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Drugs for Treatment of Constipation-Predominant IBS

Drugs for Treatment of Constipation-Predominant IBS

Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...

Drugs for Treatment of Diarrhea-Predominant IBS

Drugs for Treatment of Diarrhea-Predominant IBS

Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...

Drugs Affecting GI Tract Motility: Serotonin Receptor Agonists

Drugs Affecting GI Tract Motility: Serotonin Receptor Agonists

Serotonin, a crucial neurotransmitter synthesized by enterochromaffin cells, plays a cardinal role in regulating gastrointestinal (GI) motility. With over 90% of the body's total serotonin in the GI tract, its influence on digestive processes is profound. Serotonin is swiftly released upon various stimuli, such as food boluses or certain drugs, triggering intrinsic sensory neurons in the myenteric plexus and extrinsic vagal and spinal sensory neurons. This leads to the activation of the...

Drugs Affecting GI Tract Motility: Other Laxatives

Drugs Affecting GI Tract Motility: Other Laxatives

Laxatives are primarily used to alleviate constipation, a common gastrointestinal disorder characterized by infrequent bowel movements and difficulty passing stools. They work by various mechanisms to increase the volume or frequency of bowel movements. The primary modes of action of laxatives include increasing stool bulk, softening the stool, stimulating intestinal motility, and osmotically drawing water into the intestines.
Osmotic or saline laxatives, like magnesium hydroxide or milk of...

Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents

Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents

Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...

Drugs Affecting GI Tract Motility: Bulk-Forming and Stimulant Laxatives

Drugs Affecting GI Tract Motility: Bulk-Forming and Stimulant Laxatives

Laxatives enhance bowel movements and alleviate constipation. They augment the stool's bulk, stimulate intestinal muscle contractions, draw water into the intestines, or soften the stool. There are five key types of laxatives: bulk laxatives, stimulant laxatives, osmotic laxatives, stool softeners, and lubricant laxatives.
Bulk-forming laxatives, such as psyllium, methylcellulose, and polycarbophil, absorb water in the intestine, increasing stool bulk and promoting bowel movement. This makes...

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Life-threatening constipation associated with clozapine.

Sanil Rege¹, Tim Lafferty

¹Consultation Liaison Psychiatry, Wyong Mental Health Unit, Wyong Hospital, NSW, Australia.

Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists

|June 24, 2008

Summary

This summary is machine-generated.

Clozapine, an antipsychotic, can cause severe, life-threatening constipation. This case highlights the critical need for vigilance regarding this serious adverse effect in patients undergoing treatment.

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Area of Science:

Psychiatry
Gastroenterology
Pharmacology

Background:

Clozapine is an essential antipsychotic medication used for treatment-resistant schizophrenia and schizoaffective disorder.
Gastrointestinal hypomotility is a known, yet often underestimated, side effect of clozapine therapy.
Early recognition and management of clozapine-induced constipation are crucial to prevent severe complications.

Observation:

A case report detailing a 53-year-old male patient with schizoaffective disorder treated with clozapine for over a year.
The patient presented with severe abdominal pain and bilious vomiting, indicative of gastrointestinal distress.
Surgical intervention revealed extensive fecal impaction in both the large and small intestines.

Findings:

Clozapine cessation was followed by psychiatric management challenges.
Reintroduction of clozapine, even with laxative use, led to recurrent severe constipation and fecal impaction.
This case underscores a direct and serious association between clozapine and severe gastrointestinal issues.

Implications:

Healthcare providers, including psychiatrists, physicians, surgeons, and radiologists, must be aware of clozapine-induced constipation.
Prompt identification and proactive management strategies are essential to mitigate potentially fatal outcomes.
Consideration of gastrointestinal side effects should be routine in patients prescribed clozapine, necessitating multidisciplinary collaboration.