caffeine may cause nausea and vomiting in overdosage and has been implicated in convulsions occurring after dural puncture. Successful use of the anti-migraine serotonin-receptor agonist sumatriptan (6mg subcutaneously) has been described anecdotally, as has adrenocorticotrophic hormone (ACTH 1-5mU kg in 1000-2000ml saline given intravenously over one hour). However, despite anecdotal reports of ACTH's synthetic analogue Synacthen being successful, a randomised controlled trial found no benefit of...

Cardinal Signs and Symptoms

This sets up a vicious cycle of constipation, which only exacerbates the condition. Bleeding is generally self-limited and of low volume, spotting the toilet tissue or coating the stool surface. Repeated trauma at the site may cause intermittent bleeding. Patients may also develop discharge and pruritis.

Management

Monitoring should continue until sufficient breathing, coughing, and swallowing ability have returned so that apnea and aspiration are unlikely to occur. The need for nutritional support can require gavage feeding, intravenous glucose and electrolytes, and sometimes hyperalimentation. Because bladder atony is often present, the bladder should be emptied frequently by Crede method. Tube feeding may stimulate peristalsis and has been used successfully in most patients. Patients should not be fed by mouth until they are able to gag and swallow. The patients should receive mother's milk, if available. Otherwise, formula without added iron is the next choice. Intravenous feeding has been used as a last resort. To reduce the quantity of C. botulinum organisms and toxin in the intestine, cathartic agents or bulk laxatives may be judiciously administered if adynamic ileus is absent, but rarely have these proved efficacious.

Symptoms And Signs

The incubation time of poliomyelitis is usually 7-14 days, but may vary from 4 to more than 30 days. The disease typically starts with a prodromal phase of a few days' duration. The patient has fever and complains of myalgia. Constipation is a common feature. This phase ('minor disease') is usually followed by an interval of a few days when temperature becomes normal and the patient seems to recover. The temperature then increases again with the development of paralysis and frequently also aseptic meningitis. Such a biphasic course is especially common in children. The second phase is initially characterized by hyperirritability and increased tendon reflexes. This may last from several hours to a few days, leading to the paralytic stage with loss of tendon reflexes. The paralysis is flaccid and most frequently affects the extremities, but any voluntary muscle (group) may be involved. The development of paralysis may take some hours or a few days. During the initial phase of the...

Ghrelin Antagonists

Introduction - Gut dysmotility involves both myogenic and neuronal mechanisms corresponding to modifications of smooth muscle contractility (phasic or tonic contractions) or motor coordination (altered motor pattern). Prokinetic agents are drugs able to stimulate smooth muscle contractility or to modulate gastroduodenal motor coordination. These actions are of particular interest in the treatment of 1) dyspesia, a major gastroduodenal disorder centered in the upper abdomen where gastrointestinal hypomotility is often associated with symptoms such as discomfort or pain and 2) constipation which is defined by a lower gastrointestinal (bowel) transit impairment ending in altered stools or defecations.

Procedure

Elective colon surgery requires bowel preparation. The goal of bowel preparation is to diminish the bacterial load logarithmically. The mechanical portion of the prep is accomplished by oral laxatives, which have replaced old-fashioned enema preps. The oral prep may be performed with a high volume solution of polyethylene glycol plus electrolytes, with Fleets phospho-soda solution, or with magnesium citrate. Additional antimicrobial preparation is achieved via the oral intake of poorly absorbed antibiotics such as neomycin and erythromycin base. Preoperative bowel preparation has lowered infectious complications of colon surgery from double-digit rates to single-digit rates.

Abdominal

This is a chronic, localized, inflammatory process that often occurs weeks, months, or years after the integrity of the gastrointestinal mucosa is broken by surgery for acute appendicitis with perforation, or for perforated colonic diverticulitis, or by emergency surgery on the lower intestinal tract after trauma. Occasionally, abdominal actinomycosis may manifest without identifiable predisposing factors. The ileocecal region is involved most frequently (usually following appendicitis with perforation), with the formation of a mass lesion. The infection extends slowly to contiguous organs, especially the liver, and may involve retroperitoneal tissues, the spine, or the abdominal wall. Hepatic, renal, and splenic disseminations are uncommon complications (5). Persistent draining sinuses may form, and those involving the perianal region can simulate Crohn's disease or tuberculosis. The extensive fibrosis of actinomycotic lesions, presenting to the examiner as a mass, often suggests...

Pathophysiology

Despite the high prevalence of hemorrhoids, the exact etiology is still unclear. Detailed anatomic studies have demonstrated that sliding downward of the anal cushions is a likely etiology (7). The anal cushions are composed of blood vessels, smooth muscle, and elastic connective tissue within the submucosa. Hemorrhoids are associated with straining and irregular bowel habits. Although it is commonly believed that constipation is an important risk factor for the development of hemorrhoids, other studies have suggested that diarrheal disorders are more frequently associated with hemorrhoidal disease (8). Straining maneuvers related to diarrheal disease or constipation may cause engorgement of the anal cushions during defecation and tend to push the anal cushions out of the

Psychotic Disorders

Antipsychotic medications (such as haloperidol, thioridazine, or fluphen-azine) are prescribed to treat the hallucinations and delusions that frequently occur and may also help improve emotional expression. Most of these medications are taken by mouth, but seriously affected people may have to take them by injection. Antipsychotic medications can produce side effects such as muscle spasms, drowsiness, faintness, dry mouth, blurred vision, sensitivity to sunlight, and constipation. Some men who take these medications have difficulty with sexual function.

Opioid Analgesics

Thetics, administered by different ways (wound infiltration, peripheral nerve block, epidural or iv). Opioids should be used in a multimodal balanced analgesia approach that minimizes opioid requirement and the degree of their side effects 70, 71 . Optimal use of opioid analgesics requires a sound understanding of the general principles of opioid pharmacology, the pharmacological characteristics of each of the commonly used drugs and principles of administration. Fear of potential side effects has limited their use in many countries this cultural phenomenon seems now to be overcame by the effective opioid titration with the use of incremental doses and a careful monitoring of side effects this has largely increased their use both in adult patients and especially in children 68, 72 . The mechanism of action of opioid analgesics depends on the interaction of these molecules with specific receptors to which they bind and their intrinsic activity at that receptor 5 . The receptors have a...

Clinical Findings

In cases involving toxin types B and E, the gastrointestinal symptoms of nausea and vomiting may precede neurologic symptoms. Involvement of the gastrointestinal tract varies and is related somewhat to the toxin serotype. Types A and B, the most common causes of botulism in the U.S.A., cause abdominal complaints (e.g., abdominal pain, bloating, cramps, diarrhea) in approximately one-third of patients. These complaints are replaced quickly by constipation or obstipation. Type E produces more significant gastrointestinal complaints than do the other types.

Other Indications

GVHD may develop in immunocompromised individuals who receive transplants containing immunocompetent donor cells (52-54). Donor T cells are believed to induce an immune reaction against the recipient's issues, either immediately (acute GVHD) or with delayed onset (chronic GVHD). However, subpopulations other than cytotoxic T lymphocytes may be the mediators of the disease. Suppressor T cell numbers are also reduced (55). Anatomic locations most prominently involved are skin and the gastrointestinal mucosa, but other structures may be affected. Mortality may be as high as 60 of affected individuals, despite immunosuppressive therapy. Administration of thalidomide improved the clinical condition of about 50 of patients with chronic GVHD after bone marrow transplantation in whom other therapeutic regimens had failed, but improvement was noted in only 1 of 7 patients with acute GVHD (56). The dosing regimen explored in some of the anticancer trials is based on the pharmacokinetically...

Side Effects

As discussed above, thalidomide has been used for the treatment of leprosy, graft versus host disease, rheumatoid arthritis, aphthous ulcers associated with AIDS, and various dermatologic disorders. The side effects of thalidomide have been well documented and they include drowsiness, constipation, peripheral sensory neuropathy, swelling of the limbs, erythema of the limbs, hair loss, fever, rash, and amenorrhea. Dizziness and mood changes occurred in 33-100 of all patients. Other frequent adverse effects are xerostomia, increased appetite, loss of libido, nausea, pruritus, and menstruation abnormalities have been occasionally observed. The most serious of these side effects is peripheral neuropathy. Its incidence has been estimated to be approx 1 in patients treated for lepra reactions (81), 12 in rheumatoid arthritis (65), 22 in prurigo nodularis (66), and 25 in patients with discoid lupus erythematosus (67). Based on electrophysiologic studies the incidence was estimated at 21...

Alvimopan Entereg

In healthy subjects, the plasma concentration of 3 peaks h after ingestion 28 . The steady-state volume of distribution of 3 in humans is estimated to be 30 + 10 L kg with a mean terminal half-life ranging from 4.4 to 13.8 h 7 . The drug's oral bioavailability is approximately 6 and it plasma protein binding is 70-80 . Single and multiple oral doses of 3 (up to 18 mg) produced linear pharmacokinetics with Cmax values exceeding the Ki for opioid receptor binding, supporting a potential for systemically mediated activity of 3. In patients suffering from chronic constipation, the pharmacokinetics of 3 was similar to that seen in healthy control subjects although drug Cmin was somewhat elevated. Alvimopan has been studied for both acute (impact on gastrointestinal recovery following major abdominal surgery) and chronic (OBD) indications. In five randomized, placebo-controlled, Phase 3 clinical trials (four North American, one non-US) in bowel resection patients, oral 3 at 12 mg...

Organizations

Anticholinergic Drugs that block the effect of the hormone acetyl-choline in the body and are called anticholinergic drugs. These drugs include atropine, scopolamine, Ditro-pan, etc. and are used to slow the heart rate down, dry secretions, and reduce the contractions of bowel and bladder. These drugs produce dryness of the mouth and constipation as common side effects.

Colorectal Cancer

Each year about 57,000 people in the United States die from complications caused by colorectal cancer (CRC) and approximately 147,000 new cases are diagnosed. Moreover, at least 1 in 2 people worldwide will develop a benign colorectal tumor by the age of 70. In 10 of these cases, malignancy will develop and the cancer will spread to other sites. Colorectal cancer need not be life threatening if it is detected early and the tumor(s) is removed surgically. The initial signs of CRC are blood in the stool, diarrhea or constipation, and a persistent dull abdominal pain.

Lubiprostone

(Chronic idiopathic constipation) US (Chronic idiopathic constipation) US Chronic constipation is an affliction affecting 4-5 million Americans alone. When no specific cause is identified, it is classified as idiopathic. Dietary and lifestyle modifications are the first-line conventional approaches followed by the administration of laxatives. Unfortunately, chronic idiopathic constipation is frequently refractory to traditional therapy thus, the need for novel agents exists. Lubiprostone is a bicyclic fatty acid with a novel mechanism of action. Without affecting sodium and potassium ion concentrations, lubiprostone activates intestinal chloride ion channels, thereby, increasing intestinal water secretion and intestinal fluid chloride ion concentration. In basolateral membrane-permeabilized T84 gastrointestinal epithelial cells under chloride gradient conditions, lubiprostone concentration-dependently increased short-circuit current with an EC5o of approximately 20 nM. Lubiprostone...

Other Side Effects

Gastrointestinal side effects include loss of appetite, nausea, vomiting and taste disturbances (15-25 ). A retrospective survey of diarrhoea episodes in treated diabetic patients was carried out by Dandona et al. (1983). Of 265 patients investigated, 30 reported diarrhoea or alternating diarrhoea and constipation 11 from 54 taking metformin 9 from 45 taking metformin with a sulphonylurea 3 from 53 taking a sulphonylurea only 5 from 78 on insulin therapy 2 from 35 on diet alone. Of 150 non-diabetic controls, 12 reported having diarrhoea (Dandona et al., 1983).

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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