Schiller Lawrence R
Department of Internal Medicine, Baylor University Medical Center, 260 Wadley Tower, Dallas, TX, 75246, USA.
Texas A&M University Health Science Center College of Medicine, Dallas Campus, Dallas, TX, 75246, USA.
Curr Gastroenterol Rep. 2017 May;19(5):18. doi: 10.1007/s11894-017-0557-x.
Acute diarrhea often runs a self-limited course and little by way of treatment is needed except for oral rehydration therapy. Chronic diarrhea poses a longer-term problem. If not treatable with specific therapy aimed at the underlying pathophysiology, chronic diarrhea often needs long-term symptomatic therapy.
This paper aims to examine the options for symptomatic, nonspecific treatment of diarrhea.
The most frequently used therapies are opiate antidiarrheal drugs. These drugs are effective for a wide variety of diarrheal conditions and generally can be used safely if monitored closely. They work by slowing motility and allowing more time for absorption. They vary in potency and in addictive liability. In recent years, a variety of other drugs have been developed, which provide more targeted therapy that can mitigate diarrhea in specific situations. These drugs work on other regulatory pathways in the gut or on mucosal absorptive mechanisms. There is evidence for efficacy for both traditional and newer agents used for the symptomatic management of diarrhea. Opiates are used most often for this indication. Other agents may benefit individuals, but further research is needed to establish indications and best practices.
急性腹泻通常呈自限性病程,除口服补液疗法外,几乎无需其他治疗。慢性腹泻则是一个长期问题。如果无法通过针对潜在病理生理学的特异性疗法进行治疗,慢性腹泻往往需要长期的对症治疗。
本文旨在探讨腹泻对症、非特异性治疗的选择。
最常用的疗法是阿片类止泻药。这些药物对多种腹泻病症有效,如果密切监测,一般可安全使用。它们通过减缓肠道蠕动并留出更多吸收时间来发挥作用。其效力和成瘾性各不相同。近年来,已研发出多种其他药物,这些药物提供了更具针对性的疗法,可在特定情况下减轻腹泻。这些药物作用于肠道的其他调节途径或黏膜吸收机制。有证据表明,用于腹泻对症治疗的传统药物和新型药物均有效。阿片类药物最常用于此适应症。其他药物可能对个体有益,但需要进一步研究以确定适应症和最佳治疗方法。