The large intestine is the last section of the gastrointestinal system. By the time digestive products reach it, almost all of the nutritionally useful products have been removed. The large intestine removes water from the remainder, passing semi-solid feces into the rectum to be expelled from the body.
An anal fissure is a small tear or cut in the skin lining the anus. The typical symptoms are extreme pain during bowel movements and red blood streaking the stool. A hard, dry bowel movement can cause a tear in the anal lining, resulting in a fissure. Or it may be caused by diarrhea and inflammation of the anorectal area, overly tight or spastic anal sphincter muscles, scarring, or an underlying medical problem.
Commonly Prescribed (On-Label) Drugs: Docusate
Off-Label Prescription Drugs Breakthrough Options: Botulinum Toxin Type B, Diltiazem, Lidocaine Topical, Nifedipine, Nitroglycerin, Sildenafil
Constipation is defined as having only hard, dry bowel movements, straining or difficulty moving your bowels, and passing your bowels infrequently, usually fewer than three times a week. People who are constipated may find it painful to have a bowel movement and feel as if they have not evacuated completely.
Commonly Prescribed (On-Label) Drugs: Tegaserod
Off-Label Prescription Drug Breakthrough Option: Misoprostol
When bowel movements consist of loose, watery stools that pass more than three times in one day, it is called diarrhea. When the condition lasts for more than two weeks, it is considered chronic. In an otherwise healthy person, chronic diarrhea may be a nuisance, but for someone with a weak immune system, it is a life-threatening illness. In general, diarrhea may be caused by an infection or by other diseases, or the cause may be unknown.
Commonly Prescribed (On-Label) Drugs: Loperamide
Off-Label Prescription Drugs Breakthrough Options: Clonidine, Codeine, Octreotide
Crohn’s disease is an inflammatory bowel disease that generally causes inflammation in the lower part of the small intestine, although it can affect any part of the digestive tract, from the mouth to the anus. The main symptoms are pain and frequent diarrhea. Bleeding from the rectum may be serious and persistent, leading to anemia. Fever and weight loss also may occur. The cause of Crohn’s disease remains unknown.
Commonly Prescribed (On-Label) Drugs: Mesalamine, Sulfasalazine
Off-Label Prescription Drugs Breakthrough Options: Azathioprine, Mercaptopurine, Balsalazide, Ciprofloxacin, Metronidazole, Thalidomide
Diarrhea is the occurrence of loose, watery stools more than three times in one day. While uncomfortable, it is a common problem that usually lasts a day or two and then disappears without any treatment. The typical adult has diarrhea about four times a year. However, prolonged diarrhea can be a serious concern because fluid loss can cause dehydration. Diarrhea may be caused by an infection, or a chronic problem, like an intestinal disease.
Commonly Prescribed (On-Label) Drugs: Bismuth Subsalicylate, Diphenoxylate, Furazolidone, Kaolin/Pectin, Sodium Bicarbonate
Off-Label Prescription Drugs Breakthrough Options: Azithromycin, Erythromycin
Diverticula are little pouches in the colon (which comprises most of the large intestine) that bulge outward. They are weak spots in the “tubing” of the intestine. Simply having such diverticula is a condition called diverticulosis. The condition is more common as you age, afflicting about 10% of those over age 40 and about half of those over age 60. If the diverticula become infected or inflamed, it is called diverticulitis.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Amoxicillin-Clavulanate, Piperacillin-Tazobactam, Ticarcillin-Clavulanate, Ampicillin-sulbactam, Cefoxitin, Cephalexin, Ciprofloxacin, Clindamycin, Gentamicin, Metronidazole, Rifampin, Imipenem - cilastatin, Rifaximin
Irritable bowel syndrome (IBS) is a disorder that interferes with the normal functions of the large intestine (colon). It causes symptoms such as crampy abdominal pain, bloating, constipation, and diarrhea, although it does not permanently harm the intestines nor lead to bleeding. Usually symptoms can be controlled with diet, stress management, and prescription medication.
Commonly Prescribed (On-Label) Drugs: Alosetron, Atropine, Dicyclomine, Loperamide, Tegaserod, Tridihexethyl Chloride
Off-Label Prescription Drugs Breakthrough Options: Alprazolam, Amitriptyline, Clonidine, Imipramine, Octreotide
People get traveler’s diarrhea by eating food and drinking water that contain germs to which their bodies are not accustomed. Other people who live in these areas often drink tap water that contains these same germs, but they do not get diarrhea because their bodies are used to the germs. The most common pathogens in traveler’s diarrhea are Escherichia coli, Campylobacter, Shigella, Salmonella, and Yersinia. However, viruses and protozoa can also be the cause. Traveler’s diarrhea can usually be avoided by carefully selecting foods and beverages.
According to the American Family Physician, approximately one-third of travelers to less developed areas of the world become ill from ingesting food or water contaminated with feces, and up to 20% of them develop bloody diarrhea and fever. Such illness requires medical treatment with an antibiotic to kill the bacteria. Unfortunately, many of the bacteria that cause such illness have become resistant to the standard antibiotics usually prescribed.
Commonly Prescribed (On-Label) Drugs: Loperamide
Off-Label Prescription Drug Breakthrough Option: Norfloxacin
People get traveler’s diarrhea by eating food and drinking water that contain germs to which their bodies are not accustomed. They lack protective antibodies (infection-fighting agents in the blood) that attack these germs. Local people do not get sick from these germs, just as cooks and food handlers may have the germs that cause traveler's diarrhea on their hands, but they may not get sick themselves. In some cases, traveler's diarrhea can be avoided by careful food and beverage selection; in others, premedication may be appropriate.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drug Breakthrough Option: Doxycycline
Inflammatory Bowel Disease (IBD) generally has two components: ulcerative colitis, which affects primarily the colon, and Crohn's disease, which primarily affects the lower part of the small intestine. Ulcerative colitis can be difficult to diagnose because its symptoms are similar to other intestinal disorders. It involves immune system abnormalities in which immune cells in the gut that should be protecting the body from infection are instead attacking healthy tissue and causing inflammation.
Commonly Prescribed (On-Label) Drugs: Balsalazide, Mesalamine, Methylprednisolone, Olsalazine, Sulfasalazine
Off-Label Prescription Drugs Breakthrough Options: Azathioprine, Cyclosporine, Thalidomide
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