1,721,168 research outputs found
The daily diary and the questionnaire are not equivalent for the evaluation of bowel habits
Full text linkCOLLABORATOR ITALIAN CONSTIPATION STUDY GROUP:
Bellini M, Biagi S, Costa F, De Bortoli N, Gambaccini D, Mammini C, Mumolo MG, Ricchiuti A, Marchi S, Bove A, Balzano A, Sormani MP, Bruzzi P, Battaglia E, Niola P, Verna C, Grassini M, Bocchini R, Cimatti M, Fornasari L, Montaletti I, Pazzi P, Alduini P, Berni I, Ceccarelli G, Bassotti G, Corazzi N, Morozzi B, Viegas LB, Pucciani F, Giani I, Ringressi N
What can be done pharmacologically for a subject with severe refractory constipation-predominant irritable bowel syndrome?
No full textThe use of prucalopride in real life for the treatment of constipation subtypes: Ups and downs
Full text linkPharmacological options in achalasia
No full textAchalasia is a common primary oesophageal motor disorder. Treatment has been based traditionally on a surgical approach: however, there is new evidence that some medical strategies may be of benefit. The purpose of the present article was to review the current medical management of achalasia. A Medline search identified original articles and reviews published in the English-language literature between 1966 and 1998. This search has revealed that the pharmacological treatment of achalasia is limited to some subgroups of patients (for example, early stages of the disease and elderly patients), and that nitrates, nifedipine, and botulinum toxin are the best studied and most effective compounds
Chronic Idiopathic Constipation in Adults: A Review on Current Guidelines and Emerging Treatment Options
Full text linkGabrio Bassotti,1 Paolo Usai Satta,2 Massimo Bellini3 1Gastroenterology & Hepatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; 2Gastrointestinal Unit, “G. Brotzu” Hospital, Cagliari, Italy; 3Gastrointestinal Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, ItalyCorrespondence: Gabrio BassottiClinica di Gastroenterologia ed Epatologia, Ospedale Santa Maria della Misericordia, Piazzale Menghini, 1, San Sisto (Perugia), 06156, ItalyEmail [email protected]: Chronic idiopathic constipation (CIC) is a common functional bowel disorder characterized by difficult, infrequent, and/or incomplete defecation. It has a great impact on the quality of life and on health care system and represents a heavy economic burden. The diagnosis is based on symptoms, classified by the Rome IV criteria. The aim of this review was to evaluate the current therapeutic guidelines for adult CIC and highlight new emerging treatments. In detail, European, French, Spanish and Korean guidelines have been identified and compared. Osmotic laxatives, and in particular polyethylene glycol, represent the first-line therapeutic approach. Stimulant laxatives are recommended as a second-line therapy. Pelvic floor rehabilitation is recommended in patients with ano-rectal dyssynergia. In patients who fail to improve with pharmacological therapies sacral nerve stimulation is considered as last chance before surgery. Surgical approach has however limited indications in selected cases. Inertia coli refractory to any approach and obstructed defecation are two subtypes which can benefit from surgery. Among emerging agents, prucalopride, a prokinetic agent, is recommended as a second-line treatment in refractory CIC patients. In addition, the secretagogues linaclotide and plecanatide and the bile acid transported inhibitor elobixibat can be effective in patients not responsive to a second-line therapeutic regimen, although they are not worldwide commercially available.Keywords: chronic idiopathic constipation, guidelines, osmotic laxatives, pelvic floor rehabilitation, prokinetics, secretagogue
Histopathological Aspects of Coeliac Disease
No full textCurrently, the diagnosis of coeliac disease (CD) is based on the combination of raised serum anti-tissue transglutaminase or antiendomysial antibodies and the presence of histological alterations of variable degree in the duodenal mucosa. Interpretation of duodenal biopsies depends on a number of variables - biopsy number, size, orientation, handling and staining - and the lack of standardisation may cause diagnostic controversy or even misdiagnosis. Biopsy handling and orientation are of utmost importance in order to avoid artifacts that may impair the pathologist's ability to detect pathology. Immunostaining with anti-CD3 monoclonal antibody should be carried out and a simplified histological classification may help to distinguish atrophic from non-atrophic stages of CD enteropathy, to differentiate it from other entities and from some complications as refractory CD and lymphoma. © 2011 Touch Briefings
Prucalopride: For functional constipation only?
Full text linkPrucalopride is a new prokinetic agent, recently available in Europe for the treatment of functional constipation in adults in whom treatment with laxatives failed to provide adequate relief. However, due to its intrinsic properties (highly selective agonist activity and high affinity for 5-HT4 receptors, neuroprotection), this drug has shown the potential to be used in other pathologic conditions, in and outside of the gastrointestinal tract. We performed a systematic review of the evidence supporting these possible alternative uses of prucalopride. Further studies in this area are, however, mandatory
Plecanatide for the treatment of chronic idiopathic constipation in adult patients
Full text linkIntroduction. Chronic idiopathic constipation (CIC) is a functional gastrointestinal disorder that is associated with an increased healthcare cost and an abnormally poor quality of life. Plecanatide is a natural analog to the peptide agonist of the guanylate cyclase-C (GC-C) receptor, uroguanylin. The conversion of guanosine 5-triphosphate to cyclic guanosine monophosphate results in an increased bowel fluid secretion. Plecanatide is a promising new agent for CIC unresponsive to current therapeutic regimes.Areas covered. A comprehensive online search of Medline and the Science Citation Index was made using the keywords 'plecanatide', 'guanylate cyclase-C agonists', and 'constipation', in various combinations. We reviewed the pharmacodynamics, pharmacokinetics, and metabolism of this agent, and the most significant studies regarding the clinical efficacy and safety of plecanatide in CIC therapy.Expert opinion. Experimental studies showed that plecanatide was significantly better than placebo in reducing CIC severity, straining, stool consistency, bowel movements and quality of life. Apart from limited cases of diarrhea, no serious adverse events were reported. However, few data are available on its long-term safety. Furthermore, patients' affordability of plecanatide can be limited by its costs. Finally, this new agent with a different way of action can be proposed in patients refractory to common therapy
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