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  1. Investigation on antidiarrhoeal activity of Aristolochia indica Linn. Root extracts in mice
    Dharmalingam SR, Madhappan R, Ramamurthy S, Chidambaram K, Srikanth MV, Shanmugham S, et al.
    Afr J Tradit Complement Altern Med, 2014;11(2):292-4.
    PMID: 25435611
    BACKGROUND: The present study aimed at investigating the effect of ethanolic extract (EtAI), and aqueous extract (AqAI) of Aristolochia indica Linn roots on castor oil-induced diarrhoea and study on small intestinal transit. Phytochemical analysis of extracts was performed as per standard procedure.

    MATERIALS AND METHODS: The oral toxicity study using Swiss albino mice was performed in accordance with OECD guidelines. The EtAI and AqAI extracts of Aristolochia indica Linn were studied for antidiarrhoeal property using castor oil-induced diarrhoeal model and charcoal-induced gastrointestinal motility test in Swiss albino mice.

    RESULTS: Among the tested doses of 200 and 400 mg/kg body weight, the extracts reduced the frequency and severity of diarrhoea in test animals throughout the study period. At the same doses, the extract delayed the intestinal transit of charcoal meal in test animals as compared to the control and the results were statistically significant.

    CONCLUSION: Experimental findings showed that ethanol extract of Aristolochia indica Linn root possess significant antidiarrheal activity and may be a potent source of anti-diarrhoeal drug in future.

    Matched MeSH terms: Diarrhea/drug therapy*
  2. Management of diarrhoea cases by community pharmacies in 3 cities of Pakistan
    Hussain A, Ibrahim MI
    East Mediterr Health J, 2012 Jun;18(6):635-40.
    PMID: 22888622
    Community pharmacies are valued for their potential role in the management of common ailments. This cross-sectional study aimed to document the management of diarrhoea by community pharmacies in 3 cities in Pakistan. Visits were performed to 371 randomly selected pharmacies to request advice for a simulated paediatric case of diarrhoea. The pharmacy's management was scored on a checklist including history taking and provision of advice and information. Customers were served by a salesperson in 97.3% of visits and by a pharmacist in only 2.2%. Medication was dispensed in 77.1% of visits. Of the medications dispensed, 58.7% were antiamoebics, 14.0% antibiotics and 18.9% antidiarrhoeals; only 8.4% were oral rehydration salts. None of the regimens matched with a standard prescription. The dosage regimen was explained to the customer in only 52.6% of cases. Drug safety, unqualified personnel, lack of history taking, inappropriate treatment and lack of counselling are concerns to be addressed.
    Matched MeSH terms: Diarrhea/drug therapy*
  3. Fulltext Tetracycline-resistant vibrio cholerae El Tor
    Hassan H, Teh A
    Med J Malaysia, 1993 Mar;48(1):95-6.
    PMID: 8341181
    http://www.e-mjm.org/1993/v48n1/Vibrio_Cholerae_El_Tor.pdf
    Matched MeSH terms: Diarrhea/drug therapy
  4. Oral diosmectite reduces stool output and diarrhea duration in children with acute watery diarrhea
    Dupont C, Foo JL, Garnier P, Moore N, Mathiex-Fortunet H, Salazar-Lindo E, et al.
    Clin Gastroenterol Hepatol, 2009 Apr;7(4):456-62.
    PMID: 19268266 DOI: 10.1016/j.cgh.2008.12.007
    Diosmectite is a clay used to treat children with acute watery diarrhea. However, its effects on stool output reduction, the key outcome for pediatric antidiarrheal drugs, have not been shown.
    Matched MeSH terms: Diarrhea/drug therapy*
  5. Inhibition of gastrointestinal release of acetylcholine by quercetin as a possible mode of action of Psidium guajava leaf extracts in the treatment of acute diarrhoeal disease
    Lutterodt GD
    J Ethnopharmacol, 1989 May;25(3):235-47.
    PMID: 2747259
    The electrically stimulated guinea-pig ileum and spontaneously contracting guinea-pig ileum preparations were employed in studies on the effects of an alcoholic extract and two flavonoid compounds, quercetin and quercetin-3-arabinoside, extracted from the leaves of Psidium guajava. The extract showed a morphine-like inhibition of acetylcholine release in the coaxially stimulated ileum, together with an initial increase in muscular tone, followed by a gradual decrease. The morphine-like inhibition was found to be due to quercetin, starting at concentrations of 1.6 micrograms/ml. The glycoside did not show any such action at concentrations of up to 1.28 mg/ml. The extract inhibited spontaneous contractions in the unstimulated ileum with a concentration-response relationship.
    Matched MeSH terms: Diarrhea/drug therapy*
  6. Fulltext Antidiarrhoeal investigation of Apium leptophyllum (Pers.) by modulation of Na+K+ATPase, nitrous oxide and intestinal transit in rats
    Sahoo HB, Sagar R, Kumar A, Bhaiji A, Bhattamishra SK
    Biomed J, 2016 Dec;39(6):376-381.
    PMID: 28043416 DOI: 10.1016/j.bj.2016.11.003
    BACKGROUND: Apium leptophyllum (Pers.) is an annual herb with traditional appreciation for various pharmacological properties; however, the scientific information on this herb is insufficient. The aim of the present investigation was undertaken to evaluate flavonoidal fraction of A. leptophyllum fruit (FFALF) against diarrhoea on albino rats.

    METHODS: The antidiarrhoeal study was conducted by castor oil induce diarrhoea, prostaglandin E2 (PGE2) induced enteropooling and intestinal transit by charcoal meal test. The rats were divided into five groups (six/group). Group I served as control and received orally 2% acacia suspension; Group II served as standard and received orally loperamide (3 mg/kg) or atropine sulphate (5 mg/kg); Group III, IV and V served as test groups and received the FFALF at doses of 5, 10 and 20 mg/kg orally, respectively.

    RESULTS: In castor oil-induced diarrhoeal model, the FFALF significantly (p 

    Matched MeSH terms: Diarrhea/drug therapy*
  7. Studies of bacterial disease in West Malaysian Orang Asli. Distribution of enteropathogens
    Haug NL, Davis CE, Anandan J, Lim TW
    Med J Malaya, 1969 Sep;24(1):24-31.
    PMID: 4243839
    Matched MeSH terms: Diarrhea/drug therapy
  8. Effect of nitazoxanide on diarrhea: A systematic review and network meta-analysis of randomized controlled trials
    Hashan MR, Elhusseiny KM, Huu-Hoai L, Tieu TM, Low SK, Minh LHN, et al.
    Acta Trop, 2020 Oct;210:105603.
    PMID: 32598920 DOI: 10.1016/j.actatropica.2020.105603
    We aimed to systematically review evidence pertaining to the safety and efficacy of nitazoxanide in treating infectious diarrhea. On September 21, 2017, we identified relevant studies using 12 databases. The estimates of the included studies were pooled as a risk ratio (RR). We conducted a network and pairwise random-effects meta-analysis for both direct and indirect comparisons of different organisms that are known to cause diarrhea. The primary and secondary analysis outcomes were clinical response until cessation of illness, parasitological response and adverse events. We included 18 studies in our analysis. In cryptosporidiosis, the overall estimate favored nitazoxanide in its clinical response in comparison with placebo RR 1.46 [95% CI 1.22-1.74; P-value <0.0001]. Network meta-analysis among patients with Giardia intestinalis showed an increase in the probability of diarrheal cessation and parasitological responses in comparison with placebo, RR 1.69 [95% CI 1.08-2.64, P-score 0.27] and RR 2.91 [95% CI 1.72-4.91, P-score 0.55] respectively. In Clostridium difficile infection, the network meta-analysis revealed a non-significantly superior clinical response effect of nitazoxanide to metronidazole 31 days after treatment RR 1.21 [95% CI 0.87-1.69, P-score 0.26]. In Entamoeba histolytica, the overall estimate significantly favored nitazoxanide in parasitological response with placebo RR 1.80 [95% CI 1.35-2.40, P-value < 0.001]. We highlighted the effectiveness of nitazoxanide in the cessation of diarrhea caused by Cryptosporidium, Giardia intestinalis and Entamoeba histolytica infection. We also found significant superiority of NTZ to metronidazole in improving the clinical response to G. intestinalis, thus it may be a suitable candidate for treating infection-induced diarrhea. To prove the superiority of NTZ during a C. difficile infection may warrant a larger-scale clinical trial since its superiority was deemed insignificant. We recommend nitazoxanide as an appropriate option for treating infectious diarrhea.
    Matched MeSH terms: Diarrhea/drug therapy*
  9. Presence of calcium antagonist activity explains the use of Syzygium samarangense in diarrhoea
    Ghayur MN, Gilani AH, Khan A, Amor EC, Villaseñor IM, Choudhary MI
    Phytother Res, 2006 Jan;20(1):49-52.
    PMID: 16397921
    Syzygium samarangense (Family; Myrtaceae) or 'makopa', as it is commonly known, is native to Malaysia, some islands of Indonesia and to Far East in general. This study was undertaken to rationalize the use of this plant in hypermotility states of the gut. The hexane extract of S. samarangense (Ss.Hex) was found to dose-dependently (10-3000 microg/mL) relax the spontaneously contracting isolated rabbit jejunum. When tested for a possible calcium channel blocking (CCB) activity, the extract (10-1000 microg/mL) relaxed the high K+-induced contractions and also decreased the Ca++ dose-response curves in a dose-dependent manner (30-100 microg/mL), confirming the CCB activity. Four flavonoids isolated from the hexane extract were tested for a possible spasmolytic activity. All flavonoids, identified as: 2'-hydroxy-4',6'-dimethoxy-3'-methylchalcone (SS1), 2',4'-dihydroxy-6'-methoxy-3',5'-dimethylchalcone (SS2), 2',4'-dihydroxy-6'-methoxy-3'-methylchalcone (SS3) and 7-hydroxy-5-methoxy-6,8-dimethylflavanone (SS4), showed dose-dependent (10-1000 microg/mL) spasmolytic activity with SS2 being the most potent. These results indicate that the presence of compounds with spasmolytic and calcium antagonist activity may be responsible for the medicinal use of the plant in diarrhoea.
    Matched MeSH terms: Diarrhea/drug therapy*
  10. Increase number of mitochondrion-like organelle in symptomatic Blastocystis subtype 3 due to metronidazole treatment
    Raman K, Kumar S, Chye TT
    Parasitol Res, 2016 Jan;115(1):391-6.
    PMID: 26481491 DOI: 10.1007/s00436-015-4760-0
    Blastocystis sp., an intestinal organism is known to cause diarrhea with metronidazole regarded as the first line of treatment despite reports of its resistance. The conflicting reports of variation in drug treatment have been ascribed to subtype differences. The present study evaluated in vitro responses due to metronidazole on ST3 isolated from three symptomatic and asymptomatic patients, respectively. Symptomatic isolates were obtained from clinical patients who showed symptoms such as diarrhea and abdominal bloating. Asymptomatic isolates from a stool survey carried out in a rural area. These patients had no other pathogens other than Blastocystis. Ultrastructural studies using transmission electron microscopy (TEM) and scanning electron microscopy (SEM) revealed drug-treated ST3 from symptomatic patients were irregular and amoebic with surface showing high-convoluted folding when treated with metronidazole. These organisms had higher number of mitochondrion-like organelle (MLO) with prominent cristae. However, the drug-treated ST3 from asymptomatic persons remained spherical in shape. Asymptomatic ST3 showed increase in the size of its central body with the MLO located at the periphery.
    Matched MeSH terms: Diarrhea/drug therapy
  11. Rome foundation Asian working team report: Real world treatment experience of Asian patients with functional bowel disorders
    Xiong L, Gong X, Siah KT, Pratap N, Ghoshal UC, Abdullah M, et al.
    J Gastroenterol Hepatol, 2017 Aug;32(8):1450-1456.
    PMID: 28084664 DOI: 10.1111/jgh.13730
    BACKGROUND AND AIM: Information on real world treatment experiences of patients with functional bowel disorders is lacking from Asia. This study aimed to describe the medication exposure and treatment satisfaction of patients presenting to gastroenterology clinics across a sampling of Asian cities.

    METHODS: From March 2011 to October 2013, adult patients presenting to hospital-based gastroenterology outpatient clinics in 11 cities across Asia, who fulfilled screening criteria for any functional gastrointestinal disorder, were asked to complete a validated culturally adapted translation of the Rome III diagnostic questionnaire, a checklist of medications received in the preceding 3 months and questions on treatment satisfaction.

    RESULTS: A total of 1376 patients (female 755, male 621, 41.36 ± 13.25 years) comprising irritable bowel (621, 45.1%), unspecified functional bowel disorder (372, 27.8%), functional constipation (202, 14.7%), functional bloating (144, 10.5%), and functional diarrhea (56, 4.1%) completed the study. Of 1105 patients with a previous consultation, 509 (46.1%) were dissatisfied with their treatment, with ineffective treatment being the commonest reason. Satisfaction with previous consultation was lowest by diagnosis for functional constipation (29.2%), and the most bothersome symptom was straining (37.5%). Of 1046 patients who had taken medications for their gastrointestinal symptoms in the last 3 months, 793 (75.8%) had received two or more drugs. For irritable bowel syndrome patients, treatment with proton pump inhibitors and antispasmodics was recorded in 57% and 31%, with overlapping epigastric pain and heartburn predicting proton pump inhibitors use.

    CONCLUSIONS: More attention should be given to treatment gaps with regards to possible under-treatment with antispasmodics in irritable bowel syndrome and to critically evaluating the efficacy of constipation management.
    Matched MeSH terms: Diarrhea/drug therapy
  12. Anti-diarrheal activities of phytol along with its possible mechanism of action through in-vivo and in-silico models
    Islam MT, Rahman MA, Saeed M, Ul-Haq Z, Alam MJ, Mondal M, et al.
    Cell Mol Biol (Noisy-le-grand), 2020 Jun 25;66(4):243-249.
    PMID: 32583783
    Phytol (PHY), a chlorophyll-derived diterpenoid, exhibits numerous pharmacological properties, including antioxidant, antimicrobial, and anticancer activities. This study evaluates the anti-diarrheal effect of phytol (PHY) along with its possible mechanism of action through in-vivo and in-silico models. The effect of PHY was investigated on castor oil-induced diarrhea in Swiss mice by using prazosin, propranolol, loperamide, and nifedipine as standards with or without PHY. PHY at 50 mg/kg (p.o.) and all other standards exhibit significant (p < 0.05) anti-diarrheal effect in mice. The effect was prominent in the loperamide and propranolol groups. PHY co-treated with prazosin and propranolol was found to increase in latent periods along with a significant reduction in diarrheal section during the observation period than other individual or combined groups. Furthermore, molecular docking studies also suggested that PHY showed better interactions with the α- and β-adrenergic receptors, especially with α-ADR1a and β-ADR1. In the former case, PHY showed interaction with hydroxyl group of Ser192 at a distance of 2.91Å, while in the latter it showed hydrogen bond interactions with Thr170 and Lys297 with a distance of 2.65 and 2.72Å, respectively. PHY exerted significant anti-diarrheal effect in Swiss mice, possibly through blocking α- and β-adrenergic receptors.
    Matched MeSH terms: Diarrhea/drug therapy*
  13. Antimicrobial effects of Caulerpa sertularioides extract on foodborne diarrhea-caused bacteria
    Darah I, Tong WY, Nor-Afifah S, Nurul-Aili Z, Lim SH
    Eur Rev Med Pharmacol Sci, 2014;18(2):171-8.
    PMID: 24488904
    Caulerpa (C.) sertularioides has many therapeutic uses in the practice of traditional medicine in Malaysia. Crude methanolic, diethyl ether extract, ethyl acetate extract and butanolic extract from C. sertularioides were subjected to antimicrobial screening including the three Gram-positive and three Gram-negative diarrhea-caused bacteria.
    Matched MeSH terms: Diarrhea/drug therapy
  14. Fulltext Symptomatic chronic strongyloidiasis in children following treatment for solid organ malignancies: case reports and literature review
    Norsarwany M, Abdelrahman Z, Rahmah N, Ariffin N, Norsyahida A, Madihah B, et al.
    Trop Biomed, 2012 Sep;29(3):479-88.
    PMID: 23018511
    Strongyloidiasis is an infection caused by the intestinal nematode Strongyloides stercoralis. Infected healthy individuals are usually asymptomatic, however it is potentially fatal in immunocompromised hosts due to its capacity to cause an overwhelming hyperinfection. Strongyloidiasis could be missed during routine screening because of low and intermittent larval output in stool and variable manifestations of the symptoms. We present two cases of strongyloidiasis occurring in children with solid organ malignancies suspected to have the infection based on their clinical conditions and treatment history for cancer. Both patients were diagnosed by molecular and serological tests and were successfully treated. Thus, strongyloidiasis in patients undergoing intensive treatment for malignancies should be suspected, properly investigated and treated accordingly.
    Matched MeSH terms: Diarrhea/drug therapy
  15. Pre-admission therapy for childhood acute diarrhoea--a hospital-based study
    Ng YJ, Lo YL, Lee WS
    J Clin Pharm Ther, 2009 Feb;34(1):55-60.
    PMID: 19125903 DOI: 10.1111/j.1365-2710.2008.00985.x
    Acute gastroenteritis (AGE) is a common illness among infants and children contributing to significant mortality and morbidity. As such, appropriate treatment received prior to hospital admission is of utmost importance. This retrospective observational study aimed to determine preadmission management in paediatric patients prior to hospital admission. Two hundred and twenty-two case notes of paediatric AGE patients were reviewed over a 12-month period. One hundred and fifty-four patients received medications prior to admission with 143 (92.9%) patients received known classes of medications. Antipyretic agents were the most commonly prescribed (69.2%), followed by antibiotics (38.5%), anti-emetics (35.7%), oral rehydration salts (29.4%) and antidiarrhoeals (28.0%). The mean duration of stay in hospital was slightly shorter in patients, who received prior medications than those who did not (2.22 vs. 2.32 days respectively). Seventy per cent of children admitted for AGE were treated suboptimally prior to hospital admission with oral rehydration salts being largely under-utilized, despite their proven efficacy and safety. Sex, race and age had no influence on the type of preadmission treatment. A greater effort should be made to educate the general public in the appropriate treatment of AGE.
    Matched MeSH terms: Diarrhea/drug therapy*
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