Drug-induced diarrhea: a diverse problem in clinical medicine

A. M. Osadchuk, I. D. Loranskaya, M. A. Osadchuk
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Abstract

Currently, the problem of diarrheal syndrome against the background of therapy with non-antimicrobial drugs, with a frequency of occurrence of up to 24%, has become particularly relevant. This is due to an increase in the number of people taking drug therapy for a long time, an increase in the population of older people, an increase in comorbidity, polypragmasia and hypersensitivity of this group of patients to medications. The mechanism of drug-induced diarrhea is complex and insufficiently studied. Many drugs are able to affect various pathogenetic links, causing disorders of the intestinal microbiome, motor evacuation dysfunction, layering on existing intestinal diseases with the development of functional disorders, catarrhal and erosive ulcerative lesions, which makes it difficult to diagnose and choose an adequate therapeutic tactic. The situation is often complicated by the impossibility of canceling the therapy of the underlying disease or changing the treatment regimen, which can lead to serious consequences for a patient with diarrhea syndrome. Thus, the issues of early diagnosis, differential diagnosis and approaches to the treatment of drug-induced diarrhea are becoming increasingly important in clinical practice.
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药物引起的腹泻:临床医学中的一个多样化问题
目前,在使用非抗菌药物治疗的背景下,腹泻综合症的发生率高达 24%,这一问题变得尤为重要。这是由于长期接受药物治疗的人数增加、老年人口增加、合并症增加、多发性瘫痪以及这类患者对药物过敏。药物诱发腹泻的机制复杂,研究不足。许多药物能够影响各种致病环节,导致肠道微生物群紊乱、运动排空功能障碍、在原有肠道疾病基础上发展出功能性紊乱、卡他性和侵蚀性溃疡病变,这使得诊断和选择适当的治疗策略变得十分困难。由于无法取消基础疾病的治疗或改变治疗方案,情况往往变得更加复杂,这可能会给腹泻综合征患者带来严重后果。因此,药物性腹泻的早期诊断、鉴别诊断和治疗方法等问题在临床实践中变得越来越重要。
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