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Diarrhea (Acute)
Published in Charles Theisler, Adjuvant Medical Care, 2023
Bulk forming agents (soluble fiber) such as methylcellulose (Citrucel), psyllium fiber (Metamucil), or polycarbophil (Fibercon) help to absorb excess fluid in the large bowel and slow transit in the intestinal tract, thus helping to solidify loose stools. To help regulate the bowels, women should take 7 gm/day and build to 25 gm/day. Men can build up to 38 gm/day.16
Rational Medical Therapy of Functional GI Disorders
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Richard M. Sperling, Kenneth R. McQuaid
A major problem with these studies is the lack of information provided regarding the number of IBS patients treated with constipation-predominant symptoms. In fact, the mean number of bowel movements in the study by Longstreth et al. (203) was greater than three per week, and Lucey et al. (204) had few constipated patients. A controlled trial by Prior and Whorwell (208) reported overall symtomatic improvement in 82% of IBS patients treated with ispaghula compared with 53% treated with placebo. Of note, nearly half of these patients had constipation. A decreased number of days without bowel movements and a decrease in intestinal transit time occurred in treated patients; however, there was no effect of treatment on pain or distension. Most recently, in a 6-month, double-blind, crossover trial of polycarbophil in 23 IBS patients, 71% of patients preferred the fiber treatment periods (202). Polycarbophil was preferred in 79% of patients with constipation, 87% of those with bloating, and 100% of patients with alternating diarrhea and constipation. However, when diary scores for individual symptoms were assessed, only ease of fecal passage was statistically better during treatment with polycarbophil. The scores for nausea, bloating, and pain did not change significantly. Thus, although target symptoms are not obviously improved, patients appear to derive some improved overall sense of well-being during fiber therapy (202).
Faecal incontinence: a narrative review of clinic-based management for the general gynaecologist
Published in Journal of Obstetrics and Gynaecology, 2018
Kathryn S. Williams, Dara F. Shalom, Harvey A. Winkler
Supplementing a restricted diet with fibre can be beneficial for patients suffering from incontinence of liquid stool. Fibre acts as a bulking agent and can allow for increased rectal sensation as well as decreased ‘intestinal hurry’. It is recommended that the daily dose of fibre (including dietary and supplemental) not exceed 30 g (Costilla et al. 2013). Table 1 provides a list of readily available over the counter (OTC) options including: psyllium (Metamucil®), wheat dextrin (Benefiber®), methylcellulose (Citrucel®) and calcium polycarbophil (Fibercon®). While these supplements are beneficial, they may be associated with mild side effects. In a randomised controlled trial (RCT) of 16 g of supplemental fibre versus placebo symptoms of bloating, belching, flatus and fullness were 1–2 times higher in subjects taking the fibre (Bliss et al. 2011). If these symptoms are severe and bothersome, Rao (2014) recommend methylcellulose as a first-line bulking agent. Methylcellulose (Citrucel®) is resistant to fermentation by colonic microflora and less likely than other forms of fibre to cause bloating and exacerbate diarrhoea. Supplemental fibre in quantities of 1–2 tablespoons per day can improve stool consistency and be especially helpful in patients who have low-volume loose stool.
Formulation and evaluation of Cyclosporin A emulgel for ocular delivery
Published in Drug Delivery, 2015
Yan Shen, Xiang Ling, Weiwei Jiang, Shuang Du, Yang Lu, Jiasheng Tu
Cyclosporine A (CsA) was purchased from Galena (Czech Republic). Polycarbophil was obtained from The Lubrizol Corporation (Ohio Clif Lancaster, USA). Poloxamer188 was supplied by Nanjing Well Chemical Co., Ltd (Nanjing, China). Castor oil (analytical reagent) was purchased from Shanghai Chemical Reagent Co., Ltd. (Shanghai, China). Dialysis membrane was purchased from Sigma Chemical Company (Shanghai, China). Methanol and acetonitrile were of HPLC grade and other chemicals were all of analytical reagent grade.
The stimulation of the vaginal immune system with short-term administration of a vaginal gel containing fraction of Propionibacterium acnes, hyaluronic acid and polycarbophil is efficacious in vaginal infections dependent on disorders in the vaginal ecosystem
Published in Gynecological Endocrinology, 2018
Gian Benedetto Melis, Bruno Piras, Maria Francesca Marotto, Manuela Neri, Valentina Corda, Valerio Vallerino, Alessandra Saba, Stefano Lello, Monica Pilloni, Pierina Zedda, Anna Maria Paoletti, Valerio Mais
The findings of this observational multicenter study suggest that a short-term local treatment of 5 days with Immunovag® is capable of contrasting the VVI sustained by the impairment of vaginal ecosystem which favors the growth of vaginal mycroflora such as GV, CA, and other microorganisms responsible for BV. Only in a minority of subjects with VVI induced by GV, CA, and MV, the VVS was positive after the treatment, whereas in the majority of them the VVS did not show the microbes responsible for the VVI. The sole vaginal application of the gel containing the bacterial lysate of P. acnes, which is known to be able to stimulate up to 90% the phagocytosis activity of macrophages [11], allowed this result. Relevant clinical findings, such as a significant reduction of subjects with symptoms and signs of VVI at the post-treatment visit (see Table 1) are the direct consequences of the abolition of microorganisms. However, the intensity of symptoms and signs of VVI was significantly decreased in the few cases in which they were still present at the end of treatment (Table 2). It is likely that the partial, though not total, activation of local immune system, favored the significant reduction of symptoms and signs of VVI, even though a concurrent action of hyaluronic acid and polycarbophil in which the P. acnes is emulsioned is not to be excluded. Hyaluronic acid, a natural polysaccharide present on the connective tissue matrix of vertebrates, binds a large number of water molecules, allowing a correct hydration of the skin and mucous membranes [16,17]. Polycarbophil is high molecular weight polymer which ‘sticks’ to the mucous membranes for a prolonged period. This characteristic is due to its capacity to form complexes with the mucus, which covers the mucous membranes. Mucus is mainly composed of mucin, a protein that forms flexible chains of glycoproteins. The polycarbophil has many carboxy-residues, useful for the formation of hydrogen ties with residues of the mucin: this mechanism ensures the distribution on the vaginal mucosa simulating the function and characteristics of the mucus [18].