Articles Index - Hydrolats
 
Patrick Quanten, MD Independent Health Adviser
 
Gastro-Intestinal System Drugs
 
Drugs for Dyspepsia
Dyspepsia, typically known as heartburn or food-related discomfort (indigestion), occurs with gastro-oesophageal reflux, gastric and duodenal ulcers and gastric cancer. Most commonly dyspepsia is of uncertain origin. Helicobacter pylori infection may be present in some people with non-ulcer dyspepsia but there is little evidence that eradication provides symptomatic relief. Antacids (usually containing aluminium or magnesium compounds) can often relieve symptoms in ulcer dyspepsia and in reflux. Their use in non-ulcer dyspepsia is questionable. Bismuth-containing antacids are best avoided because absorbed bismuth can be neurotoxic. Calcium-containing antacids can induce rebound acid secretion.
 
Aluminium- and magnesium-containing antacids Aluminium Hydroxide, Magnesium Carbonate, Magnesium Trisilicate, Hydrotalcite, Altacite Plus, Asilone, Diovol, Maalox Plus, are constipating and the magnesium-containing ones are laxatives. Compound preparations have no clear advantage over simpler preparations. Antacids interfere with the absorption of all other major drugs, from painkillers to antibacterial, cardiac medication and neurological drugs. There does not appear to be one drug family that is excluded from the list.
 
Sodium Bicarbonate should be avoided in people on salt restriction, with liver and kidney impairment, with cardiac disease, in the elderly and during pregnancy.

Side-effects: belching and alkalosis.
 
Other drugs for Dyspepsia. Algicon, Gastrocote, Gaviscon, Peptac, Topal, and a long list of over-the-counter preparations, Antispasmodics Antimuscarinics
Atropine Suphate, Dicycloverine Hydrochloride, Hyoscine Butylbromide, Propantheline Bromide Neurological disturbances, both central (confusion) and peripheral (tremor), are common. They should not be used in glaucoma, myasthenia gravia, paralytic ileus (paralysed bowel), pyloric stenosis and prostate enlargement. Also these should not be used in Down's syndrome, in children or the elderly. Contraindications: reflux, diarrhoea, ulcerative colitis, acute heart attack, high blood pressure, tachycardia (rapid heartbeat), fever, pregnancy and breastfeeding. Side-effects include: constipation, bradycardia (slow heartbeat) followed by tachycardia and palpitations, drying up of the bronchial secretions, urinary urgency and retention, disturbed vision, photophobia, dry mouth, flushing and dryness of the skin, nausea, vomiting and giddiness. Others include Antispasmodics Alverine, Mebeverine, Peppermint Oil. Contraindications: there are none for peppermint oil, but the others list paralytic ileus, intestinal obstruction, faecal impaction, colon atony, and pregnancy and breastfeeding. Side-effects: nausea, headache, itching, rash, and dizziness.
 
Motility Stimulants. Metoclopramide, Domperidone, Cisapride Contraindications include: liver and kidney impairment, heart arrhythmias. Should be avoided by the elderly and in all cases where gastro-intestinal stimulation is dangerous. Side-effects: abdominal cramp, diarrhoea, hypersensitivity (allergic reactions), headache, lightheadedness, convulsions, increased urinary frequency.
 
Anti-diarrhoeal Drugs. The first line of treatment is oral rehydration preparations. Anti-motilium drugs should not be used for primary treatment. Antispasmodics and antiemetics should be avoided in young children since they are rarely effective and have troublesome side-effects. Antibacterial drugs are generally unnecessary in gastro-enteritis, even when a bacterial cause is suspected, because the complaint will usually resolve quickly without treatment.
 
Anti-motilium Drugs. Codeine Phosphate, Co-phenotrope, Loperamide Hydrochloride, Morphine. They should be avoided where abdominal distension develops or in acute diarrhoeal conditions. Side-effects include: nausea, vomiting, constipation, drowsiness, respiratory depression, low blood pressure, urinary retention, gallbladder spasm, dry mouth, sweating, headache, facial flushing, vertigo, slow heartbeat, fast heartbeat, palpitations, hypothermia, hallucinations, mood changes, dependency, pupil contraction, decreased libido, rash, urticaria, itching, abdominal cramp.
 
Laxatives. Laxatives should generally be avoided except when straining will exacerbate a condition (such as angina) or increase the risk of rectal bleeding, as in haemorrhoids.
 
Bulk-forming Laxatives. Bran, Isapaghula Husk, Methylcellulose, Sterculia Adequate fluid intake should be maintained. These laxatives should not be used with difficulty in swallowing, intestinal obstruction, colon atony and faecal impaction. Side-effects include: flatulence, abdominal distension, gastro-intestinal bstruction or impaction, and hypersensitivity.
 
Stimulant Laxatives. Bisacodyl, Dantron, Docusate Sodium, Glycerol, Senna, Sodium Picosulfate. There is a potential carcinogenic risk with Dantron. All stimulants cause abdominal cramp and prolonged use can induce atonic non-functioning colon and low potassium levels.

 
Osmotic Laxatives. Lactitol, Lactulose, Macrogols, Magnesium Salts, Phosphates (rectal), Sodium Citrate (rectal). These should not be used where intolerance occurs, or with intestinal obstruction or perforation, as well as paralytic ileus, severe inflammatory conditions of the intestinal tract. Side-effects include: flatulence, cramps, abdominal discomfort and nausea.
 
 
Jan Feb 07
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