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Volume 5, No 1 - Winter 2005

Volume 5, No 1 - Winter 2005

Table of Contents

Differentiating Functional Constipation from Constipation-Predominant Irritable Bowel Syndrome: Management Implications
Symptoms of constipation are commonly seen in medical practice. Once other medical causes have been excluded, distinguishing patients who have constipation-predominant irritable bowel syndrome (IBS) from those with functional constipation has been considered useful in terms of planning management. However, the criteria used to distinguish IBS from functional constipation are arguably arbitrary, and the availability of new therapeutic approaches may render such distinctions of little practical relevance. In this article, the author presents a review of the management implications of differentiating constipation-predominant IBS from functional constipation. [Rev Gastroenterol Disord. 2005;5(1):1-9]
New Concepts in Anti-Tumor Necrosis Factor Therapy for Inflammatory Bowel Disease
Crohn’s disease is a T helper type 1 response immune disease characterized by increased production of interleukin-12 tumor necrosis factor- (TNF-), and interferon-. Clinical trials have demonstrated that inhibition of TNF is effective for the treatment of Crohn’s disease. Adverse events reported in patients treated with anti-TNF agents include immunogenicity, acute infusion reactions, delayed hypersensitivity-type reactions, autoimmune diseases including drug-induced lupus and demyelination, and infection. This article reviews new concepts in the treatment of Crohn’s disease and ulcerative colitis with a variety of anti-TNF biologic therapies: infliximab, adalimumab, CDP870, CDP571, etanercept, and onercept. [Rev Gastroenterol Disord. 2005;5(1):10-18]
Rifaximin: A Nonabsorbed Oral Antibiotic
Rifaximin is a rifamycin analogue with a broad spectrum of activity similar to that of rifampin; however, because it is poorly absorbed in the gastrointestinal tract, the focus of its development has been on intestinal infections and diseases. This agent has proven to be as effective as ciprofloxacin in treating travelers’ diarrhea due to Escherichia coli, although it is ineffective in treating infections due to Campylobacter jejuni. Other potential uses for rifaximin in gastroenterologic disorders include treatment of hepatic encephalopathy, intestinal gas and gas-related symptoms, diverticular disease, intestinal bacterial overgrowth, pouchitis, ulcerative colitis, and active Crohn's disease. This article highlights several studies demonstrating the efficacy of rifaximin in treating travelers’ diarrhea as well as other gastrointestinal diseases and discusses the drug's pharmacokinetics, indications, contraindications, warnings, precautions, adverse reactions, and dosing. [Rev Gastroenterol Disord. 2005;5(1):19-30]