[Chronic, non-infectious diarrhea: diagnostics and therapy]
Deutsche Medizinische Wochenschrift (1946)
|September 20, 2016
Summary
Chronic diarrhea management involves identifying triggers and symptoms. New treatments like Eluxadolin offer options alongside existing therapies and dietary changes for gastrointestinal disorders.
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Chronic non-infectious diarrhea stems from diverse gastrointestinal diseases.
- Identifying warning signs and triggers is crucial during patient history.
- Fecal calprotectin aids in distinguishing organic from functional disorders but lacks specificity.
Purpose of the Study:
- To review current and emerging therapeutic strategies for chronic diarrhea.
- To highlight novel treatment options for refractory cases, including Irritable Bowel Syndrome with Diarrhea (IBS-D).
Main Methods:
- Literature review of symptomatic treatments for chronic diarrhea.
- Analysis of pharmacological interventions targeting the enteric nervous system.
- Evaluation of dietary interventions and their efficacy.
Main Results:
- Symptomatic treatments include gelling fibers, Loperamide, Cholestyramine, and probiotics.
- Racecadotril has limited long-term data for chronic use.
- Eluxadolin offers a new approach by modulating enteric opioid receptors.
- For IBS-D, options include 5-HT3 antagonists, Rifaximin, and low-dose TCAs.
- Low-FODMAP diets show symptom relief in IBS.
Conclusions:
- A multi-faceted approach is necessary for managing chronic diarrhea.
- Eluxadolin represents a promising new therapeutic avenue.
- Dietary modifications and targeted pharmacological agents are key for IBS-D management.
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