Disorders of the Gastrointestinal Tract

Fagan, Elizabeth A.

doi:10.1002/9780470752371.ch10

Cited by 5 publications

(4 citation statements)

References 301 publications

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“…Previous detailed description of the natural history of severe hyperemesis is lacking and the present observations allow correction of the textbook definition of hyperemesis as 'severe vomiting of onset before 20 weeks gestation'. 11 Steroid therapy has been used for severe asthma and inflammatory bowel disease for many years, and many studies have not identified evidence of any harmful effect on the fetus. 12 -17 The transplacental passage of prednisolone is limited to around 10%.…”

Section: Discussionmentioning

confidence: 99%

Termination is not the treatment of choice for severe hyperemesis gravidarum: Successful management using prednisolone

2009

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Summary: Severe hyperemesis gravidarum causes profound maternal morbidity. Termination of pregnancy is still offered before the use of medical therapy. This report describes management of a woman who had undergone two previous terminations for hyperemesis, and additionally presents the dosage profile of prednisolone used to successfully manage a consecutive series of 33 women with severe hyperemesis gravidarum. The treatment protocol is described. The group had a median weight loss in pregnancy of 5.5 kg (range 2.0 -12.5 kg), had been admitted on a median of 3.0 (range 0 -9) occasions and had spent 7.5 (range 0 -25) days on i.v. fluids. Continuing vomiting prevented oral steroid therapy in 14 women and i.v. hydrocortisone (50 mg t.i.d.; two women required 100 mg t.i.d.) was used initially for 24-48 h. Nineteen women commenced prednisolone 10 mg t.i.d. and this achieved suppression of vomiting within 48 h in all but two women who required 15 mg t.i.d. Two distinct subtypes of hyperemesis gravidarum were identified. Remitting hyperemesis spontaneously ceases between 14 and 22 weeks gestation and accounts for approximately 80% of cases. In contrast, full-term hyperemesis persists until minutes after delivery. These separate sub-types have not previously been described. Steroid treatment of hyperemesis should be considered in women who fulfil the criteria of severe disease.

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Section: Discussionmentioning

confidence: 99%

Termination is not the treatment of choice for severe hyperemesis gravidarum: Successful management using prednisolone

2009

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“…Gastrointestinal symptoms and/or disorders are common in pregnant women (Fagan 2002) and can be divided into two groups. The first group includes gastrointestinal disorders specific to pregnancy, such as nausea, vomiting and hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, and preeclampsia.…”

Section: Introductionmentioning

confidence: 99%

“…Constipation is one of the most frequent pathological conditions affecting 11-38% of pregnant women (Welsh 2005). However, some clinical reports have mentioned the complaint of constipation in over half of pregnant women (Fagan 2002). Sometimes the management of constipation through diet is not effective, and drug treatment is necessary.…”

Section: Introductionmentioning

confidence: 99%

No association between severe constipation with related drug treatment in pregnant women and congenital abnormalities in their offspring: A population‐based case‐control study

Ács

Bánhidy

Puhó

et al. 2010

Congenital Anomalies

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Constipation is a common pathological condition in pregnant women; nevertheless, its possible association with structural birth defects (i.e. congenital abnormalities [CA]) in their offspring has not been studied in controlled epidemiological studies. We evaluated the possible association between severe constipation with laxative treatment in pregnant women and congenital abnormalities in their offspring. The dataset of the population-based Hungarian Case-Control Surveillance System of Congenital Abnormalities (HCCSCA) 1980-1996 contained 22 843 cases with CA and 38 151 matched controls without CA. Only pregnant women with prospectively and medically recorded constipation were included in the study and 13 CA groups were compared in cases and all their matched controls. A total of 78 (0.34%) cases had mothers with severe constipation and treatment during pregnancy compared to 144 (0.38%) controls (adjusted OR with 95% CI = 1.0, 0.7-1.3). Specified groups of CA were also assessed versus controls, but a higher occurrence of pregnant women with severe constipation and related treatment was not found in any CA group. Among laxative drugs, senna has no teratogenic potential; thus, if severe constipation requires laxative drug treatment in pregnant women, senna is not contraindicated. A higher rate of CA was not found in the offspring of pregnant women with severe constipation and related senna treatment.

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“…rritable bowel syndrome might be associated with gastric and duodenal ulcers and inflammation of the gastrointestinal tract (1,2). Antacids are the most widely recommended drugs for treatment of the gastrointestinal tract (3).…”

mentioning

confidence: 99%

Mebeverine HCl and Aluminium/Magnesium Antacid Interactions: A Potential Impact on Electrolyte Replacement Therapy

Aleanizy¹,

Tahir²,

Alqahtani³

et al. 2018

Dissolution Technol.

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When antacids are administered with other drugs, they can alter the absorption, bioavailability, and/or excretion of concomitantly administered drugs. This study aims to characterize the in vitro interaction between different formulations of mebeverine HCl and magnesium trisilicate antacids and salts used for electrolyte-replacement therapy. The dissolution profiles of different formulations of mebeverine alone and in the presence of aluminium/magnesiumcontaining antacids and salts were studied. The release profiles of the drugs and the model and mechanisms of drug release were determined using differential scanning calorimetry and infrared techniques. The loss of mebeverine HCl in each case appeared to be caused by absorption. The calorimetry and infrared results suggest that mebeverine HCl interacts with the antacids and with Movicol. These results should be added to the in vitro drug-drug interaction chart. It is advisable to administer other drugs at least 0.5-1.0 h before antacid ingestion to ensure consistent absorption and effect and to avoid potential interactions.

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Disorders of the Gastrointestinal Tract

Cited by 5 publications

References 301 publications

Termination is not the treatment of choice for severe hyperemesis gravidarum: Successful management using prednisolone

Termination is not the treatment of choice for severe hyperemesis gravidarum: Successful management using prednisolone

No association between severe constipation with related drug treatment in pregnant women and congenital abnormalities in their offspring: A population‐based case‐control study

Mebeverine HCl and Aluminium/Magnesium Antacid Interactions: A Potential Impact on Electrolyte Replacement Therapy

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