Evaluation of Antidiarrheal Activity of the Ethanol Extract Leucaena leucocephala (Lam) de Wit Seed

BACKGROUND: Leucaena leucocephala belongs to the Leguminosae/Fabaceae family. L. leucocephala seeds contain alkaloids, flavonoids, and tannins which according to the previous research have antidiarrhea activity. AIM: This study was investigate the antidiarrheal activity of the ethanol extracts of Leucaena leucocephala (Lam) de Wit seeds induced by oleum ricini and intestinal transit methods for rats. MATERIALS AND METHODS: L. leucocephala seeds were extracted by maceration with 80% ethanol. Evaluation of antidiarrheal extract activity was performed by induction of oleum ricini and intestinal transit methods. The extract at dose doses of 50, 100, 200, and 400 mg/kg BW was orally administered to the animals 1 h after induction by oleum ricini. Then diarrhea time, frequency, consistency, stool weight, and duration of diarrhea were observed every 30 min for 6 h. In determining the intestinal transit method, a percentage of the distance of the Chinese ink determined. This study was used positive control as Loperamide (1 mg/kg BW) and 0.5% Na-CMC as a negative control. RESULT: In diarrhea induced by castor oil, L. leucocephala seed extract at doses of 100, 200, and 400 mg/kg bw has been shown to significantly delay the onset of diarrhea, reduce diarrhea frequency, stool weight and duration of diarrhea compared with Na CMC as a negative control (p < 0.05). The extract at a dose of 400 mg/kg bw did not differ significantly from loperamide as positive control (p > 0.05). In this study, L. leucocephala extract reduced the distance traveled by Chinese ink in the intestine but only at a dose of 400 mg/kg bw which has a comparable activity with loperamide significantly . The antidiarrheal activity of extract showed at a dose dependent manner. CONCLUSION: The ethanol extract of L. leucocephala seeds has antidiarrheal activity which supports its use in folk medicines.

Clofazimine for Treatment of Cryptosporidiosis in Human Immunodeficiency Virus Infected Adults: An Experimental Medicine, Randomized, Double-blind, Placebo-controlled Phase 2a Trial

Background We evaluated the efficacy, pharmacokinetics (PK), and safety of clofazimine (CFZ) in patients living with human immunodeficiency virus (HIV) with cryptosporidiosis. Methods We performed a randomized, double-blind, placebo-controlled study. Primary outcomes in part A were reduction in Cryptosporidium shedding, safety, and PK. Primary analysis was according to protocol (ATP). Part B of the study compared CFZ PK in matched individuals living with HIV without cryptosporidiosis. Results Twenty part A and 10 part B participants completed the study ATP. Almost all part A participants had high viral loads and low CD4 counts, consistent with failure of antiretroviral (ARV) therapy. At study entry, the part A CFZ group had higher Cryptosporidium shedding, total stool weight, and more diarrheal episodes compared with the placebo group. Over the inpatient period, compared with those who received placebo, the CFZ group Cryptosporidium shedding increased by 2.17 log2 Cryptosporidium per gram stool (95% upper confidence limit, 3.82), total stool weight decreased by 45.3 g (P = .37), and number of diarrheal episodes increased by 2.32 (P = .87). The most frequent solicited adverse effects were diarrhea, abdominal pain, and malaise. One placebo and 3 CFZ participants died during the study. Plasma levels of CFZ in participants with cryptosporidiosis were 2-fold lower than in part B controls. Conclusions Our findings do not support the efficacy of CFZ for the treatment of cryptosporidiosis in a severely immunocompromised HIV population. However, this trial demonstrates a pathway to assess the therapeutic potential of drugs for cryptosporidiosis treatment. Screening persons living with HIV for diarrhea, and especially Cryptosporidium infection, may identify those failing ARV therapy. Clinical Trials Registration NCT03341767.

Impact of Agaricus bisporus Mushroom Consumption on Gut Health Markers in Healthy Adults

Eating Agaricus bisporus mushrooms may impact gut health, because they contain known prebiotics. This study assessed mushroom consumption compared to meat on gastrointestinal tolerance, short chain fatty acid (SCFA) production, laxation, and fecal microbiota. A randomized open-label crossover study was conducted in healthy adults (n = 32) consuming protein-matched amounts of mushrooms or meat twice daily for ten days. Breath hydrogen measures were taken on day one, and gastrointestinal tolerance was evaluated throughout treatments. Fecal sample collection was completed days 6–10, and samples were assessed for bacterial composition, SCFA concentrations, weight, pH, and consistency. There were no differences in breath hydrogen, stool frequency, consistency, fecal pH, or SCFA concentrations between the two diets. The mushroom diet led to greater overall gastrointestinal symptoms than the meat diet on days one and two. The mushroom-rich diet resulted in higher average stool weight (p = 0.002) and a different fecal microbiota composition compared to the meat diet, with greater abundance of Bacteroidetes (p = 0.0002) and lower abundance of Firmicutes (p = 0.0009). The increase in stool weight and presence of undigested mushrooms in stool suggests that mushroom consumption may impact laxation in healthy adults. Additional research is needed to interpret the health implications of fecal microbiota shifts with mushroom feeding.

Analytical and diagnostic performance of two automated fecal calprotectin immunoassays for detection of inflammatory bowel disease

Background:We evaluated the (pre-)analytical and diagnostic performance of two automated fecal calprotectin (FC) immunoassays, LiaisonMethods:Our study comprised 229 consecutive patients with clinical suspicion of inflammatory bowel disease (IBD).Results:All assay related stool extraction procedures showed excellent correlation with the established method, but the new stool extraction devices tend to give higher results as compared with stool weight methods. Both automated assays demonstrated good performance in terms of precision (CVConclusions:In conclusion, the newly developed stool extraction device protocols showed acceptable and comparable performance to the stool weight method. Overall, the automated Liaison

Diarrhea, Malabsorption, and Small-Bowel Disorders

Diarrhea is a symptom or a sign, not a disease. As a symptom, it can manifest as 1 or more of the following: a decrease in consistency, an increase in fluidity, or an increase in number or volume of stools. A stool frequency of 3 or more times daily is considered abnormal; however, most people consider increased fluidity of stool as the essential characteristic of diarrhea. As a sign, diarrhea is an increase in stool weight or volume of more than 200 g or 200 mL per 24 hours for a person eating a Western diet. Although stool weight is often used in the objective definition, diarrhea should not be strictly defined by stool weight because the amount of dietary fiber influences the water content of the stool.

Diarrhea and Malabsorption

The objective definition of diarrhea is stool weight 〉200 g per day. The more common subjective definition is frequency of defecation that is greater than or equal to three stools per day combined with less-than-normal form and consistency. Diarrhea is also defined by duration. Acute diarrhea is defined as 〈2 weeks in duration, persistent diarrhea between 2 and 4 weeks, and chronic diarrhea more than 4 weeks in duration. In the United States most cases of acute diarrhea are due to infections and are self-limited. Noninfectious etiologies are more common in chronic diarrhea. The evaluation and general management of acute and chronic diarrhea are discussed in this chapter.