Antispasmodics for Chronic Abdominal Pain: Analysis of North American Treatment Options

Brenner, Darren M.; Lacy, Brian E.

doi:10.14309/ajg.0000000000001266

Cited by 22 publications

(14 citation statements)

References 55 publications

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“…Some may also help with vomiting and nausea. Jackson et al 101 Kaplan and Carson 102 Khoury et al 103 Brzozowska et al 104 Anemüller et al 105 Corticosteroid Prednisone and methylprednisolone Used via oral or intravenous for more severe cases of allergic reaction (controls urticaria, angioedema and pruritis) Ghahramani and Temprano 106 Wen et al 107 Mast cell stabilizer Oral cromolyn solution Reduces persistent gastrointestinal symptoms when avoidance diet is insufficient Commins 42 Antiemetic Domperidone and metoclopramide Reduces vomiting and nausea Zhang et al 108 Saleem and Nilsson 109 Antispasmodic Dicycloverine and hyoscine Helps controlling abdominal pain Guillier et al 110 Brzozowska et al 104 Brenner and Lacy 111 Antidiarrheal Loperamide Used to stop or slow diarrhea (anti-motility drug) Kaplan and Carson 102 Bircher et al 112 Laxative Sennosides and bisacodyl Treat constipation by stimulating bowel movement Emmanuel et al 113 Saleem and Nilsson 109 …”

Section: Treatment/management Methodsmentioning

confidence: 99%

Current and Future Strategies for the Diagnosis and Treatment of the Alpha-Gal Syndrome (AGS)

Vaz-Rodrigues¹,

Mazuecos²,

Fuente³

2022

JAA

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The α-Gal syndrome (AGS) is a pathognomonic immunoglobulin E (IgE)-mediated delayed anaphylaxis in foods containing the oligosaccharide galactose-α-1,3-galactose (α-Gal) such as mammalian meat or dairy products. Clinical presentation of AGS can also comprise immediate hypersensitivity due to anticancer therapy, gelatin-containing vaccines or mammalian serum-based antivenom. The IgE initial sensitization is caused by hard-bodied tick bites and symptomatic individuals typically develop delayed pruritus, urticaria, angioedema, anaphylaxis, malaise or gut-related symptoms. Due to inapparent presentation, delayed reactions and a wide variety of patients´ clinical history, the AGS diagnosis and treatment remain challenging. This review covers not only current diagnostic methods used for AGS such as the skin prick test (SPT), the oral food challenge (OFC), anti-α-Gal IgE levels measurement and the basophil activation test (BAT), but also potentially relevant next-generation diagnostic tools like the mast cell activation test (MAT), the histamine-release (HR) assay, omics technologies and model-based reasoning (MBR). Moreover, it focuses on the therapeutical medical and non-medical methods available and current research methods that are being applied in order to elucidate the molecular, physiological and immune mechanisms underlying this allergic disorder. Lastly, future treatment and preventive tools are also discussed, being of utmost importance for the identification of tick salivary molecules, with or without α-Gal modifications, that trigger IgE sensitivity as they could be the key for further vaccine development. Bearing in mind climate change, the tick-host paradigm will shift towards an increasing number of AGS cases in new regions worldwide, which will pose new challenges for clinicians in the future.

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Section: Treatment/management Methodsmentioning

confidence: 99%

Current and Future Strategies for the Diagnosis and Treatment of the Alpha-Gal Syndrome (AGS)

Vaz-Rodrigues¹,

Mazuecos²,

Fuente³

2022

JAA

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“…Tienen efectos extraintestinales, y posibles efectos colaterales como boca seca, taquicardia, visión borrosa (125,126).…”

Section: Otros Antiespasmódicosunclassified

“…Este síntoma no hace parte de los criterios de Roma IV para el diagnóstico de SII, sin embargo, la mayoría de los pacientes lo presentan y su severidad se correlaciona con menor calidad de vida (121,122). Los medicamentos que han demostrado eficacia en la resolución del Bloating son: Rifaximina, Eluxadolina, Bromuro de pinaverio, de otilonio (58,(126)(127)(128)(129)(130)(131)(132)(133)(155)(156). Los pacientes con este síntoma, presentan con mayor frecuencia alteración de la microbiota y esto ha estimulado explorar la posibilidad de trasplante fecal, en casos severos (193,194).…”

Section: Otras Opcionesunclassified

Síndrome de intestino irritable (SII): Nuevos conceptos en 2023.

P.²,

2022

Med.

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El síndrome de intestino irritable, considerado antes como un trastorno funcional, forma actualmente parte del grupo de los trastornos de la interacción del eje intestino-cerebro, una enfermedad orgánica que se identifica clínicamente por la presencia de dolor abdominal recurrente y alteración en la frecuencia o consistencia de las heces. Es una patología multifactorial con impacto negativo en la calidad de vida y hasta el momento, incurable. El objetivo del tratamiento es controlar los síntomas, lo que representa un alto costo para los servicios de salud a nivel mundial. El presente artículo revisa la epidemiología, fisiopatología, el tratamiento y algunos posibles factores relacionados como las alteraciones en la motilidad gastrointestinal, hipersensibilidad visceral, inflamación intestinal, alteración de la microbiota intestinal o disbiosis, sobrecrecimiento bacteriano y la respuesta inmunológica a la dieta.

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“…Multiple meta-analyses and randomized controlled trials have shown that antispasmodic drugs are more efficacious than placebo at improving abdominal pain in patients with IBS. [43][44][45][46][47][48] However, because of the lack of head-to-head trials and sparsity of recent data, limited evidence exists to support differentiation of antispasmodic therapies. There are also very few studies, which have specifically investigated antispasmodics as a treatment for FACP.…”

Section: Commentsmentioning

confidence: 99%

Functional Abdominal Cramping Pain

Müller-Lissner¹,

Andresen

Corsetti

et al. 2022

Journal of Clinical Gastroenterology

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Functional abdominal cramping pain (FACP) is a common complaint, which may present either on its own or in association with a functional gastrointestinal disorder. It is likely caused by a variety of, probably partly unknown, etiologies. Effective management of FACP can be challenging owing to the lack of usable diagnostic tools and the availability of a diverse range of treatment approaches. Practical guidance for their selection and use is limited. The objective of this article is to present a working definition of FACP based on expert consensus, and to propose practical strategies for the diagnosis and management of this condition for physicians, pharmacists, and patients. A panel of experts on functional gastrointestinal disorders was convened to participate in workshop activities aimed at defining FACP and agreeing upon a recommended sequence of diagnostic criteria and management recommendations. The key principles forming the foundation of the definition of FACP and suggested management algorithms include the primacy of cramping pain as the distinguishing symptom; the importance of recognizing and acting upon alarm signals of potential structural disease; the recognition of known causes that might be addressed through lifestyle adjustment; and the central role of antispasmodics in the treatment of FACP. The proposed algorithm is intended to assist physicians in reaching a meaningful diagnostic endpoint based on patient-reported symptoms of FACP. We also discuss how this algorithm may be adapted for use by pharmacists and patients.

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Antispasmodics for Chronic Abdominal Pain: Analysis of North American Treatment Options

Cited by 22 publications

References 55 publications

Current and Future Strategies for the Diagnosis and Treatment of the Alpha-Gal Syndrome (AGS)

Current and Future Strategies for the Diagnosis and Treatment of the Alpha-Gal Syndrome (AGS)

Síndrome de intestino irritable (SII): Nuevos conceptos en 2023.

Functional Abdominal Cramping Pain

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