The drugs for the gastrointestinal system are designed for care and treatment of the digestive system organs (including the liver, biliary tract and pancreas) and diseases that may affect those organs. Among the latter are included constipation and diarrhea, Crohn's disease and irritable bowel syndrome, gastroesophageal reflux disease, ulcers, stomach cancer, gallbladder disease, liver disease and hemorrhoids.
The most common gastrointestinal medications include:
– The 5-aminosalicylates: they are used to treat inflammatory diseases of the intestines, such as ulcerative colitis, proctitis, and Crohn's disease. They act by exerting an anti-inflammatory action; among the main operating mechanisms it also performs the inhibition of prostaglandin production and the reduction of the production of antibodies by plasma cells, elements of the immune system;
– The bile agents solubilizing the cholesterol: used in the presence of non-calcified small calculations that do not necessarily require surgical removal, and they work by reducing the synthesis of cholesterol by the liver or its absorption in the gut;
– The Helicobacter pylori eradicative agents: they are used in combination with antibacterial agents to treat H. pylori infection and work by reducing the acidity in the stomach. This can be antacids or proton pump inhibitors, molecule involved in the production of gastric juices;
– The antacids: they are used in case of failure associated with poor digestion and to relieve the symptoms of peptic ulcers. They act by neutralizing the acidic juices, thus increasing the pH of the stomach and sometimes are matched to the use of alginates, substances that float above the material present in the stomach and form a barrier that prevents the acid from reaching the esophagus and irritate or even damage it;
– The over-the-counter products: their common goal is to stop diarrhea, but to do so they can act very differently. In some cases, they are in the form of antibacterials that act on the removal of a microbe, but often the problem is not associated with an infection; instead, in many other circumstances an active ingredient is necessary to block the intestinal motility or an antispasmodic agent;
– The digestive enzymes: they are used in the case of difficulty of absorption of food caused by enzyme deficiencies. They act by participating in the digestion of food;
– Drugs against the functional disorders of intestines: they are used to relieve the symptoms of irritable bowel syndrome, chronic bloating, diarrhea and constipation. Their mechanisms of action are very variable depending on the active principle considered: some, for example, are antispasmodic drugs, while others act on the gut channels, finally favoring the transit of stool;
– The H2 antagonists (or H2 receptor antagonists): these are used in case of gastro-oesophageal reflux, gastrointestinal ulcers and other disorders associated with an excessive secretion of acids. They act on some receptors in some of the stomach mucosa cells (H2 receptors) normally stimulated by histamine (molecule involved in allergic reactions) to promote the secretion of gastric acids. By interacting with these receptors H2 antagonists reduce acid secretion in the stomach;
– The proton pump inhibitors: they act on some of the stomach wall cells to inhibit the secretion of acid by interfering with the activity of the so-called proton pump. They are used in case of gastric or duodenal ulcers, gastroesophageal reflux disease, or other disorders related to acid hypersecretion;
– The laxatives: these are useful for constipation, in increasing the frequency of bowel movements or favor the transit of feces, for example by taking action on a stool softener or lubricant;
– The gastrointestinal stimulating agents: used in case of gastroesophageal reflux and other gastrointestinal disorders characterized by the slowdown of movement. They act by increasing the motility of the smooth muscles of the intestine without behaving like laxatives. Their mechanism of action varies, but the final effect is always the same: to accelerate intestinal transit;
How should gastrointestinal drugs be taken?
Many gastrointestinal medications require a prescription, but many others can be purchased without one. They come in the form of tablets, solutions, gels, enemas: what matters is always to follow the instructions on the package leaflet or follow the doctor's directions in terms of dose and mode of application.
Contraindications and warnings associated with the use of gastrointestinal drugs
The assumption of gastrointestinal drugs may be associated with variable adverse effects depending on the active principle taken into account. Some side effects concern the digestive system (such as diarrhea, nausea and vomiting), while others act at the neurological level (such as headaches or dizziness). In other cases, like that of laxatives, excessive use may lead to habituation. Therefore, it is always recommended to follow the doctor's instructions or the instructions on the package insert of the drug.
Moreover, in some cases their intake is contraindicated. This is the case, for example, for the proton pump inhibitor lansoprazole, which should not be taken in case of stomach cancer, fructose intolerance or glucose or galactose malabsorption. Thus, it is always advisable to seek advice from your doctor before taking a medication to treat a gastrointestinal problem. The recommendation is especially important when you are living with health problems, if you are already taking other medications or if you are pregnant or breastfeeding.
