COLOPSA — INDICATIONS AND MECHANISM OF ACTION.

Colospa is a drug often used and proven to be effective in irritable bowel syndrome.

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Colospa is used in adults and children over 10 years for:

-Symptomatic treatment of abdominal pain and cramps, bowel disorders and intestinal discomfort associated with irritable bowel syndrome.
-Treatment of gastrointestinal spasms caused by organic diseases.

Colospa has a muscle relaxant effect on the smooth muscle of the gastrointestinal tract, without affecting the normal peristalsis. It is believed that its effect is the result of two main mechanisms: local anesthetic activity, blocking voltage-dependent sodium channels and potentiating sympathetic inhibitory signals, limiting extracellular calcium ions needed to stimulate smooth muscle receptors. Unlike other asthmatics, Colospa has no anticholinergic effect and has no side effects. Numerous clinical trials have shown excellent tolerability using the drug 135 mg or 200 mg with a frequency of side effects equivalent to the frequency of placebo groups. Currently, Colospa is sold under different trade names in more than 56 countries.

COLOPSA in CHRONIC CALCULOUS CHOLECYSTITIS.

Colospa was studied in 68 patients with chronic cholecystitis aged 18 to 60 years with symptoms lasting from 6 months to 15 years. Patients were randomized to standard therapy with choleretics, enzyme preparations and antacids and standard therapy with + 2 x 200 mg Colospa for 30 days. The effect of treatment on pain and dyspeptic complaints was evaluated by patients with a 5-degree scale. At the end of the first week there was a statistically significant (p <0.01) decrease in the incidence of pain in the Colospa group (22.2% of patients) compared with the control group (37.5%). After 30 days of Colospa treatment, the syndrome was fully controlled, unlike the control group, where 12.5% of patients had pain. Side effects during the study were not observed, and, as in other studies, the drug showed very good tolerability.

COLOPSA IN POSTCHOLECYSTECTOMY SYNDROME.

PHES is a heterogeneous group of symptoms that recur and / or persist after cholecystectomy. This includes both early postoperative bile complications (duct calculus, choledocholithiasis, damage or ligation of the common duct, bile leakage) and late (again choledocholithiasis, common channel strictures, papillary stenosis, biliary dyskinesia) and are directly related to the complications of cholecystectomy (gastritis and diarrhea due to impaired enterohepatic bile duct). Therefore, its incidence in different studies ranges from 5 to 45% with an average incidence of 10-15%. Symptoms can occur from 2 days to 25 years after surgery. Approximately 1/4 of the cases of etiology is a functional disorder. Risk factors for PES are urgent cholecystectomy, longer duration of symptoms before surgery (15% for symptoms below 1 year, 34% for symptoms within 10 years), young age (43% 20 and 29 years., 21% in 50-59 years., 26% in 60-69 years.), female (28% female, 15% male). The most common complaints are colic, diarrhea, nausea and flatulence. The diagnosis is made after a thorough analysis of cholestectomy prior to cholecystectomy and repeated laboratory and imaging studies. The role in the treatment of these patients is assigned to antispasmodics, and in particular Colospa.

A clinical study compared the effect of Colospa 135 mg twice daily, starting 7 days before cholecystectomy until the end of the 3rd month after surgery in 20 control patients with the same characteristics as drotaverine. The best effect was observed in the Colospa group, which received a 100% response to pain syndrome and a 95% response to dyspepsia and a significantly higher quality of life a month after surgery. Interestingly, the Colospa group has also demonstrated a good response to the motor-evacuator function of the intestine, which the authors associate with the possible effect of Colospa to restore small and large intestine microbes after surgery. These results led to the development of a large, promising, multicenter clinical study evaluating the efficacy of Colospa for 2-6 weeks on quality of life and gastrointestinal spasms after cholecystectomy.

Conclusion.

1.Colospa has an excellent effect on pain response and dyspeptic syndrome in patients with biliary diseases such as post-cholecystectomy syndrome, and has been proven to be more effective than other commonly used antispasmodic agents.

2.Colospa improves the quality of life in patients with bile diseases such as post-cholecystectomy syndrome.

3.Numerous clinical trials have confirmed its good tolerability and the absence of significant side effects.

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