The differential diagnosis of small intestinal ulceration and stricture formation is extensive. This is generally classi­fied into broad groups such as congenital, mechanical, in­flammatory, vascular, neoplastic and miscellaneous. Most formations are self-evident from clinical history and are rare. Granulomatous disease, especially with broad-based stric­tures, raises the possibility of Crohn’s disease or an in­fection such as [...]

A 58-year-old, Indo-Canadian male was evaluated for recur­rent bouts of upper epigastric pain and distension that was exacerbated by meals. There was no nausea, vomiting, change in appetite or weight loss. A barium study of the stomach and duodenum showed a dilated duodenum with­out ulceration (Figure 1). Radiographic studies of the jejunum and ileum were [...]

In 1988, Bjarnason et al and Lang et al described the clinical and pathological features associated with small intestinal strictures in patients who had received non- steroidal anti-inflammatory drugs. These small intestinal strictures were very distinctive and unique to the known forms of small intestinal pathology associated with nonster- oidal anti-inflammatory drugs. Investigators used the [...]

This is the first prospective, controlled study of loperamide in pregnancy to date. The results do not support the findings in the previous study with the Michigan Medicaid patients. In that study, which was a surveillance study with no personal interviews of patients (108), six major malformations were found in the first trimester, three of [...]

A total of 105 women from five centres were followed pro- spectively. There were 58 cases from Toronto, Ontario; 25 from Rome, Italy; 16 from Jerusalem, Israel; four from Milan, Italy; and two from Helsinki, Finland. Eighty-nine (85%) women took loperamide during organogenesis, with 21 (20%) taking it throughout their pregnancies. Indications for use were [...]

The Motherisk Program is a counselling service for pregnant and lactating mothers, and their health professionals. Infor­mation about the safety or risk of drugs, chemicals, radiation and infectious diseases is given to approximately 35,000 call­ers per year. The other centres in Italy, Israel and Finland have similar services. The authors attempted to follow all the [...]

Loperamide (Imodium, Janssen-Ortho Inc, North York, Ontario/McNeil Consumer Products, Guelph, Ontario) is a synthetic piperidine derivative used for the treatment of both acute and chronic diarrhea. It exerts its action via cholinergic, noncholinergic, opiate and nonopiate recep­tor-mediated mechanisms. After oral administration, little systemic absorption takes place. About 40% ofa2 mg dose is excreted in the [...]