Chapter 8 Drugs for Gastrointestinal Disorders

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Chapter 8Drugs for Gastrointestinal Disorders
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Gastrointestinal (GI) Disorders

• Peptic ulcer disease
• Gastroesophageal reflux disease
• Diarrhea
• Constipation
• Intestinal gas

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Peptic Ulcer Disease (PUD)

• Mucosa erosion stomach or duodenum
• Often asymptomatic
• Damage from
• Alcohol abuse
• Cigarette smoking
• NSAIDs

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Signs and symptoms of PUD

• Dull stomach ache
• Poor appetite
• Bloating
• Burping
• Nausea
• Vomiting

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Treatment Options for PUD

• Directed towards relieving pain, accelerating
  ulcer healing, and minimizing recurrence
• H2 receptor antagonists (Tagamet, Zantac)
• Proton pump inhibitors (Prilosec, Prevacid)
• Antacids (Tums, Rolaids)
• Sucralfate (prescription only)
• Bismuth compounds (Pepto-Bismol)
• Antibiotics

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Adverse Effects

• Diarrhea
• Constipation
• Headache
• Stomach cramps
• Dizziness
• Rash
• Nausea
• Vomiting

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Gastroesophageal Reflux Disease (GERD)

• Movement of gastric contents into the esophagus
• Lower esophageal sphincter (LES) does not close
  properly

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GERD (cont.)

• Possible problems with GERD
• Esophageal strictures (narrowing or constriction)
• Esophageal ulcers
• Perforations
• Hemorrhage
• Aspiration
• Motility disorders

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Heartburn

• Most common symptom of GERD
• Pain in center of chest
• Most do not seek treatment right away
• Aggravated by
• Foods high in fat
• Spices, onions, citric juices, coffee (caffeine)
• Alcohol
• Body position

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Treatment and Adverse Effects

• Goals of treatment
• Eliminate symptoms
• Limit frequency and duration
• Promote healing
• Prevent complications
• Alter factors that cause reflux
• Lose weight, proper diet
• Loose-fitting clothes
• Limit smoking, alcohol, laying down after eating

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Antacids

• Relieve mild to moderate symptoms
• Decrease gastric acidity
• Rapid onset, short duration
• Taken with food last up to 3 hours
• Adverse effects
• Diarrhea
• Constipation

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Table 8-2 Antacid Classifications
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Diarrhea

• Genetic Disorder
• Abnormal frequency and liquidity of fecal
  discharge
• Origin
• Infection (Salmonella)
• Toxic
• Drug-induced
• Diet

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Acute or Chronic

• Acute (sudden onset)
• Food induced (travelers)
• Chronic (2 weeks or longer)
• Stress or Irritable bowel syndrome

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Treatment and Adverse Effects

• Goals of treatment
• Control the loss of fluids (athletes)
• Identify and treat cause
• Provide symptomatic relief
• Refer to physician if
• Persists for several days
• Blood in stool
• Severe abdominal pain, cramps
• If from a bacterial infection do not stop
  movement

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• Antiperistaltic agents (Imodium)
• Dizziness, dry mouth , rash
• Bismuths (Pepto-Bismol)
• Figure 8-1, pg 111

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Constipation

• Decrease in the frequency of fecal elimination
  (hard/dry stool)
• Diet low in fiber
• Lack of exercise
• Insufficient fluid intake
• Excessive intake of foods
• Resisting defecation impulses
• Diabetes, pregnancy

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• Antidiarrheal medications
• Can cause constipation
• Low back pain, headache, distension, abdominal
  pain

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Treatment

• Increase fiber intake
• Bulk-forming laxatives
• FiberCon, Metamucil
• Increase fluid intake
• Aerobic exercise
• Stimulant laxatives
• Dulcolax
• Saline salt laxatives
• Phillips Milk of Magnesia/Fleet enema
• Implications for athletes, pg 113

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Intestinal Gas

• Belching, abdominal discomfort, bloating,
  flatulence
• Results from malabsorption of carbohydrates and
  proteins
• Fruits, vegetables, lactose
• Simethicone (Gas-X)
• Alpha-galactoside (Beano)

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Athletic Trainers Responsibility

• Recognize and refer
• Trusting relationship