Eluxadoline is a novel drug approved for the management of diarrhea predominant irritable bowel syndrome (IBS-D). It has unique pharmacology and works on three different opioid receptors. Several Phase II and III clinical trials have demonstrated eluxadoline's efficacy in reducing symptoms related to IBS-D. Clinical trial results and postmarketing reports show a risk of pancreatitis in patients...

INTRODUCTION Children with spinal cord lesions very often experience bowel dysfunction, with a significant impact on their social activities and quality of life. Our aim was to evaluate the efficacy of the Peristeen transanal irrigation (TI) system in patients with neuropathic bowel dysfunction (NBD). MATERIAL AND METHODS We prospectively reviewed 40 children with spina bifida and NBD who did...

The definitions of constipation include a reference to infrequent, difficult or incomplete bowel evacuation that may lead to pain and discomfort; with stools that can range from small, hard ’rocks’, to a large bulky mass. Constipation may be debilitating among those who require chronic analgesia (7); OIC or OBD affected an average of 41 % patients taking an oral opioid for up to 8 weeks in a me...

Postoperative Ileus (POI), which occurs after surgical manipulation of the bowel during abdominal operations, is associated with prolonged hospital stay, increasing medical costs, and delayed advancement of enteral diet, which contributes to a significant economic burden on the healthcare system. The use of accelerated care pathways has shown to positively impact gut function, but inevitable po...

Prolonged administration of benzodiazepines and/or opioids to children in a pae diatric intensive care unit (PICU) may induce physiological depen dence and withdrawal symptoms. We reviewed the lit erature for relevant contributions on the nature of these withdrawal symptoms and on availability of valid scoring systems to assess the extent of symptoms in children. Symptoms of benzodiazepine and ...

Gastrointestinal symptoms occur frequently among people with diabetes mellitus and are associated with considerable morbidity. Enteropathy, or large bowel dysfunction, includes constipation, diarrhea and fecal incontinence, and is particularly disturbing for many patients. The pathogenesis of diabetic enteropathy is complex, primarily related to gastrointestinal autonomic dysfunction and etiolo...

BACKGROUND The characteristics of patients who suffer from noncancer pain and opioid-induced constipation are not well understood. METHODS Cross-sectional patient survey and chart review data from the baseline assessment of an ongoing longitudinal study in the USA, Canada, Germany, and the UK were evaluated via descriptive statistics. Participants had confirmation of daily opioid therapy ≥30 ...

We report a case of 42-year-old male patient with hypogonadotropic hypogonadism. He suffered from general fatigue and erectile dysfunction after the treatment with transdermal fentanyl for chronic pain by traffic injury. Endocrine examinations and hormone stimulating tests showed that he had hypogonadotropic hypogonadism. Brain magnetic resonance imaging (MRI) showed no abnormal findings, and h...

Postoperative ileus (POI) in patients undergoing abdominal surgery is associated with signifi cant morbidity. In 2008, alvimopan (Entereg®) was approved by the Food and Drug Administration (FDA), and is the only available POI therapy in the United States for patients undergoing bowel resection. Data from preclinical studies demonstrate that alvimopan and its primary metabolite, ADL 08-0011, beh...

INTRODUCTION In spite of advances in understanding and technology, postoperative pain remains poorly treated for a significant number of patients. In colorectal surgery, the need for developing novel analgesics is especially important. Patients after bowel surgery are assessed for rapid return of bowel function and opioids worsen ileus, nausea and constipation. We describe a prospective, double...