Steatorrhea medical therapy: Difference between revisions
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{{Steatorrhea}} | {{Steatorrhea}} | ||
{{CMG}}; {{AE}}{{Vbe}} | {{CMG}} ; {{AE}}{{Vbe}} | ||
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==Medical Therapy== | ==Medical Therapy== | ||
Management of steatorrhea include treatment of underlying etiology , control of diarrhea and correction of nutritional deficiencies. | Management of [[steatorrhea]] include treatment of underlying etiology, control of [[diarrhea]] and correction of [[nutritional deficiencies]]. | ||
=== Correction of Nutritional Deficiencies === | === Correction of Nutritional Deficiencies === | ||
* Preferred regimen (1) : Vitamin A 40,000 to 50,000 units q12h | * Preferred regimen (1) : [[Vitamin A]] 40,000 to 50,000 units q12h | ||
** Note : Maintenance: 8000 to 20,000 units/day (dosage ≥15,000 units can be teratogenic) | ** Note : Maintenance: 8000 to 20,000 units/day (dosage ≥15,000 units can be [[teratogenic]]) | ||
* Preferred regimen (2) : Vitamin D3 (cholecalciferol) 30,000 to 50,000 units q24h | * Preferred regimen (2) : [[Vitamin D3]] ([[cholecalciferol]]) 30,000 to 50,000 units q24h | ||
* Preferred regimen (3) : Vitamin K 2.5 to 12.5 mg q24h | * Preferred regimen (3) : [[Vitamin K]] 2.5 to 12.5 mg q24h | ||
* Preferred regimen (4) : Folic acid 5 mg q24h during repletion | * Preferred regimen (4) : [[Folic acid]] 5 mg q24h during repletion | ||
* Preferred regimen (5) : Vitamin B12 (cyanocobalamin) 1 mg subcutaneously | * Preferred regimen (5) : [[Vitamin B12]] ([[cyanocobalamin]]) 1 mg [[Subcutaneous|subcutaneously]] | ||
* Preferred regimen (6) : Ferrous | * Preferred regimen (6) : [[Ferrous sulfate]] 325 mg (65 mg elemental [[iron]]) q8h | ||
* Preferred regimen (7) : Magnesium gluconate 1 to 4 g (54 to 216 mg elemental magnesium) | * Preferred regimen (7) : [[Magnesium gluconate]] 1 to 4 g (54 to 216 mg elemental [[magnesium]]) q6h | ||
* Preferred regimen (8) : Calcium carbonate 500 mg (elemental calcium) | * Preferred regimen (8) : [[Calcium carbonate]] 500 mg (elemental [[calcium]]) q12h | ||
=== Antidiarrheal agents === | === Antidiarrheal agents === | ||
*Preferred regimen (1) : Loperamide 2 to 4 mg as needed, not to exceed 12 mg/day | *Preferred regimen (1) : [[Loperamide]] 2 to 4 mg as needed, not to exceed 12 mg/day | ||
*Preferred regimen (1) : Diphenoxylate with atropine (Lomotil) 1 to 2 tabs after loose stool, not to exceed 8 per day | *Preferred regimen (1) : [[Diphenoxylate and Atropine|Diphenoxylate with atropine]] ([[Lomotil]]) 1 to 2 tabs after loose stool, not to exceed 8 per day | ||
*Preferred regimen (1) : Deodorized opium tincture 10 percent (10 mg per mL) 0.3 to 0.6 mL | *Preferred regimen (1) : [[Opium Deodorized|Deodorized opium tincture]] 10 percent (10 mg per mL) 0.3 to 0.6 mL q8h | ||
=== Bile acid binding resins === | === Bile acid binding resins === | ||
:* Preferred regimen (1) : Cholestyramine 4 g three times daily | :* Preferred regimen (1) : [[Cholestyramine]] 4 g three times daily | ||
:* Preferred regimen (1) : Colestipol granules 5 to 10 g three times daily | :* Preferred regimen (1) : [[Colestipol]] granules 5 to 10 g three times daily | ||
:** Note: Administer ≥1 hour before or >4 hours after other drugs to prevent decreased absorption of other drugs. | :** Note: Administer ≥1 hour before or >4 hours after other drugs to prevent decreased absorption of other drugs. | ||
===Pancreatic enzymes=== | ===Pancreatic enzymes=== | ||
* Preferred regimen (1) : Pancrelipase delayed-release capsules (Creon minimicrospheres) | * Preferred regimen (1) : Pancrelipase delayed-release capsules (Creon minimicrospheres) | ||
* Preferred regimen (1) : Pancrelipase tablets and powder (Viokase | * Preferred regimen (1) : [[Pancrelipase]] tablets and powder (Viokase) 1 g (equivalent to 20,000 units [[lipase]] component) with meals | ||
** Note: Approximately 30,000 units (90,000 USP) (lipase component) with each meal | ** Note: Approximately 30,000 units (90,000 USP) ([[lipase]] component) with each meal | ||
=== Management of Underlying Etiologies === | === Management of Underlying Etiologies === | ||
Revision as of 18:26, 8 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]
Overview
Medical Therapy
Management of steatorrhea include treatment of underlying etiology, control of diarrhea and correction of nutritional deficiencies.
Correction of Nutritional Deficiencies
- Preferred regimen (1) : Vitamin A 40,000 to 50,000 units q12h
- Note : Maintenance: 8000 to 20,000 units/day (dosage ≥15,000 units can be teratogenic)
- Preferred regimen (2) : Vitamin D3 (cholecalciferol) 30,000 to 50,000 units q24h
- Preferred regimen (3) : Vitamin K 2.5 to 12.5 mg q24h
- Preferred regimen (4) : Folic acid 5 mg q24h during repletion
- Preferred regimen (5) : Vitamin B12 (cyanocobalamin) 1 mg subcutaneously
- Preferred regimen (6) : Ferrous sulfate 325 mg (65 mg elemental iron) q8h
- Preferred regimen (7) : Magnesium gluconate 1 to 4 g (54 to 216 mg elemental magnesium) q6h
- Preferred regimen (8) : Calcium carbonate 500 mg (elemental calcium) q12h
Antidiarrheal agents
- Preferred regimen (1) : Loperamide 2 to 4 mg as needed, not to exceed 12 mg/day
- Preferred regimen (1) : Diphenoxylate with atropine (Lomotil) 1 to 2 tabs after loose stool, not to exceed 8 per day
- Preferred regimen (1) : Deodorized opium tincture 10 percent (10 mg per mL) 0.3 to 0.6 mL q8h
Bile acid binding resins
- Preferred regimen (1) : Cholestyramine 4 g three times daily
- Preferred regimen (1) : Colestipol granules 5 to 10 g three times daily
- Note: Administer ≥1 hour before or >4 hours after other drugs to prevent decreased absorption of other drugs.
Pancreatic enzymes
- Preferred regimen (1) : Pancrelipase delayed-release capsules (Creon minimicrospheres)
- Preferred regimen (1) : Pancrelipase tablets and powder (Viokase) 1 g (equivalent to 20,000 units lipase component) with meals
- Note: Approximately 30,000 units (90,000 USP) (lipase component) with each meal
Management of Underlying Etiologies
- For a detailed explanation of management of Crohn's disease click here
- For a detailed explanation of management of celiac disease click here
- For a detailed explanation of management of gallstones disease click here
- For a detailed explanation of management of cystic fibrosis disease click here
- For a detailed explanation of the management of small bowel bacterial overgrowth syndrome click here