Constipation & Diarrhea F12 (1)

Acute diarrhea including travelers diarrhea should

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Acute diarrhea (including traveler’s diarrhea) Should not be used in children < 12 yr • Reye’s syndrome Do not use in patients with aspirin allergy Do not use in pregnant females Should not use for > 48 hr
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Bismuth Subsalicylate Adverse effects Black stool or darkening of the tongue Harmless
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Lactase Enzyme Preparations Lactaid® Useful in patients with are lactose intolerant Can be taken with dairy products to prevent osmotic diarrhea
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Probiotics Definition Live microorganisms which confer a health benefit to the host when taken in adequate amounts Dosing Wide range Colony forming units (CFU) Strains Lactobacillus Bifodobacterium Streptococci
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Some Additional Information For  You  Probiotics are dietary supplements, so they: Must have this label (I taught this lecture last week) “This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent disease.” Prohibits: “health” claims Relationship between a food or dietary supplement and a reduction in a disease or condition – Ex: “Improves symptoms of depression” Permits: “structure-function” claims Relationship between a product and how it maintains normal healthy structure or function of the body – Ex: “May help enhance mood”
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Probiotic Products Activia® Bifidus regularis Yogurt and drink products “Reduces intestinal transit time” Align® Bifidobacterium infantis 35624 Capsule with 1 X 10 9 CFU (28 capsules/packet) One capsule daily “Promotes a healthy digestive system”; “Restores natural balance” VSL #3® 8 strains of bacteria (450 billion bacteria/packet) Medical food Bifidobacteria, Lactobacilli, Streptococci Flavored powder packets or unflavored powder packets Dose is 1-8 packets/day For: UC, IBS, and ileal pouch
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Proposed Uses Digestive health Prevention of antibiotic-associated diarrhea Decreases adverse effects Lactobacillus IBD/IBS Questionable benefits Large placebo effects
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Safety Profile Generally recognized as safe Common adverse effects Flatulence, abdominal pain/discomfort
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Product Selection for Diarrhea Should be based on: Potential etiology of diarrhea Potential drug interactions Contraindications Patient preference
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Patient Assessment Need to assess symptoms Look for symptoms that would preclude self- treatment If present, refer to health care provider immediately If not present, then assess degree of dehydration What is the urgency of the situation? Assess patient’s current medication regimen Drug-induced? Travel and food intake history
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Patient Counseling Avoiding dehydration OTC antidiarrheals Maximum # of doses/24 hr Potential drug interactions Maximum duration of therapy before seeing health care provider
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Questions? [email protected]
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Acute diarrhea including travelers diarrhea Should not be...

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