USE OF CLONIDINE TO REDUCE DIARRHEA LOSSES IN PATIENTS WITH PROXIMAL JEJUNOSTOMY

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Patients who have had massive resection of their small intestine require intravenous nutrition in order to supply their daily nutritional and fluid requirements. However, some patients with very limited remaining intestine are at especially increased risks for severe dehydration despite conventional therapies, dietary manipulation, and intravenous fluids. In addition, the greater the fecal losses, the greater the electrolyte and trace element losses. This pilot study will test the hypertenive medication clonidine to determine if it may be useful in decreasing diarrheal and electrolyte loses in such patients. Patients will be studied during a baseline period in the GCRC followed by a treatment period. They will act as their own controls. Treatment will consist of a 0.5 mg clonidine patch applied for a week. A comprehensive battery of nutrient balance tests will be completed at baseline and following treatment. Clonidine has proven useful for the treatment of diarrheal losses associated with diarrhea and electrolyte losses associated with cholera. This medication has also been shown to exhibit anti motility effects on small intestine, and therefore, may increase transit time, allowing for more efficient intestinal nutrient and electrolyte absorption.