Medical uses
Lubiprostone is a laxative used for the treatment of constipation, specifically:
Chronic idiopathic constipation (difficult or infrequent passage of stools that lasts for 3 months or longer and is not caused by diet, disease, or drugs).Constipation caused by certain opioid (narcotic) pain medications in people with chronic (on-going), noncancer pain, or in patients with long-lasting pain caused by a previous cancer or its treatment who do not need weekly increases in opioid dosage.The effectiveness of lubiprostone has not been established in patients who are taking a diphenylheptane opioid (e.g., methadone).Irritable bowel syndrome with constipation (IBS-C; a condition that causes stomach pain or cramps, bloating, and infrequent or difficult passage of stools) in women who are at least 18 years of age.Lubiprostone has not been studied in children. There is current research under way to determine the safety and efficacy in postoperative bowel dysfunction. It comes in a liquid filled capsule and is available only with a doctors prescription. If one misses a dose it should be taken as soon as possible unless it is almost time for the next dose, in which case it should be skipped and the user should return to their regular dosing schedule. Adverse effects
In clinical trials, the most common adverse event was nausea (31%) . Other adverse events (≥5% of patients) included diarrhea (13%), headache (13%), abdominal distension (5%), abdominal pain (5%), flatulence (6%), sinusitis (5%), vomiting (5%), and fecal incontinence (1%).
There is probably also a genetic predisposition, and smoking is thought to be an aggravating factor. Pathophysiology
The presence of rheumatoid arthritis alters how a persons immune system responds to foreign materials, such as dust from a coal mine. When a person with rheumatoid arthritis is exposed to such offensive materials, they are at an increased risk of developing pneumoconiosis. Diagnosis
Chest radiology shows multiple, round, well defined nodules, usually 0.5-2.0 cm in diameter, which may cavitate and resemble tuberculosis. Lung function tests may reveal a mixed restrictive and obstructive ventilatory defect with a loss of lung volume. There may also be irreversible airflow limitation and a reduced DLCO. Rheumatoid factor, antinuclear antibodies, and non-organ specific antibodies may be present in the serum. Silicosis and asbestosis must be considered in the differential with TB. Management
Once tuberculosis has been excluded, treatment is with steroids. All exposure to coal dust must be stopped, and smoking cessation should be attempted. Rheumatoid arthritis should be treated normally with early use of DMARDs. Prognosis
The nodules may pre-date the appearance of rheumatoid arthritis by several years. Otherwise prognosis is as for RA; lung disease may remit spontaneously, but pulmonary fibrosis may also progress. Epidemiology
Incidence is currently 1 in 100,000 people but is likely to fall as the coal mining industry declines. It has also been shown to occur in cases of complicated silicosis (marked by progressive massive pneumoconiosis).