Review article: an analysis of safety profiles of treatments for diarrhoea‐predominant irritable bowel syndrome

Lacy, Brian E.

doi:10.1111/apt.14948

Cited by 29 publications

(30 citation statements)

References 108 publications

(373 reference statements)

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“…It should be noted that IBD patients were excluded from the trials assessing these drugs. While alosetron is contraindicated in patients with IBD, eluxadoline is contraindicated in patients with previous cholecystectomy and can cause pancreatitis, which limits their use in IBD population[55,56].…”

Section: Ibd/irritable Bowel Syndrome Overlapmentioning

confidence: 99%

Gastrointestinal motility and absorptive disorders in patients with inflammatory bowel diseases: Prevalence, diagnosis and treatment

Barros

Farias

Rezaie

2019

WJG

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Inflammatory bowel diseases (IBD), Crohn`s disease and ulcerative colitis, are chronic conditions associated with high morbidity and healthcare costs. The natural history of IBD is variable and marked by alternating periods of flare and remission. Even though the use of newer therapeutic targets has been associated with higher rates of mucosal healing, a great proportion of IBD patients remain symptomatic despite effective control of inflammation. These symptoms may include but not limited to abdominal pain, dyspepsia, diarrhea, urgency, fecal incontinence, constipation or bloating. In this setting, commonly there is an overlap with gastrointestinal (GI) motility and absorptive disorders. Early recognition of these conditions greatly improves patient care and may decrease the risk of mistreatment. Therefore, in this review we describe the prevalence, diagnosis and treatment of GI motility and absorptive disorders that commonly affect patients with IBD.

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Section: Ibd/irritable Bowel Syndrome Overlapmentioning

confidence: 99%

Gastrointestinal motility and absorptive disorders in patients with inflammatory bowel diseases: Prevalence, diagnosis and treatment

Barros

Farias

Rezaie

2019

WJG

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“…Loperamide is an established and safe over the counter treatment for acute, chronic, and iatrogenic diarrhea . Like other mu opioid receptor agonists, loperamide increases intestinal transit time by decreasing propulsive activity and increasing non‐propulsive activity via its effect on the myenteric plexus in the muscularis propria, where mu opioid receptors have been identified in particular subsets of myenteric neurons .…”

Section: Discussionmentioning

confidence: 99%

“…Loperamide is an established and safe over the counter treatment for acute, chronic, and iatrogenic diarrhea. [1][2][3] where mu opioid receptors have been identified in particular subsets of myenteric neurons. 56 Indeed, loperamide gastrointestinal motor effects are sensitive to non-selective and selective mu opioid receptor antagonists (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Although 50‐fold more potent than morphine on mu opioid receptors, it displays low central nervous system (CNS) penetration at therapeutic doses. Indeed, it is considered a safe drug and is available over the counter in several oral forms for diarrhea treatment . It also improves continence in patients with ileo‐anal pouches and reduces dehydration and malnutrition in ileostomized patients .…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, it is considered a safe drug and is available over the counter in several oral forms for diarrhea treatment. 2,3 It also improves continence in patients with ileo-anal pouches 4 and reduces dehydration and malnutrition in ileostomized patients. 5 Gastrointestinal symptoms (nausea and constipation), urinary retention, drowsiness, dizziness, and headache may occur at therapeutic doses.…”

Section: Introductionmentioning

confidence: 99%

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Radiographic dose‐dependency study of loperamide effects on gastrointestinal motor function in the rat. Temporal relationship with nausea‐like behavior

Vera

Girón

Martín-Fontelles

et al. 2019

Neurogastroenterology Motil

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Background Loperamide is a potent mu opioid receptor agonist available over the counter to treat diarrhea. Although at therapeutic doses loperamide is devoid of central effects, it may exert them if used at high doses or combined with drugs that increase its systemic and/or central bioavailability. Recently, public health and scientific interest on loperamide has increased due to a growing trend of misuse and abuse, and consequent reports on its toxicity. Our aim was to evaluate in the rat the effects of increasing loperamide doses, with increasing likelihood to induce central effects, on gastrointestinal motor function (including gastric dysmotility and nausea‐like behavior). Methods Male Wistar rats received an intraperitoneal injection of vehicle or loperamide (0.1, 1, or 10 mg kg−1). Three sets of experiments were performed to evaluate: (a) central effects (somatic nociceptive thresholds, immobility time, core temperature, spontaneous locomotor activity); (b) general gastrointestinal motility (serial X‐rays were taken 0‐8 hours after intragastric barium administration and analyzed semiquantitatively, morphometrically, and densitometrically); and (c) bedding intake (a rodent indirect marker of nausea). Animals from sets 1 and 3 were used to evaluate gastric dysmotility ex vivo at 2 and 4 hours after administration, respectively. Key Results Loperamide significantly induced antinociception, hypothermia, and hypolocomotion (but not catalepsy) at high doses and dose‐dependently reduced gastrointestinal motor function, with the intestine exhibiting higher sensitivity than the stomach. Whereas bedding intake occurred early and transiently, gastric dysmotility was much more persistent. Conclusions and inferences Our results suggest that loperamide‐induced nausea and gastric dysmotility might be temporally dissociated.

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Multicultural factors in the treatment of patients with functional gastrointestinal disorders

Sperber

2020

Clinical and Basic Neurogastroenterology and Motility

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Review article: an analysis of safety profiles of treatments for diarrhoea‐predominant irritable bowel syndrome

Cited by 29 publications

References 108 publications

Gastrointestinal motility and absorptive disorders in patients with inflammatory bowel diseases: Prevalence, diagnosis and treatment

Gastrointestinal motility and absorptive disorders in patients with inflammatory bowel diseases: Prevalence, diagnosis and treatment

Radiographic dose‐dependency study of loperamide effects on gastrointestinal motor function in the rat. Temporal relationship with nausea‐like behavior

Multicultural factors in the treatment of patients with functional gastrointestinal disorders

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