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Digestive

Our Digestive section contains a wide range of medications that can be used to treat a variety of gastrointestinal problems of the small and large intestine, also nausea and problems caused by overproduction of stomach acid.

The different classes of digestive medication are listed on the left of the page and when you click on one of these, the principal brand name products display in the left column and generic alternatives to the right.

Use the search feature to quickly find the product you are looking for, by entering either the active ingredient, e.g. omeprazole or the product name, e.g. Losec

Our Bowel class of Digestive medications used to treat of disorders the bowel (lower GI tract) like Inflammatory bowel disease and Irritable bowel syndrome, caused by inflammation, immune system dysfunction, stress, muscle spasm and infection; also constipation due to dysmobility of the intestine.

Use the search feature to quickly find the product you are looking for, by entering either the active ingredient, e.g. mesalazine or the product name, e.g. Asacol.

Inflammatory bowel diseases

Inflammatory bowel disease (IBD) is a group of disorders caused by chronic inflammation of the intestines. The two most common forms of IBD are Crohn's Disease, which can affect any part of the upper or lower GI tract, and ulcerative colitis that affects only the large intestine or colon and rectum. Both diseases are thought to be autoimmune diseases due to an over-reactive immune system, when the immune system attacks self, in this case, intestinal tissue. Symptoms vary from mild to severe when inflammation flares up with symptoms including, abdominal pain and cramping, rectal bleeding, diarrhoea and vomiting. Medications used for treating IBD to relieve symptoms include:
  • Anti-inflammatory drugs like Mesalazine that inhibit the cyclo-oxygenase enzyme (COX) and block the production of inflammatory chemicals like prostaglandins and leukotrienes, which also inhibits the migration of inflammatory cells like macrophages into intestine wall.

  • Immunomodifiers like sulphasalazine, which have anti-inflammatory, immunomodulatory and immunosuppressive effects and work by several different mechanisms, including, inhibiting production of inflammatory chemicals like prostaglandins and leukotrienes, which are also involved in immune reactions, influencing white cell function and inhibiting antibody production.

  • Corticosteroids like budesonide, which are also anti-inflammatory but work by a different mechanism, binding to a glucocorticosteroid receptor in the intestinal cells and inhibiting the production of inflammatory cytokines and cytokine-mediated immune responses.

Irritable bowel syndrome

Irritable bowel syndrome (IBS) covers a range of functional bowel disorders and includes conditions like chronic irritable colon (spastic colon), spastic constipation, spastic colitis and nervous diarrhoea. IBS has no specific cause but may be triggered by several factors, including food sensitivity, stress and infection. Symptoms are caused by spasm of the intestinal muscle as it squeezes food through the intestine and include abdominal pain and cramps, diarrhoea (with or without alternating constipation) and flatulence (wind). Medications used for treating IBD include:
  • Antispasmodics like mebeverine and propantheline that are both anticholinergic and work primarily by blocking the action of the neurotransmitter acetylcholine that is involved in regulating intestinal smooth muscle contraction. This action allows the smooth muscle to relax, reducing muscle spasm.

  • Serotonin agonists like tegaserod that also regulate intestinal smooth muscle contraction by binding to specific serotonin receptors found only in the nerve cells of the GI tract and this helps restore normal bowel motility; it also helps reduce sensitivity to pain and discomfort caused by symptoms of IBS.

Constipation

Chronic constipation may be a symptom of several GI disorders and is characterised by hard stools that are difficult to pass and infrequent bowel movements. Laxatives like lactulose help soften the stools by changing the osmotic pressure in the colon and allowing water to be drawn into the colon, which also increases bowel motility and makes the stools easier to pass.
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Our Stomach class of Digestive medications are used to treat disorders of the stomach, oesophagus and small intestine (upper GI tract) like nausea, reflux and peptic ulcers(stomach and duodenal ulcers); also gastroparesis, which is delayed emptying of the stomach.

Use the search feature to quickly find the product you are looking for, by entering either the active ingredient, e.g. hyoscine or the product name, e.g. Buscopan.

Peptic ulcers and reflux

Gastric acid is needed for digestion of food. Gastric reflux or gastroesophageal reflux disease (GORD) is when the acidic contents of the stomach flow back into the oesophagus causing heartburn (a burning feeling from the stomach towards the neck) and dyspepsia (indigestion and abdominal pain). Reflux disease, as this condition is commonly known, is usually due to damage or loss of normal function of the sphincter muscle at the junction of the oesophagus and stomach that normally acts as a one-way valve and prevents backflow of stomach contents. Reflux can also damage the oesophagus causing oesophagitis or inflammation of the oesophagus.

Peptic ulcers are damage to the stomach lining (gastric ulcers) or the lining of the upper intestine (duodenal ulcers) and are caused by excess gastric acid production due to use of nonsteroidal anti-inflammatory drugs (NSAID) or by infection of the stomach with the bacterium Helicobacter pylori.

Medications used to treat reflux and ulcers are based on reducing the amount of gastric acid produced and released into the stomach, and fall into two categories:
  • Proton pump inhibitors like omeprazole, esomeprazole, rabeprazole and lansoprazole, which block the enzyme involved in producing gastric acid by stomach lining cells.
  • H2-receptor antagonists like ranitidine, which block the gastric H2-receptor preventing the normal stimulation by histamine of gastric acid production.

Ulcer protection

Another treatment for peptic ulcers is using a cytoprotectant like sucralfate that forms a protective barrier over the ulcer from the damaging effects of gastric acid and digestive enzymes.

Gastroparesis

Gastroparesis is when the stomach muscles do not work properly causing a partial paralysis of the stomach and delayed emptying of the contents. The result is that food stays too long in the stomach before emptying into the small intestine and this can put extra pressure on the esophageal sphincter. Gastroparesis is usually due to nerve damage and can be treated using a serotonin (5HT) receptor agonist like cisapride. This action stimulates stomach muscle contraction so that food can be moved out into the small intestine.

Stomach muscle spasm

Muscle spasm in the stomach can be caused by a variety of GI disorders, including peptic ulcers, reflux disease, infection or food intolerance. Muscle spasm can be treated symptomatically using an antispasmodics medication like propantheline that works as an anticholinergic by blocking the action of the neurotransmitter acetylcholine that is involved in regulating intestinal smooth muscle contraction. This action allows the smooth muscle to relax, reducing muscle spasm.

Nausea

Nausea and vomiting are symptoms of several different conditions, including, gastrointestinal disorders, migraine, chemotherapy and radiotherapy for cancer treatment, reaction to surgical anaesthetic and dysmobility, which is when the intestinal or stomach muscles do not work efficiently and movement of food through the GI tract slows down. The vomiting reflex originates in the chemoreceptor trigger zone (CTZ) of the area postrema of the brain sending nerve messages to the vomiting centre of the brain. Medications used to relieve nausea and vomiting include two types of antiemetic:
  • Serotonin receptor-antagonists like ondansetron that work by binding to specific 5HT3 receptors in the intestine and in the CTZ and block the transmission of nerve messages from the intestines and from the CTZ to the vomiting centre in the brain, which prevents the vomiting reflex from being triggered.
  • Dopamine antagonist like domperidone and metoclopramide that work by binding to dopamine receptors in the CTZ blocking the transmission of nerve messages to the vomiting centre in the brain, which prevents the vomiting reflex from being triggered. They also have gastrokinetic action by interacting with nervous control of muscle contraction in the stomach and upper intestine, which helps relieve symptoms of dysmobility (when food processing slows down) and this also helps prevent vomiting.


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What are digestive problems?

Digestive problems are caused by various conditions in different parts of the digestive or gastrointestinal (GI) tract. The upper GI tract comprises the oesophagus, stomach and upper part of the small intestine or duodenum. The lower GI tract comprises the remainder of the small intestines or ileum and the large intestine, or colon, (commonly known as the bowel), rectum and anus.

Symptoms of a digestive problem include heartburn, indigestion, nausea, vomiting, diarrhoea, abdominal pain and cramps, constipation and flatulence (wind). These symptoms can be due to a wide variety of causes, including too much stomach acid, stimulation of the vomiting reflex, muscle spasm in the intestines, dysfunction of intestinal motility and bowel inflammation or irritation.

Digestive cleansing

A complete body cleanse system is available to help with the body’s natural detoxification process.

Medication for upper gastrointestinal problems

Medications that are used for digestive problems of the upper GI tract include:
  • Antiemetics for the treatment of nausea, which include 5HT3 receptor-antagonist and dopamine antagonist.

  • Inhibitors of gastric acid production for the treatment of peptic ulcers and gastric reflux, including proton pump inhibitors, histamine receptor antagonists and serotonin agonists.

  • Cytoprotectants that protect cells that line the stomach from the effects of too much acid.

  • Gastrokinetic drugs that work as serotonin agonists to promote GI motility and are used to treat reflux and gastroparesis, which is delayed emptying of the stomach and causes symptoms like nausea, vomiting and heartburn.

Medication for lower gastrointestinal problems

Medications that are used for digestive problems of the lower GI tract include:
  • Anti-inflammatory drugs that are used for Inflammatory bowel diseases like Crohn's disease and ulcerative colitis; these include both non-steroidal anti-inflammatory drugs (NSAID) and corticosteroids; also immunomodulatory drugs that affect the immune system.

  • Antispasmodics used to treat irritable bowel syndrome (IBS) and other similar conditions including, chronic irritable colon, spastic constipation, functional bowel disorders, mucous colitis, spastic colitis, nervous diarrhoea.

  • Gastrokinetic drugs that work as serotonin agonists to promote GI motility and are used to treat IBS with constipation.

  • Laxatives that are used to loosen stools and relieve constipation.
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