Presentation
Often 2 or more mechanisms are present simultaneously. [ncbi.nlm.nih.gov]
That didn’t exactly describe the tsunami that his problems presented! “He decided to quit taking his beloved Cialis. Lo and behold! His digestive tract improved: No more Questran, no more Reglan, Librax, or other drugs.” [peoplespharmacy.com]
Clinical presentations • Mild diarrhoea to pseudomembranous colitis, characterized by a watery diarrhoea • Fever • Leucocytosis • presence of pseudomembranes on endoscopic examination Severe complications include - • Toxic megacolon • Perforation • Shock [slideshare.net]
Four weeks before presentation she started having diarrhea. She had no history of fever or night sweats. [archivesofrheumatology.org]
Entire Body System
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Fatigue
C 17, 18 Testing for celiac disease should be considered in patients with irritable bowel syndrome, type 1 diabetes mellitus, thyroid disease, iron deficiency anemia, weight loss, infertility, elevated liver transaminase levels, and chronic fatigue. [aafp.org]
[…] by the World Health Organization as “the passage of 3 or more loose or liquid stools per day, or more frequently than normal for the individual.” 2 This disease is associated with several symptoms, including abdominal cramps, fever, nausea, vomiting, fatigue [pharmacytimes.com]
Warning signs (for liver injury) Severe fatigue. Abdominal pain and swelling. Jaundice (yellow eyes and skin, dark urine). Fever. Nausea or vomiting. [healingwell.com]
Gastrointestinal
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Diarrhea
Abstract Many drugs have been known to cause diarrhea, although their mechanism of action has not been well described. [ncbi.nlm.nih.gov]
What to Do When Diarrhea Appears? If diarrhea is due to a remedy, this should be discontinued until diarrhea stops. Next time the remedy can be tried in lower amount. [healthhype.com]
Osmotic diarrhea Osmotic diarrheas can occur from intentional use of a drug as part of its mechanism of action, or unintentionally. [abdominalkey.com]
Drug-induced diarrhea is loose, watery stools that occurs when you take certain medicines. Nearly all medicines may cause diarrhea as a side effect. The drugs listed below, however, are more likely to cause diarrhea. [medlineplus.gov]
Definition Drug-induced diarrhea is loose, watery stools that occurs when you take certain medicines. Alternative Names Diarrhea associated with medicines Causes Nearly all medicines may cause diarrhea as a side effect. [mclarenhealthplan.org]
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Chronic Diarrhea
Moreover, identification of a drug as a cause of chronic diarrhea is a challenge in patients taking multiple medications. [journals.lww.com]
Cirkan-induced chronic diarrhea. Gastroenterol Clin Biol 1992; 16: 373 PubMed Google Scholar 112. Raoul JL, Dautreme S, Heresbach N, et al. Chronic diarrhea during treatment with Veinotonyl 75. [link.springer.com]
Laxatives Laxatives abuse, often by people with chronic constipation, regularly causes chronic diarrhea. Antacids Antacids containing magnesium may cause diarrhea by stimulating bowel motility (peristalsis). [healthhype.com]
He was a seemingly healthy man suffering severe, chronic diarrhea that caused him to lose 30 pounds. He changed his eating habits, trying gluten-free, lactose-free diets, but nothing made a difference. [peoplespharmacy.com]
Unfortunately, it is not only difficult to determine the true cause of chronic diarrhea, but is expensive as well. [empr.com]
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Nausea
The most commonly reported adverse effects include abdominal cramps, mild nausea, injection site reactions and hypoglycemia (at high doses.) [healio.com]
Other possible causes of diarrhea include: Radiation to abdomen or pelvis Anxiety or stress Surgery on the small or large bowel or pelvis Infection Antibiotics, Antacids containing magnesium, anti-nausea medicines, laxatives, or stool softeners Lactose [chemocare.com]
Cleveland Clinic Journal of Medicine. 2015 October;82(10):671-676 A 56-year-old man presents to the emergency department with nausea, weakness, and exertional dyspnea, which have been going on for 1 week. [mdedge.com]
Symptoms of viral gastroenteritis typically last only 48-72 hours and include: nausea, vomiting, abdominal cramps, and diarrhea. [medicinenet.com]
In such conditions, you may experience: Foul smelling diarrhea Abdominal cramps Nausea and vomiting Low-grade fever Loss of appetite Pus or blood in the stools Antibiotic-associated diarrhea often begins about a week after you start taking an antibiotic [gleneaglesglobalhospitals.com]
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Abdominal Pain
He has had diarrhea with intermittent abdominal pain over the past year, with 10 stools daily, including 3 or 4 at night. The stools are described as large, nonbloody, sticky, greasy, and occasionally watery. [mdedge.com]
Abdominal pain, diarrhea, fever, perianal fistulae, and stools positive for blood are common, although bloody diarrhea is unusual. The diagnosis of IBD is usually supported by colonoscopy. [aafp.org]
Typical symptoms range from slightly loose stools to bloody diarrhea, abdominal pain, and fever. [msdmanuals.com]
Motility related diarrhea is more likely to be associated with cramping abdominal pain. Inflammatory diarrhea often is associated with crampy abdominal pain as well as signs of inflammation, for example, fever, and abdominal tenderness. [medicinenet.com]
Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders characterized by lower abdominal pain, disturbed defecation, and bloating. Many nongastrointestinal manifestations also exist with IBS. [accesspharmacy.mhmedical.com]
Neurologic
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Headache
Topiramate is approved for the treatment of seizure, as a migraine headache prophylaxis, and for weight loss, with off-label use for bipolar disorder, obesity, neuropathic pain, and smoking cessation 31. It inhibits CA II, IV, and XII 31. [f1000research.com]
Workup
This workup should include complete blood count, examination of stool for occult blood, metabolic panel to assess electrolyte levels, BUN/creatinine, albumin, stool cultures for enteric pathogens, C difficile, and ova and parasites, and a flat plate of [oncology.tv]
Workup for Suspected IBD Figure 2. Workup for suspected inflammatory bowel disease (IBD) in adults. Adapted with permission from van Rheenen PF, Van de Vijver E, Fidler V. [aafp.org]
Colonoscopy
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Colitis
Acute colitis related to spiramycin. Lancet 1978; II: 993 CrossRef Google Scholar 50. David XR, Pierrugues R, Michel H. Acute hemorrhagic colitis related to oral administration of cephalosporin. [link.springer.com]
In some cases, antibiotics can allow a type of bacteria called Clostridium difficile to grow too much. • This can lead to severe, watery, and often bloody diarrhea called pseudomembranous colitis. 6. [slideshare.net]
The disease spectrum of antimicrobial-associated diarrhoea ranges from benign diarrhoea to pseudomembranous colitis. [ncbi.nlm.nih.gov]
Chemotherapy can result in diffuse or segmental colitis, whereas olmesartan and a few other medications infrequently induce a disease that mimics celiac disease, but is not associated with gluten intolerance. [journals.lww.com]
This can lead to severe, watery, and often bloody diarrhea called pseudomembranous colitis. Many other drugs may cause diarrhea: Chemotherapy medicines used to treat cancer. [medlineplus.gov]
Treatment
Treatment of AAD • Rehydration • Drug therapy • Probiotics 10. [slideshare.net]
Diarrhea can easily be managed by loperamide, dose reduction or treatment interruptions [41]. [abdominalkey.com]
Treatment may vary depending on this classification and usually includes withdrawal of the offending drug. [ncbi.nlm.nih.gov]
Benson, AB III, Ajani, JA, Catalano, RB, et al.: Recommended guidelines for the treatment of cancer treatment-induced diarrhea. J Clin Oncol 2004, 22: 2918–2926. PubMed CrossRef Google Scholar 35. [link.springer.com]
Etiology
Etiology Each case of diarrhea has either an infectious or noninfectious etiology. Infectious causes include the transmission of viral, bacterial, or parasitic pathogens (Table 2 1 ). [pharmacytimes.com]
Sensor, a population-based cohort study on gastroenteritis in the Netherlands: Incidence and etiology. Am J Epidemiol 2001;154:666-74. Dial S, Alrasadi K, Manoukian C, et al. [wikidoc.org]
An often unrecognized etiology? Therapie 1993; 48: 494–5 PubMed Google Scholar 213. Talal AH, Murray JA. Acute and chronic diarrhea. How to keep laboratory testing to a minimum. Postgrad Med 1994; 96: 30–8 PubMed Google Scholar 214. [link.springer.com]
Celiac Disease: Etiology, Diagnosis, and Treatment. New York, NY: Nova Biomedical Books; 2009: 95–146. 25. Volta U, Granito A, Parisi C, et al. Deamidated gliadin peptide antibodies as a routine test for celiac disease: a prospective analysis. [aafp.org]
Epidemiology
He is a specialist in Internal Medicine with training in Clinical Epidemiology and Gastroenterology who has been the lead investigator in the design and implementation of randomized controlled trials since 1986. [books.google.com]
Epidemiology, risk factors and treatments for antibiotic-associated diarrhea. Dig Dis 1998;16:292-307. McInnes GT, Lawson DH, Jick H. Acute adverse reactions attributed to allopurinol in hospitalized patients. Ann Rheum Dis 1981;40:245-9. [wikidoc.org]
Pathophysiology
Several pathophysiological mechanisms are involved in drug-induced diarrhoea: osmotic diarrhoea, secretory diarrhoea, shortened transit time, exudative diarrhoea and protein-losing enteropathy, and malabsorption or maldigestion of fat and carbohydrates [ncbi.nlm.nih.gov]
This article aims to review drug-induced diarrhea to (a) understand known pathophysiological mechanisms; (b) assess the risk associated with frequently prescribed medications, and discuss the pathogenesis; and (c) provide easily retrievable data in tables [journals.lww.com]
Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 16. Seller RH, Symons AB. Diarrhea. In: Seller RH, Symons AB, eds. [medlineplus.gov]
Prevention
Prevention To prevent diarrhea due to antibiotic use, talk to your health care provider about taking supplements containing healthy bacteria (probiotics) and/or eating yogurt. Some of these products may reduce the risk for diarrhea. [mclarenhealthplan.org]
Prevention of AAD • Taking supplements containing healthy bacteria (probiotics) • Limit antibiotic use • In the case of C difficile related diarrhoea hygiene measures- • use of gloves • Handwashing etc. [slideshare.net]
Now in its second edition, this popular and essential comprehensive resource provides a detailed analysis of how to identify, prevent, and manage drug-induced diseases. Edited by James E. Tisdale and Douglas A. [books.google.com]
To prevent diarrhea due to antibiotic use, talk to your health care provider about taking supplements containing healthy bacteria (probiotics) and/or eating yogurt. Some of these products may reduce the risk for diarrhea. [medlineplus.gov]