Question:
What is the role of azithromycin for the treatment of gastroparesis?
Background:
Gastroparesis is a chronic condition that is characterized by the slow movement of gastric contents from the stomach to the small intestine, without evidence of obstruction. Symptoms include nausea, vomiting, abdominal pain, bloating, and lack of appetite. The most common cause of gastroparesis is diabetes mellitus, however most patients are diagnosed with an idiopathic cause.1
The treatment of gastroparesis aims to relieve symptoms and improve quality of life. Erythromycin is a macrolide antibiotic that improves gastric emptying through its prokinetic effects. When given orally many motilin agonists, including erythromycin, improve symptoms for several
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Patients included in the study had suspected functional or organic dysmotility, however patients were excluded if they had a prior history of obstruction or malignancy. The ADM test was divided into three phases: an initial fasting phase of 5-6 hours, a digestive phase during which patients were given two 470-calorie shakes, and a postprandial phase in which IV erythromycin and azithromycin were given. IV erythromycin 250 mg was administered to all patients followed by a 4-hour observation period; IV azithromycin 250 mg (n=15) or 500 mg (n=15) was then administered followed by another 4-hour observation period. Measured endpoints include: mean amplitude of antral contractions, duration of highest amplitude antral contractions, total duration of antral contractions, number of cycles per minute, and motility index …show more content…
There was no statistically significant difference in endpoints when comparing lower dose azithromycin to erythromycin. Results also showed no statistically significant difference between higher dose azithromycin and erythromycin with respect to total duration of antral contractions (p=0.11) or the number of cycles of antral contractions per minute (p=0.31). However, higher dose azithromycin showed increased mean amplitude of antral contractions (p=0.006), duration of highest amplitude antral contractions (p=0.03), and motility index (p=0.007), when compared to
The guidelines’ first focus is the definition of sepsis, which makes sense, because there is no way to effectively treat sepsis without an accurate and categorical definition of the term. The guidelines define sepsis as “the presence (probable or documented) of infection together with systemic manifestations of infection”. Such systemic manifestations can include fever, tachypnea, AMS, WBC >12k, among others; these manifestations are listed in full in Table 1 of the guidelines. The definition for severe sepsis builds on to the definition of sepsis, bringing organ dysfunction and tissue hypoperfusion (oliguria, hypotension, elevated lactate) into the picture; full diagnostic criteria is listed in Table 2. The guidelines recommend that all
For people who suffer with hemorrhoids, the discomfort and pain is both real and embarrassing. Unfortunately, because it's such a sensitive topic, many people are reluctant to talk to family and friends to find out what works. In many ways, this doesn't make sense: as unpleasant a subject as it may be, it's important to realize that most people will someday have this problem. Why so many? It's because hemorrhoids are caused by so many ordinary activities. If you lift something that is heavy, are pregnant, have difficulty with constipation – all of these can cause hemorrhoids. Doctors say that anywhere between 50-75% of all Americans will someday experience this problem.
Waknine, Y. (2007, February 9). Heparin product similarities linked to fatal medication errors. Medscape News. Retrieved from http://www.medscape.com
Glazer, G., K. A. Myers, and E. R. Davies. "Ergot poisoning." Postgraduate medical journal 42.491 (1966): 562-568.Google Scholar. Web. 26 Feb 2014.
IBS is a functional GI disorder, meaning it cannot be explained by any specific structural or biochemical abnormality. The disorder is subdivided into three different types, which are named on the basis of the predominant symptom – IBS-D (diarrhea-predominant), IBS-C (constipation-predominant), IBS-M (mixed diarrhea and constipation). Clinical presentation varies considerably with regard to the quality of the predominant feature and the overall severity of symptoms. Formal diagnosis is based on the most recent Rome III criteria, which require that a patient experience recurrent abdominal discomfort of at least 3 days per month over the previous 3 months, with a total symptom duration of at least 6 months, in...
What are gallstones? Gallstones usually form in the gallbladder when liquid stored hardens into pieces of stone like material. Also, gallstones can form anywhere in the intrahepatic, hepatic, common bile, or cystic ducts. The liquid, called bile is used to help the body digest fats. Bile is made in the liver, and then stored in the gallbladder until the body needs to digest fat. At that time, the gallbladder contracts and pushes the bile into a duct which carries it to the small intestine, where it helps with assimilation. Gallstones are yellow liquid made of fats and cholesterol that convert to stones when collect it in the gallbladder. Gallstones are hard, pebble-like deposits that form inside the gallbladder. Gallstones range in size from very small to as large as a golf ball. Also, gallstones can move from the gallbladder into the common duct or the cystic. However, knowledge about gallstones, and Occurrence, Symptoms, Diagnosis, Treatment, and Complications of Gallstones are very beneficial because you will be able to avoid it in the future.
A common condition that is associated with GERD and LES problems is having a hiatal hernia. A hiatal hernia is when you have a larger than normal opening in the diaphragm where the esophagus passes through. Since this opening is larger, the stomach begins to enter this opening. When you eat, the stomach and esophagus do not join as they were properly intended and cause malfunctioning of the LES. In some cases, food remains above the LES allowing it to easily travel back up the esophagus.
Ridley, E. J., Dietet, B. N., & Davies, A. R. (2011). Practicalities of nutrition support in the intensive care unit: the usefulness of gastric residual volume and prokinetic agents with enteral nutrition. Nutrition, 27(5), 509-512. doi:10.1016/j.nut.2010.10.010
Imagine, being born with your intestines hanging out of your belly. Sounds painful and uncomfortable right? "About 2,000 babies are born with gastroschisis each year in the United States" (Gastroschisis. (n.d.). Retrieved May 9, 2014, from http://www.cardinalglennon.com/fetalcareinstitute/conditions/AbdomenIntestines/Pages/Gastroschisis.aspx). Thats about 1 in every 5,000 babies born, not rare, but fairly uncommon for it to be seen in children. Most are born prematurely, but are often delivered naturally without any surgery on the mother.
Oxygen is widely used in both chronic and acute cases, in emergency medicine, at hospital or by emergency medical services (Nicholson, 2004 ). Just like any other form of medication oxygen is a drug that if used incorrectly could cause potential harm, even death (Luettel, 2010 ). Oxygen is admitted to the patient with chest pain for two main rationales. The first is by increasing arterial oxygen tension, which in opposing causes a decrease to the acute ischemic injury, and thus over time the entire infarct area (Moradk...
Oral medications are divided into classes and each class of medication works on different parts of the body to help lower glucose levels. Also, each class of medication has different side effects associated with it. According to the American Diabetes Association, ADA, guidelines the first line therapy when being diagnosed with diabetes is to be started on Metformin. Metformin belongs to the biguanide class of medication. Biguanide oral medications work directly with the liver in order to improve glucose sensitivity. The number one side effect of Metformin is gastrointestinal events such as diarrhea or loose stools, stomach cramping, nausea, vomiting and overall abdominal discomfort that more than 10% patients experience. Over a period of time metformin can cause side effects that will cause more harm for the patient than actual benefit. Patients will start to take Metformin but however due to the uncomfortable side effects many patients decide to stop taking the drug because they find that this drug isn’t for them FIND STATISTICAL MEASUREMENT. Another serious and sometimes life threatening event that could happen while being on metformin is lactic acidosis but is a very rare side effect. Lactic acidosis is when there is a decrease of the pH level in the blood and body tissues and a built up of lactic acid. This condition usually occurs when a patient works out vigorously and the cells in their body don’t receive enough oxygen which in the end causes a buildup of lactic acid. This condition can be very detrimental to a patient's life because it can lead to a coma or possibly death FIND AMOUNT OF PATIENTS THAT HAVE PASSED AWAY THROUGH THIS DRUG (Vroomen-Durning, 2015). Even though some of these side effects are rare the patient is still at risk while taking this drug versus TLC where there are no known side
cause intestinal gas trapping. This can lead to subsequent expansion, and a high possibility of a
Gastroparesis is defined as a persistent heterogeneous defect in the gastric motility. It is characterized by the delayed emptying of solid meal in the absence of mechanical blockage. The symptoms can be mild or severe and they are mostly nausea, vomiting, epigastric pain, early satiety, fullness, anorexia, and/or weight loss.[7] Gastroparesis severely affects the patients’ nutrition, health, and social interactions. Some studies suggest there are many etiologies for gastroparesis but in a large number of patients the cause is still unknown. [8]
I remember when I was child having a lot of stomach issues. I would always get sick from the school lunches and seemed to have a very weak stomach, but the doctors never could diagnose me with anything. As
Vomiting is defined as the forceful ejection of gastric and occasionally, proximal small intestine content through the mouth.