|
Home
Basic Message
Laboratory Tests
Viral Load
When to start treatment?
Treatments
Anti-HIV Drugs
Drugs and Doses
Side Effects
Treatment Changes
Salvage Therapy
Infections
Vaccinations
Lipodystrophy
Micronutrition
Women & HIV
Glossary
| |
DIARRHOEA
Drugs associated with diarrhoea include:
 | Nelfinavir (Viracept) |
| Saquinavir (Invirase & Fortovase) |
| Amprenavir (Agenerase) |
| Ritonavir (Norvir) |
| Abacavir (Ziagen) |
| ddI (Videx) |
Diarrhoea is one of the most common side effects of HIV therapy. Up to 50% of
people with HIV will develop diarrhoea at some point and those with lower CD4
counts are at a greater risk.
TREATMENT
Eliminate all possible causes by a thorough investigation and if nothing
shows up, then treat the symptom itself.
Diet
| Reduce lactose intake – milk and dairy products. Use alternatives such
as rice and soya milk that do not contain lactose. |
| ‘Rice water’ can also help. Boiling a small amount
of rice in water for 30–45 minutes (or microwave for a shorter time),
flavouring with ginger, honey, cinnamon or vanilla when cooled, and then
drinking throughout the day. |
| Eat less insoluble fibre. Foods that contain insoluble fibre include
vegetables, whole wheat breads and cereals, skins, fruit, seeds and nuts. |
| Eat more soluble fibre. Soluble fibre can be found in white rice,
pasta. Ispaghula (psyllium) husk (i.e. Fybogel or Isogel) and oat bran tablets
increase soluble fibre in your diet. |
| Reduce caffeine – coffee, tea and cola, as this can cause the gut to speed
up and result in more bowel movements. |
| Avoid high fat, greasy and high sugar foods. |
| Don’t drink with your meals but make sure you take plenty of fluids
between meals to replace the fluid being lost due to diarrhoea. |
| Eat foods rich in potassium such as bananas, peaches, potatoes, fish and
chicken. Potassium is lost when you have diarrhoea. |
| Eat live yoghurt to enhance the friendly bacteria in your gut. Acidophilus
can be taken in pill form. If your CD4 count is under 50 this may not be
advised. |
| Make sure your diet remains balanced; don’t live on just a few food
products, as you will be missing out on essential vitamins and minerals. |
Medications and supplements
| Fluid and electrolyte replacement (such as dioralyte and sports
rehydration solutions like Gatorade etc) |
| Imodium (loperamide), lomotil and codeine phosphate are used for
diarrhoea. Start with low doses. If you are taking the maximum daily dose
(for example 8 pills a day for Imodium) and you are still not getting the
problem under control, get the medications changed. |
| Calcium supplements can help reduce diarrhoea associated with nelfinavir
and possibly other protease inhibitors. Normally 500mg twice a day will
help. |
| Glutamine in ranges from 5g to 40g a day. It is available either as a
powder that must be dissolved in water or a regular pill. |
| Probiotics (good bacteria in gut): acidophilus, lactobacillus, bifidum, s.
boulardii can be taken. |
| Herbs that may be helpful: ginger root, meadowsweet, bayberry root bark
and black walnut tincture. |
| Bulk forming laxatives, absorb fluid and bulk out the stool. Take
following a meal and you should not drink for 30 minutes after taking them.
Brands include Fybogel, Regulan, Celevac and Normacol. |
| Studies on oatbran tablets taken by people with diarrhoea using protease
inhibitors proved very successful. The dose was 2–3 oatbran tablets before
meals or after each protease inhibitor dose. |
As a last resort...
Slow release morphine sulphate (MST) or
octreotide injections can be used if
all the usual medications have failed to make a difference. The slow-release
formulation of MST means that low doses of the drug are provided throughout the
day. It comes in a wide range of strengths each coloured differently – so you
can be very careful about only taking the dose that you need. The liquid
formulation of morphine sulphate can be used for diarrhoea that occurs at
specific times – i.e. in the hours after dosing.
MST works because one of the side effects of opiates is constipation, and it
works by slowing down the gut. For some people it is the only thing that works
– and even very low doses mean you can get back to a normal life.
Treatments for
diarrhoea
| Diet changes |
| Electrolyte replacement |
| Imodium (loperamide) or Lomotil |
| Calcium supplements |
| Ispaghula (psyllium husk or seeds) |
| Glutamine |
| MST (slow release morphine sulphate) |
| Octreotide injections |
[ Reporting Side FX ] [ Grading Side FX ] [ Side FX & Drug Levels ] [ Changing Drugs ] [ Your Rights ] [ Diarrhoea ] [ Nausea & Vomiting ] [ Fatigue ] [ Skin Rash ] [ Dry Skin, Hair Loss ] [ Sexual Problems ] [ Insomnia ] [ CNS FX with Efavirenz ] [ Peripheral Neuropathy ] [ Liver Toxicity ] [ Lactic Acidosis ] [ Abacavir Sensitivity ] [ Kidney Stones ] [ Bone Changes ] [ Heart Disease ] [ T-20: ISR ] [ Increased Bilirubin, Jaundice ]
|
