Double-blind placebo-controlled study of loperamide (Imodium) in chronic diarrhoea caused by ileocolic disease or resection.

Mainguet, P.; Fiasse, René

doi:10.1136/gut.18.7.575

Cited by 44 publications

(17 citation statements)

References 5 publications

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“…288,304 Loperamide has proven efficacious and safe in several randomised, placebo-controlled trials in patients with chronic diarrhoea, in particular abolishing faecal incontinence. [306][307][308][309] Are bile acid binding agents effective in MC? Recommendation 5.7: In patients with MC and bile acid diarrhoea we suggest treatment with bile acid binders.…”

Section: Diagnosis Of MC What Is the Endoscopic Appearance Of Mc?mentioning

confidence: 99%

European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

et al. 2021

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Introduction Microscopic colitis is a chronic inflammatory bowel disease characterised by normal or almost normal endoscopic appearance of the colon, chronic watery, non-bloody diarrhoea and distinct histological abnormalities, which identify three histological subtypes, the collagenous colitis, the lymphocytic colitis and the incomplete microscopic colitis. With ongoing uncertainties and new developments in the clinical management of microscopic colitis, there is a need for evidence-based guidelines to improve the medical care of patients suffering from this disorder. Methods Guidelines were developed by members from the European Microscopic Colitis Group and United European Gastroenterology in accordance with the Appraisal of Guidelines for Research and Evaluation II instrument. Following a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the certainty of the evidence. Statements and recommendations were developed by working groups consisting of gastroenterologists, pathologists and basic scientists, and voted upon using the Delphi method. Results These guidelines provide information on epidemiology and risk factors of microscopic colitis, as well as evidence-based statements and recommendations on diagnostic criteria and treatment options, including oral budesonide, bile acid binders, immunomodulators and biologics. Recommendations on the clinical management of microscopic colitis are provided based on evidence, expert opinion and best clinical practice. Conclusion These guidelines may support clinicians worldwide to improve the clinical management of patients with microscopic colitis.

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Section: Diagnosis Of MC What Is the Endoscopic Appearance Of Mc?mentioning

confidence: 99%

European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

et al. 2021

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“…Peripheral agonists, such as loperamide and asimadoline, for example, have been developed for the treatment of diarrhea and irritable bowel syndrome, respectively (asimadoline: Mangel et al, 2008; Loperamide: Mainguet and Fiasse, 1977;Shannon and Lutz, 2002). Peripherally acting antagonists, on the other hand, such as methylnaltrexone (Yuan and Foss, 2000) and naloxegol, a pegylated form of naloxol (Chey et al, 2014), can block some of the peripheral side effects of centrally acting agonists.…”

Section: Introductionmentioning

confidence: 99%

Preferential Delivery of an Opioid Antagonist to the Fetal Brain in Pregnant Mice

Oberdick

Ling

Phelps

et al. 2016

Journal of Pharmacology and Experimental Therapeutics

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Prolonged fetal exposure to opioids results in neonatal abstinence syndrome (NAS), a major medical problem requiring intensive care and increased hospitalization times for newborns with NAS. Multiple strategies are currently available to alleviate withdrawal in infants with NAS. To prevent NAS caused by opioid maintenance programs in pregnant women, blocking fetal dependence without compromising the mother's opiate therapy is desirable. Here we tested in pregnant mice whether a peripherally selective opioid antagonist can preferentially enter the fetal brain and, thereby, in principle, selectively protect the fetus. We show using mass spectrometry that 6b-naltrexol, a neutral opioid antagonist with very limited ability to cross the bloodbrain barrier (BBB), readily crosses the placental barrier and enters the fetal brain at high levels, although it is relatively excluded from the maternal brain. Furthermore, owing to the late development of the BBB in postnatal mice, we show that 6b-naltrexol can readily enter the juvenile mouse brain until at least postnatal day 14. Taking advantage of this observation, we show that long-term exposure to morphine starting in the second postnatal week causes robust and quantifiable dependence behaviors that are suppressed by concomitant administration of 6b-naltrexol with much greater potency (ID 50 0.022-0.044 mg/kg, or 1/500 the applied dose of morphine) than previously demonstrated for either the suppression of central nervous system opioid effects or the induction of withdrawal in adults. These results indicate that peripherally selective opioid antagonists capable of penetrating the placenta may be beneficial for preventing or reducing neonatal dependence and NAS in a dose range that should not interfere with maternal opioid maintenance.

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“…Kappa ( κ )‐opioid receptors have been shown to play a role in gastrointestinal propulsion and visceral sensation . Relevant to the pharmacology of opioids is the fact that loperamide, one of the most commonly used medications world‐wide, is a ( μ ) opioid receptor agonist . The history of loperamide is interesting in that it was originally considered a schedule II narcotic, was decontrolled in 1982, and then made available as an over‐the‐counter agent in 1988, as its limited blood‐brain barrier penetration made it safe for unrestricted use.…”

Section: Pharmacologymentioning

confidence: 99%

Emerging treatments in neurogastroenterology: eluxadoline – a new therapeutic option for diarrhea‐predominant IBS

Lacy

2015

Neurogastroenterology Motil

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Double-blind placebo-controlled study of loperamide (Imodium) in chronic diarrhoea caused by ileocolic disease or resection.

Cited by 44 publications

References 5 publications

European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

Preferential Delivery of an Opioid Antagonist to the Fetal Brain in Pregnant Mice

Emerging treatments in neurogastroenterology: eluxadoline – a new therapeutic option for diarrhea‐predominant IBS

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