Mechanisms of drug-induced diarrhoea in the elderly.
Level 5 - mechanism / opinion, no new human data
Narrative review of mechanisms with no original human data or systematic synthesis.
PubMed 9789728 · doi:10.2165/00002512-199813030-00007
What was done
This is a narrative review describing the physiological and pharmacological mechanisms underlying drug-induced diarrhea in older adults, examining age-related changes in gut immunity, motility, microbiome disruption, and direct drug-enterocyte interactions.
What was found
The abstract reports no quantitative empirical data or incidence rates. It describes multiple mechanistic pathways for drug-induced diarrhea in older adults: age-related reductions in gastric acid and secretory IgA; motility alterations; commensal disruption leading to *Clostridioides difficile* infection; cyclic AMP-mediated secretory diarrhea (e.g., bisacodyl, misoprostol, chenodeoxycholic acid); enterocyte Na+/K+ ATPase inhibition (e.g., digoxin, auranofin, colchicine, olsalazine); osmotic diarrhea (e.g., magnesium antacids, lactulose, sorbitol); and direct mucosal injury causing malabsorption or colitis (e.g., neomycin, colchicine, gold salts, penicillamine).
Why it matters
It categorizes the diverse pharmacological mechanisms contributing to diarrhea in older adults to assist clinicians in recognizing medication-related causes amidst polypharmacy.
Limits
As a non-systematic narrative review, it presents mechanistic reasoning without primary data, systematic search methods, or quantitative risk estimates.
Cited by
- supports Exceeding the gastrointestinal absorption capacity with high oral doses of nutrients like magnesium causes loose stools or diarrhea, serving as an indicator of bowel tolerance.