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HIV
I-Base who publishes HIV Treatment Bulletin (incorporating the
former DrFax) have brought out a new booklet: “an introduction
to combination therapy”. This is a welcome new publication that
deals with issues in greater depth than most of the currently
available leaflets but is not too technical. The introduction
addresses What? Why? When? and other questions. Other
sections include excellent articles on Adherence Resistance,
Drug Combinations, Dosages and even a short section entitled
“Getting on with your doctor”. You can read a copy at the Hanley
Centre, but if you want to keep yourself informed you can have
your own copy (free) from HIV I-Base publications Tel: 020 7737
0567 email: admin@I-Base.org.uk Their website that is up an
running at www.i-Base.org.uk
A
number of our readers have complained of GI (Gastrointestinal)
problems recently. Positive Lives includes extracts on the subject
from a recently published book: Positively Well; Living with
HIV as a Chronic, Manageable, Survivable Disease by Dr Lark
Lands. (Please note that in the USA spelling of words applies
to this article – don’t blame us!)
Diarrhoea
and other gut problems
This is another symptom that may have many different causes.
It's important to check for and treat any parasitic infections
or other internal causes before thinking about side effects.
One big problem for people whose T cells have dropped below
100 (and especially below 75 or 50) is an infection called cryptosporidiosis.
This and other parasites can come from contaminated water, which
is why it is very important to make sure the water you drink
is clean-city water sometimes isn't. If you can, buy a water
filter that is rated NSF-3, which means that the filter is fine
enough to screen out these tiny bugs. If not, buy bottled distilled
water. Please check Consumer Reports and other resources for
the best brands as not all brands have been found to be safe
for people with HIV. If this is too expensive and you have access
to a stove or hot plate, boil your water for 5-10 minutes. Let
it cool to room temperature, covered, then place it in the fridge...
Of course, it is long been recognized that HIV itself and various
infections can cause diarrhoea…
A
wide variety of bacteria may cause diarrhoea. A variety of drugs
also cause diarrhoea. Some herbs and vitamins may cause diarrhoea.
Taking too much fibre (including psyllium) or for too long a
period may result in diarrhoea (and may also carry out too many
nutrients or drugs).
Once
you and your physician have eliminated the various infections
that might cause diarrhoea, gas or bloating, the most likely
causes are, again, HIV itself and/or the antiviral drugs you
may be taking. Your first impulse may be to go to the store
and buy lomotil/Imodium or a similar anti-diarrhoea product.
DAAIR (Direct Action Alternative Information Resources) thinks
you might try some other approaches that not only may help to
stop the diarrhoea, but may also improve how your gut is working…
acidophilus
- Those "good" bacteria your gut needs and which may be
lost during bouts of diarrhoea and/or when using antibiotics.
Take 20-30 minutes before eating
calcium
- Calcium may do the trick for the protease inhibitor nelfinavir/Viracept-related
diarrhoea. May work for other PIs as well.
fennel
- Good also for stomach upset, indigestion, bloating and
gas. Probably best to not use it for more than a couple of weeks.
Very rarely, may cause skin reactions or sun sensitivity. Women
who cannot take the "Pill" should probably avoid it. 1-2 teaspoon
of seeds per cup of water.
glutamine
- is an amino acid that has been shown to be helpful in
dealing with diarrhoea as well as AIDS-related wasting. Wilmore
et al. Nutrition 1999;15:860-864. As Lark Lands points out,
this is because it is an essential fuel for the cells that line
the inside of the intestines (called enterocytes). These cells
turn over very rapidly and in order to do so, they depend heavily
on glutamine. DAAIR has noted especially that many people have
used it to deal with diarrhoea they get when they start protease
inhibitor drugs (especially nelfinavir). You might need to take
anywhere from 4 to 40 grams a day for it to work. Start experimenting!
10-30 grams per day may be very helpful. If it doesn't work,
try some of the following or get that Imodium-but continue taking
the glutamine at a lower dose.
Quiet
Digestion - Chinese herbal blend, Quiet Digestion, which
can be helpful for cramps, gas, bloating and diarrhoea. Quiet
Digestion from Health Concerns is traditionally used to reduce
gastric distress including pain, cramping, nausea, vomiting,
diarrhoea, regurgitation, poor appetite; it treats viral or
bacterial gastroenteritis as well as motion sickness, hangover
and the effects of jet lag! Suggested use is 2 tablets taken
after meals, 3 times per day; also may be taken between meals
or as needed. Chew for best results.
The
complete article can be seen on the DAAIR website www.daair.org
further excerpts from Positively Well at Boston Buyer’s Club
www.vitatime.com (click
on ”Fact Sheets”)
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