Nonantibiotic therapy and pharmacotherapy of acute infectious diarrhea

D. W. Powell, Karen Szauter

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The most important aspect of nonantibiotic treatment of diarrhea is to prevent or repair dehydration and thus prevent significant morbidity or death. Although intravenous fluid therapy is effective, it is expensive and requires personnel and equipment. ORT has saved millions of lives in emerging nations and should be more commonly used in developed countries. Although the simple concept of glucose-stimulated Na+ and fluid absorption remains the basic tenet of such ORT, grain-based solutions appear to have added efficacy and nutritional value. Mild, nondysenteric diarrheas can be safely and reasonably effectively treated either with loperamide or with bismuth subsalicylate compounds. Effective adjunctive therapy for severe secretory diarrheas has thus far escaped discovery. Somatostatin analogues such as octreotide have approximately 50% efficacy in reduction of the moderate secretory diarrheas such as those present in AIDS. There are pharmacologic leads that should be explored to develop more gut specific antisecretory forms of α2-adrenergic agents, somatostatin, or phenothiazines. In addition, Cl- channel blockers still hold great theoretic promise. effective antisecretory therapy has been sought for the past 20 years. It is disappointing that no effective new drugs have yet emerged. Undoubtedly, this speaks of our inexact understanding of the mechanisms that result in secretory diarrheas. Because of the continued loss of life from diarrhea in emerging nations, better understandings of these mechanisms and effective therapies remain appropriate goals for medical science.

Original languageEnglish (US)
Pages (from-to)683-707
Number of pages25
JournalGastroenterology Clinics of North America
Volume22
Issue number3
StatePublished - 1993

Fingerprint

Diarrhea
Drug Therapy
Somatostatin
Therapeutics
Loperamide
Phenothiazines
Octreotide
Fluid Therapy
Nutritive Value
Dehydration
Developed Countries
Adrenergic Agents
Acquired Immunodeficiency Syndrome
Morbidity
Glucose
Equipment and Supplies
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Nonantibiotic therapy and pharmacotherapy of acute infectious diarrhea. / Powell, D. W.; Szauter, Karen.

In: Gastroenterology Clinics of North America, Vol. 22, No. 3, 1993, p. 683-707.

Research output: Contribution to journalArticle

@article{c68ce6ba2b494669806f05cca10bf1a5,
title = "Nonantibiotic therapy and pharmacotherapy of acute infectious diarrhea",
abstract = "The most important aspect of nonantibiotic treatment of diarrhea is to prevent or repair dehydration and thus prevent significant morbidity or death. Although intravenous fluid therapy is effective, it is expensive and requires personnel and equipment. ORT has saved millions of lives in emerging nations and should be more commonly used in developed countries. Although the simple concept of glucose-stimulated Na+ and fluid absorption remains the basic tenet of such ORT, grain-based solutions appear to have added efficacy and nutritional value. Mild, nondysenteric diarrheas can be safely and reasonably effectively treated either with loperamide or with bismuth subsalicylate compounds. Effective adjunctive therapy for severe secretory diarrheas has thus far escaped discovery. Somatostatin analogues such as octreotide have approximately 50{\%} efficacy in reduction of the moderate secretory diarrheas such as those present in AIDS. There are pharmacologic leads that should be explored to develop more gut specific antisecretory forms of α2-adrenergic agents, somatostatin, or phenothiazines. In addition, Cl- channel blockers still hold great theoretic promise. effective antisecretory therapy has been sought for the past 20 years. It is disappointing that no effective new drugs have yet emerged. Undoubtedly, this speaks of our inexact understanding of the mechanisms that result in secretory diarrheas. Because of the continued loss of life from diarrhea in emerging nations, better understandings of these mechanisms and effective therapies remain appropriate goals for medical science.",
author = "Powell, {D. W.} and Karen Szauter",
year = "1993",
language = "English (US)",
volume = "22",
pages = "683--707",
journal = "Gastroenterology Clinics of North America",
issn = "0889-8553",
publisher = "W.B. Saunders Ltd",
number = "3",

}

TY - JOUR

T1 - Nonantibiotic therapy and pharmacotherapy of acute infectious diarrhea

AU - Powell, D. W.

AU - Szauter, Karen

PY - 1993

Y1 - 1993

N2 - The most important aspect of nonantibiotic treatment of diarrhea is to prevent or repair dehydration and thus prevent significant morbidity or death. Although intravenous fluid therapy is effective, it is expensive and requires personnel and equipment. ORT has saved millions of lives in emerging nations and should be more commonly used in developed countries. Although the simple concept of glucose-stimulated Na+ and fluid absorption remains the basic tenet of such ORT, grain-based solutions appear to have added efficacy and nutritional value. Mild, nondysenteric diarrheas can be safely and reasonably effectively treated either with loperamide or with bismuth subsalicylate compounds. Effective adjunctive therapy for severe secretory diarrheas has thus far escaped discovery. Somatostatin analogues such as octreotide have approximately 50% efficacy in reduction of the moderate secretory diarrheas such as those present in AIDS. There are pharmacologic leads that should be explored to develop more gut specific antisecretory forms of α2-adrenergic agents, somatostatin, or phenothiazines. In addition, Cl- channel blockers still hold great theoretic promise. effective antisecretory therapy has been sought for the past 20 years. It is disappointing that no effective new drugs have yet emerged. Undoubtedly, this speaks of our inexact understanding of the mechanisms that result in secretory diarrheas. Because of the continued loss of life from diarrhea in emerging nations, better understandings of these mechanisms and effective therapies remain appropriate goals for medical science.

AB - The most important aspect of nonantibiotic treatment of diarrhea is to prevent or repair dehydration and thus prevent significant morbidity or death. Although intravenous fluid therapy is effective, it is expensive and requires personnel and equipment. ORT has saved millions of lives in emerging nations and should be more commonly used in developed countries. Although the simple concept of glucose-stimulated Na+ and fluid absorption remains the basic tenet of such ORT, grain-based solutions appear to have added efficacy and nutritional value. Mild, nondysenteric diarrheas can be safely and reasonably effectively treated either with loperamide or with bismuth subsalicylate compounds. Effective adjunctive therapy for severe secretory diarrheas has thus far escaped discovery. Somatostatin analogues such as octreotide have approximately 50% efficacy in reduction of the moderate secretory diarrheas such as those present in AIDS. There are pharmacologic leads that should be explored to develop more gut specific antisecretory forms of α2-adrenergic agents, somatostatin, or phenothiazines. In addition, Cl- channel blockers still hold great theoretic promise. effective antisecretory therapy has been sought for the past 20 years. It is disappointing that no effective new drugs have yet emerged. Undoubtedly, this speaks of our inexact understanding of the mechanisms that result in secretory diarrheas. Because of the continued loss of life from diarrhea in emerging nations, better understandings of these mechanisms and effective therapies remain appropriate goals for medical science.

UR - http://www.scopus.com/inward/record.url?scp=0027328225&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027328225&partnerID=8YFLogxK

M3 - Article

C2 - 8406736

AN - SCOPUS:0027328225

VL - 22

SP - 683

EP - 707

JO - Gastroenterology Clinics of North America

JF - Gastroenterology Clinics of North America

SN - 0889-8553

IS - 3

ER -