Reviews in gastroenterological disorders
-
Rev Gastroenterol Disord · Jan 2009
ReviewMethylnaltrexone bromide: new drug for the treatment of opioid-induced bowel dysfunction.
Constipation is a common problem associated with opiates and opioid compounds used for the treatment of pain and other medical conditions, and can influence patient quality of life. Methylnaltrexone appears effective in the therapy of opioid-induced constipation and will be useful for patients failing to respond to traditional laxative regimens.
-
Rev Gastroenterol Disord · Jan 2009
ReviewDefinitive therapy for internal hemorrhoids--new opportunities and options.
Hemorrhoids are common in Western societies. Appropriate assessment and treatment of symptomatic hemorrhoids can substantially reduce morbidity and improve patient well-being. In this article, the clinical presentation, differential diagnoses, and current treatment options, including the CRH-O'Regan banding device, an emerging technology for the anoscopic treatment of symptomatic internal hemorrhoids, are reviewed.
-
Loperamide is an effective therapy for a variety of diarrheal syndromes, including acute, nonspecific (infectious) diarrhea; traveler's diarrhea; and chemotherapy-related and protease inhibitor?associated diarrhea. Loperamide is effective for the "gut-directed" symptom of diarrhea in patients with painless diarrhea or diarrhea-predominant irritable bowel syndrome. ⋯ Loperamide has also been observed to increase anal sphincter tone, which may lead to improvement of fecal continence in patients with and without diarrhea. Loperamide is generally well tolerated at recommended nonprescription doses, with the most common side effects related to the impact on bowel motility (abdominal pain, distention, bloating, nausea, vomiting, and constipation).
-
Rev Gastroenterol Disord · Jan 2007
ReviewClinical perspectives in Crohn's disease. Moving forward with anti-TNF-alpha therapy: current needs and future treatments.
Although infliximab continues to make an important contribution to the management of Crohn's disease, its use includes several clinical challenges, including loss of response, loss of tolerability due to acute and delayed infusion reactions, and the need for intravenous administration by a health care provider. Newer anti-tumor necrosis factor-a agents such as certolizumab pegol and adalimumab have been shown in clinical trials to have similar efficacy as infliximab, without the acute and delayed infusion reactions. Further information is needed about infliximab, certolizumab pegol, and adalimumab so we can understand the relationships among these 3 agents in terms of antibody formation, drug concentration, dosing (episodic vs systematic maintenance), concomitant immunosuppressive therapy, and efficacy.