Additive Gastrointestinal Effects with Concomitant Use of Olestra and Orlistat
Bibliographic record
Abstract
AbstractOBJECTIVE: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. ResumenOBJETIVO:Reportar un caso de los efectos aditivos significativo gastrointestinales con el uso concomitante de orlistat y la merienda que contenga olestra.RESUMEN DEL CASO:Una niña afro-americana de 16 años con diabetes tipo 2, hipercolesterolemia, e hipertensión participaba de un estudio piloto para probar la seguridad y eficacia de orlistat. Después de 2 semanas de tratamiento, la paciente se presentó a la clínica con queja de evacuaciones blandas, esteatorea, flatulencia con descargas, dolor abdominal, flatulencia aumentada, e incontinencia fecal. Después de una entrevista, se determinó que ella estaba consumiendo 5 onzas de patatas fritas diariamente que contenían olestra. La paciente eliminó el olestra de su dieta y regresó a la clínica con una disminución marcada de los efectos gastrointestinales a pesar de continuar usando el orlistat.DISCUSIÓN:Este es el primer caso publicado que describe los efectos aditivos gastrointestinales con el uso concurente de orlistat y olestra. La educación acerca del potencial efecto adverso serio es bien importante con el objetivo de prevenir la descontinuación prematura sin necesidad de la terapia de orlistat. El conocimiento de esta potencial interacción podría ser importante, especialmente para pacientes con enfermedades fundamentalmente en quienes los síntomas gastrointestinales severos podrían resultar en complicaciones significativas.CONCLUSIONES:Este caso ilustra un problema gastrointestinal significativo que podría resultar con el consumo de olestra durante la terapia de orlistat. Todos los pacientes que usen orlistat para el manejo de obesidad deben ser apropiadamente educados acerca de esta potencial interacción medicamento-alimento. RésuméOBJECTIF:Signaler un cas d'effets gastro-intestinaux additifs importants lors de l'utilisation concomitante d'orlistat et d'une collation contenant de l'olestra.PRÉSENTATION SOMMAIRE DU CAS:Une jeune fille afro-américaine âgée de 16 ans et souffrant de diabète de type 2, d'hypercholestérolémie, et d'hypertension participe à un projet pilote pour vérifier la sécurité et l'efficacité de l'orlistat. Après 2 semaines de traitement avec l'orlistat, la patiente se présente à la clinique et se plaint de selles molles, graisseuses/huileuses, de flatulence avec écoulement fécal, de douleur abdominale, d'une augmentation des gaz gastro-intestinaux, et d'incontinence fécale. Lors d'un questionnaire subséquent, on apprend qu'elle consomme environ 5 onces par jour de croustilles contenant de l'olestra. La patiente élimine l'olestra de sa diète, et lors d'une visite subséquente à la clinique, elle parle d'une diminution importante des effets gastro-intestinaux, malgré la poursuite de l'orlistat.DISCUSSION:Il s'agit du premier cas signalé décrivant des effets gastro-intestinaux additifs à la suite de l'utilisation concomitante de l'orlistat et de l'olestra. Il est très important de renseigner les patients à propos de la possibilité d'effets indésirables gastro-intestinaux additifs sérieux pour prévenir le retrait prématuré et non nécessaire de l'orlistat. La connaissance de cette interaction potentielle pourrait être particulièrement importante pour les patients présentant des maladies sous-jacentes dans lesquelles des symptômes gastro-intestinaux graves pourraient résulter en des complications importantes.CONCLUSIONS:Ce cas illustre qu'une détresse gastro-intestinale importante peut résulter de la consommation d'olestra durant une thérapie avec de l'orlistat. Tous les patients recevant de l'orlistat pour le traitement de l'obésité devraient être informés de cette interaction médicament-aliment potentielle.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".