Rx Note

Introduction Irritable bowel syndrome (IBS) is a symptom-based gastrointestinal disorder characterized by chronic and/or recurrent abdominal pain or discomfort, bloating and altered bowel habits in the absence of other causes for these symptoms (i.e. absence of abnormality). IBS tends to be episodic, where the patient might have a history of being well for a number of weeks or months in between bouts of symptoms. The cause is unknown, although it is sometimes related to particular foods, and is often precipitated or aggravated by stress. A theory that it occurs due to miscommunication between the brain and the gut, and that gut coordination is affected (dysmotility). Accroding to predominant bowel habit, IBS has been subtyped as IBS with constipation IBS with diarrhoea IBS with mixed symptoms of constipation and diarrhoea (mixed type) Unclassified Indicative for Referral Blood in the stool Is unusual in IBS and can suggest inflammatory bowel disease (e.g. Crohn's disease and ulce...

Introduction The Bristol Stool Chart or Bristol Stool Scale was developed at the British Royal Infirmary, England in 1997. It classifies stools (known as "faeces" or "poo") into 7 types. Interpretation Stool types 1 and 2 indicate constipation , while stool types 6 and 7 are associated with diarrhoea (and stool type 5 to some degree). Stool types 3 and 4 are normal (ideal) stools as they are easy to defecate while not containing excess liquid. External Links Stool form scale as a useful guide to intestinal transit time, 1997 Validity and reliability of the Bristol Stool Form Scale in healthy adults and patients with diarrhoea-predominant irritable bowel syndrome, 2016 Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome, 2017 Digestive Disorders: What Your Poop Type and Color Mean, 2018 Continence Foundation of Australia - Bristol Stool Chart

Drug Safety Update The International Council for Harmonization (ICH) has established a guideline "ICHQ3D" on the levels of certain elements in medicines. The guideline aims to limit exposure to these elements, as the general population is exposed to these elements from various sources over their lifetime. Since elements such as lead occur naturally in soil, naturally occurring diosmectite - the clay from which Smecta is produced - contains trace amounts of lead too. In 2019, as a precautionary measure, the company decided to remove the use of Smecta for acute diarrhoea in infants and children under 2 years, in line with the recommendations to use oral rehydration solutions (ORS) as the preferred treatment for this age category. For the same reason, the use of Smecta in pregnant and breastfeeding women is also restricted. NOTE: To date, there have been no report of lead poisoning following the use of Smecta reported to the NPRA. Antidiarrheal Agents in Paediatric Populati...