Find information on thousands of medical conditions and prescription drugs.

Aciphex

Rabeprazole is a proton pump inhibitor sold (as its sodium salt) under the brand name Aciphex and Pariet (distributed by Janssen-Ortho).

It is used in the treatment of gastric ulcers and GERD (or heartburn). It is taken once/day along with a full glass of water (preferable 30 min before breakfast). The duration of treatment is usually 4 weeks but could be longer if the symptoms persist.

Sometimes, one may start feeling better after a few days but it is essential to complete the full course of treatment.

Home
Diseases
Medicines
A
8-Hour Bayer
Abacavir
Abamectin
Abarelix
Abciximab
Abelcet
Abilify
Abreva
Acamprosate
Acarbose
Accolate
Accoleit
Accupril
Accurbron
Accure
Accuretic
Accutane
Acebutolol
Aceclidine
Acepromazine
Acesulfame
Acetaminophen
Acetazolamide
Acetohexamide
Acetohexamide
Acetylcholine chloride
Acetylcysteine
Acetyldigitoxin
Aciclovir
Acihexal
Acilac
Aciphex
Acitretin
Actifed
Actigall
Actiq
Actisite
Actonel
Actos
Acular
Acyclovir
Adalat
Adapalene
Adderall
Adefovir
Adrafinil
Adriamycin
Adriamycin
Advicor
Advil
Aerobid
Aerolate
Afrinol
Aggrenox
Agomelatine
Agrylin
Airomir
Alanine
Alavert
Albendazole
Alcaine
Alclometasone
Aldomet
Aldosterone
Alesse
Aleve
Alfenta
Alfentanil
Alfuzosin
Alimta
Alkeran
Alkeran
Allegra
Allopurinol
Alora
Alosetron
Alpidem
Alprazolam
Altace
Alteplase
Alvircept sudotox
Amantadine
Amaryl
Ambien
Ambisome
Amfetamine
Amicar
Amifostine
Amikacin
Amiloride
Amineptine
Aminocaproic acid
Aminoglutethimide
Aminophenazone
Aminophylline
Amiodarone
Amisulpride
Amitraz
Amitriptyline
Amlodipine
Amobarbital
Amohexal
Amoxapine
Amoxicillin
Amoxil
Amphetamine
Amphotec
Amphotericin B
Ampicillin
Anafranil
Anagrelide
Anakinra
Anaprox
Anastrozole
Ancef
Android
Anexsia
Aniracetam
Antabuse
Antitussive
Antivert
Apidra
Apresoline
Aquaphyllin
Aquaphyllin
Aranesp
Aranesp
Arava
Arestin
Arestin
Argatroban
Argatroban
Argatroban
Argatroban
Arginine
Arginine
Aricept
Aricept
Arimidex
Arimidex
Aripiprazole
Aripiprazole
Arixtra
Arixtra
Artane
Artane
Artemether
Artemether
Artemisinin
Artemisinin
Artesunate
Artesunate
Arthrotec
Arthrotec
Asacol
Ascorbic acid
Asmalix
Aspartame
Aspartic acid
Aspirin
Astemizole
Atacand
Atarax
Atehexal
Atenolol
Ativan
Atorvastatin
Atosiban
Atovaquone
Atridox
Atropine
Atrovent
Augmentin
Aureomycin
Avandia
Avapro
Avinza
Avizafone
Avobenzone
Avodart
Axid
Axotal
Azacitidine
Azahexal
Azathioprine
Azelaic acid
Azimilide
Azithromycin
Azlocillin
Azmacort
Aztreonam
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z

Read more at Wikipedia.org


[List your site here Free!]


What is the most effective way for relieving constipation in children aged >1 year?
From Journal of Family Practice, 9/1/04 by Marian Torres

* EVIDENCE-BASED ANSWER

A combination of laxatives, behavioral therapy, and balanced diet is the treatment of choice for pediatric constipation (strength of recommendation [SOR]: B, based on randomized, nonrandomized, controlled and uncontrolled clinical trials). Laxatives are used for disimpaction and maintenance therapy.

Trials that compare different laxatives have shown similar effectiveness, although polyethylene glycol (PEG) 3350 (MiraLax) may be better tolerated (SOR: B). The roles of dietary changes and acupuncture have been minimally studied.

* EVIDENCE SUMMARY

Constipation in toddlers is characterized by a delay or difficulty in defecation that is present for 2 or more weeks. It is a common problem, accounting for 3% of all general pediatric visits. In most children, constipation is functional without pathological cause. Treatment for pathologic constipation is not addressed here.

Laxative therapies were compared in 2 studies. An unblinded, randomized, crossover trial enrolled 37 children referred for subspecialty evaluation of functional constipation. It found that PEG 3350 and lactulose were equivalent in improving stool frequency, stool form, and ease of passage.

However, there was a significant difference in total stool transit time in subjects taking PEG compared with those taking lactulose (47.6 hours vs 55.3 hours, respectively; P=.038). In addition, twice as many parents and guardians rated PEG effective as those rating lactulose effective (84% vs 46%); and 73% of parents preferred PEG to lactulose. (1)

A randomized trial compared PEG with milk of magnesia in 49 children with functional constipation and encopresis. Follow-up at 1, 3, 6, and 12 months revealed similar effectiveness in increasing bowel movement frequency, decreasing soiling episodes, and decreasing abdominal pain. It also revealed that PEG was more palatable and better-tolerated than milk of magnesia (33% of children refused to take milk of magnesia, whereas none refused PEG). No side effects from PEG were reported. (2)

Behavioral modification has been studied for constipation-related encopresis. A randomized controlled trial of 87 children with fecal soiling compared the effect of enhanced toilet training (including behavioral therapy) with aggressive medical management that included disimpaction, enemas, and regular laxative therapy. After 12 months, the enhanced toilet training with behavioral therapy was more effective in reducing daily frequency of soiling (78% of the children had significantly decreased average daily frequency of soiling compared with 41% in the aggressive medical management group; P<.0001; absolute risk reduction=0.37; number needed to treat for 1 year=2.7). (3)

Dietary management centers on a balanced diet with whole grains, fruits, and vegetables. A case-control study evaluated 291 subjects with constipation and compared their diet with 1602 controls. Mean daily fiber intake was lower in the constipation group. Compared with fiber intake of more than 29 g/d, the relative risk was 8.0 for fiber intake of less than 12.4 g/d. (4)

A nonrandomized, controlled trial of acupuncture treatment enrolled 17 children with history of constipation for a minimum of 6 months. Bowel movement frequency improved in both males (1.5 [+ or -] 0.1/week to 4.4 [+ or -] 0.6/week; P<.01) and females (1.4 [+ or -] 0.3/week to 5.6 [+ or -] 1.1/week; P<.01) after 10 acupuncture sessions. No other bowel movement parameter was reported. (5)

* RECOMMENDATIONS FROM OTHERS

The North American Society for Pediatric Gastroenterology and Nutrition (NASPGN) recommends parental education, initial disimpaction as needed, and maintenance therapy with a balanced diet, behavioral modification, and laxatives for all children aged >1 year. Recommended laxatives include mineral oil, magnesium hydroxide, lactulose, and sorbitol. Behavior modification includes regular toileting, unhurried time on the toilet after meals, diary of stool frequency, and a reward system. (6) The American Academy of Pediatrics supports the above guidelines.

A multispecialty panel from the University of Michigan used a structured literature review as a basis for a consensus guideline. The resulting protocol was similar to the NASPGN protocol, with the addition of stool softeners as an alternative to laxatives. (7)

REFERENCES

(1.) Gremse DA, Hixon J, Crutchfield A. A comparison of polyethylene glycol 3350 and lactulose for treatment of chronic constipation in children. Clin Pediatr (Phila) 2002; 41:225-229.

(2.) Loening-Baucke V. Polyethylene glycol without electrolytes for children constipation and encopresis. J Pediatr Gastroenterol Nutr 2002; 34:372-377.

(3.) Borowitz SM, Cox DJ, Sutphen JL, Kovatchev B. Treatment of childhood encopresis: a randomized trial comparing three treatment protocols. J Pediatr Gastroenterol Nutr 2002; 34:378-384.

(4.) Roma E, Adamidis D, Nikolara R, Constantopoulos A, Messaritakis J. Diet and chronic constipation in children: the role of fiber. J Pediatr Gastroenterol Nutr 1999; 28:169-174.

(5.) Broide E, Pintov S, Portnoy S, Barg J, Klinowski E, Scapa E. Effectiveness of acupuncture for treatment of childhood constipation. Dig Dis Sci 2001; 46:1270-1275.

(6.) Baker SS, Liptak GS, Colleti RB, et al. Constipation in infants and children: evaluation and treatment. A medical position statement of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr 1999; 29:612-626.

(7.) Felt B, Wise CG, Olson A, Kochhar P, Marcus S, Coran A. Guideline for the management of pediatric idiopathic constipation and soiling. Multidisciplinary team from the University of Michigan Medical Center in Ann Arbor. Arch Pediatr Adolesc Med 1999; 153:380-385.

* CLINICAL COMMENTARY

After disimpaction, try bowel training, exercise, dietary fiber, and increased fluid

Successful treatment of chronic constipation in children involves skillful use of diet and lifestyle modification, medication, and behavioral interventions, especially if encopresis accompanies the constipation. After initial disimpaction with lubricant laxatives, osmotic laxatives, and enemas, I recommend a maintenance program of bowel training, exercise, dietary fiber, and increased fluid intake. Effective bowel training includes having toilet-trained children sit on the commode after breakfast and prior to afternoon outdoor play.

In keeping with Healthy People 2010 recommendations, as well as studies that link diets rich in fiber to decreased constipation, I encourage parents of toddlers and children to provide them with ample fruits, vegetables, and 6 servings of whole grains per day. I address psychosocial aspects of chronic constipation by acknowledging that family tensions may surround a child's bowel habits, assisting parents to establish a sense of control within their child, advocating a nonpunitive approach to soiling accidents, and suggesting positive reinforcement of their child's successes.

For medical management, I use primarily lactulose, although PEG 3350 (Miralax) has also been shown effective and safe for long-term use. I avoid mineral oil, due to the rare association with lipoid pneumonia; I also avoid sodium phosphate (Fleet) enemas in children aged <2 years, due to the associated risks of electrolyte disturbances and cardiac arrest in this population.

Mark R. Ellis, MD, MSPH, Cox Health Systems, Springfield, MO

DRUG BRAND NAMES

Cetirizine * Zyrtec

Clemastine * Tavist

Doxepin, topical * Zonalon

Fexofenadine * Allegra

Hydroxyzine * Atarax, Vistarol

Lansoprazole * Prevacid

Lidocaine and prilocaine, topical * EMLA cream

Loratadine * Claritin

Omeprazole * Prilosec

Pantoprazole * Protonix

Pimecrolimus * Elidel

Polyethylene glycol 3350 * MiraLax

Rabeprazole * AcipHex

Tacrolimus * Prograf

Marian Torres, MD, Tamara McGregor, MD, Department of Family Practice, University of Texas Southwestern Medical Center, Dallas; Laura Wilder, MLS, University of Texas Southwestern, Dallas

COPYRIGHT 2004 Dowden Health Media, Inc.
COPYRIGHT 2004 Gale Group

Return to Aciphex
Home Contact Resources Exchange Links ebay