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Acute diarrhea, a common gastrointestinal disturbance, is characterized by the rapid evacuation of fluid stools, leading to an excessive weight in fluid. This condition typically arises from disorders affecting intestinal water and electrolyte transport. It can be triggered by an increased osmotic load within the intestine, excessive secretion of electrolytes and water, mucosal exudation of protein and fluid, or altered intestinal motility. The primary risks of acute diarrhea are dehydration...
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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.
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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
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Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
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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...
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Concomitant Vancomycin-Resistant Enterococcus faecium and Clostridium difficile Colitis.

Shehriyar Mehershahi1, Haider Ghazanfar2, Shoaib Ashraf2

  • 1Department of Gastroenterology, Bronxcare Health System, Bronx, New York, USA.

Case Reports in Gastroenterology
|April 1, 2021
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Summary
This summary is machine-generated.

Vancomycin-resistant Enterococcus faecium (VRE) can cause severe colitis, a rare but serious gastrointestinal disease. This case highlights the need for VRE surveillance in hospitals to prevent its spread.

Keywords:
Clostridium difficileColitisIntensive care unitVancomycin-resistant Enterococcus faecium

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Colitis, an inflammation of the colon lining, is often caused by infections and can lead to severe illness.
  • Vancomycin-resistant Enterococcus faecium (VRE) is an increasingly prevalent hospital-acquired pathogen.
  • VRE is a rare but significant cause of infectious colitis.

Observation:

  • A 32-year-old man developed severe diarrhea and colitis symptoms despite antibiotic treatment for pneumonia and Clostridium difficile infection.
  • Colonoscopy revealed extensive inflammation, ulceration, and bleeding in the colon.
  • Biopsy confirmed the presence of VRE as the causative agent.

Findings:

  • The patient's persistent colitis symptoms were attributed to VRE infection.
  • VRE-associated colitis presents with severe mucosal abnormalities, including ulceration and hemorrhage.
  • No established effective treatment currently exists for VRE infections.

Implications:

  • This case underscores the importance of considering VRE in refractory infectious colitis, especially in hospitalized patients.
  • Active surveillance programs are crucial for early detection and containment of VRE transmission within healthcare settings.
  • Further research into effective VRE treatments is urgently needed to address this growing public health concern.