ABSTRACT
OBJECTIVE: To report a case of significant additive gastrointestinal effects with concomitant use of orlistat and an olestra-containing snack food. CASE SUMMARY: A 16-year-old African American girl with type 2 diabetes, hypercholesterolemia, and hypertension was participating in a pilot study that tested the safety and efficacy of orlistat. After 2 weeks of orlistat treatment, the patient presented to the clinic with complaints of soft, fatty/oily stools, flatus with discharge, abdominal pain, increased flatus, and fecal incontinence. On further questioning, it was determined that she was also consuming approximately 5 ounces of olestra-containing potato chips on a daily basis. The patient eliminated olestra from her diet and returned to the clinic with substantially diminished gastrointestinal adverse effects, despite continuing to take orlistat. DISCUSSION: This is the first published case describing additive gastrointestinal effects after concurrent use of orlistat and olestra. Education about the potential for serious additive gastrointestinal adverse effects is important to prevent premature and unnecessary discontinuation of orlistat therapy. Awareness of this potential interaction could be especially important for patients with underlying disease states in which severe gastrointestinal symptoms could result in significant complications. CONCLUSIONS: This case illustrates that significant gastrointestinal distress may result after olestra consumption during orlistat therapy. All patients receiving orlistat for the management of obesity should be properly educated about this potential drug-food interaction.
Subject(s)
Fatty Acids/administration & dosage , Fatty Acids/adverse effects , Gastrointestinal Diseases/chemically induced , Lactones/administration & dosage , Lactones/adverse effects , Sucrose/analogs & derivatives , Sucrose/administration & dosage , Sucrose/adverse effects , Adolescent , Anti-Obesity Agents/administration & dosage , Anti-Obesity Agents/adverse effects , Clinical Trials as Topic , Digestive System/drug effects , Drug Interactions , Fat Substitutes/administration & dosage , Fat Substitutes/adverse effects , Female , Humans , Orlistat , Pilot ProjectsABSTRACT
OBJECTIVE: To evaluate the role of secretin in the treatment of children with autism. DATA SOURCE: Literature was assessed through MEDLINE, EMBASE, BIOSIS (November 1998-August 2001), and the World Wide Web. Literature included scientific studies, anecdotal reports, and meeting abstracts. Key search terms included autism and secretin. DATA SYNTHESIS: Autism is a pervasive developmental disorder. Although several treatments exist, no cure has been identified. New information suggests that secretin may be beneficial for this disorder. A critical evaluation of current information about the use of secretin in autism was conducted. CONCLUSIONS: Currently, several anecdotal reports and a few controlled trials with conflicting results have been published regarding the use of secretin in autism. Further studies should be conducted to determine the safety and efficacy of secretin for autism.