ENTEROSGEL is an oral intestinal adsorbent (enterosorbent).
It is based on a mineral (organosilicon compound: polymethylsiloxane polyhydrate) with adsorption capacity towards some toxic and harmful substances in the gut (e.g. endotoxins, enterotoxins), physically binding them to its surface, with the intention of reducing stool frequency and duration of diarrhoea.
ENTEROSGEL has several unique features
Both hydrophilic (-OH) and hydrophobic (-CH3) surface groups, so can adsorb both hydrophobic and hydrophilic molecules.
A hydrogel with a unique porous structure consisting of small micropores and a majority of larger mesopores suitable for adsorption of toxins.
These properties favour ENTEROSGEL’S® adsorption of toxins and limit adsorption of lower molecular mass solutes such as pharmaceutical drugs.
ENTEROSGEL is a drug free alternative that has been very widely used in many countries, with no reports of adverse effects. Its safety and performance has been confirmed in numerous clinical investigations where over three thousand patients have been treated with ENTEROSGEL.
LAB BASED STUDIES
A recent article published in the Nature journal “Scientific Reports” has demonstrated that ENTEROSGEL can adsorb (bind) bacterial toxins and bile acids which could help treat tummy bugs and IBS. The study tested the adsorption of bacterial toxins released from Clostridium difficile, Shigella and E.coli, which can cause inflammation and damage to the mucosal cells lining the colon resulting in diarrhoea. Also tested were common bile acids; the levels of which can be raised in the intestines of patients with IBS. ENTEROSGEL adsorption of these molecules was compared to an activated carbon which is used orally to treat cases of poisoning and occasionally other conditions such as diarrhoea. The results showed that ENTEROSGEL has substantial adsorption or binding capacity for these bacterial toxins and to a lesser extent the most common bile acids.
CLINICAL TRIALS
Acute diarrhoea can sometimes be caused by viral or bacterial infection and ENTEROSGEL is proven to bind and remove the bacterial toxins from such harmful bacteria such as; E.Coli, Shigella, C.difficile – common causes of gastroenteritis.
A 2018 randomised controlled clinical study published in the BMJ Open Gastroenterology, has shown that Enterosgel significantly reduces the duration of acute diarrhoea in adults.
The study recruited 105 patients from ten GP surgeries across England. Patients were randomised to the treatment group which received Enterosgel and oral rehydration solution for 8 days, or the control group which received oral rehydration solution alone. Patients completed a daily diary to record their symptoms and treatment use. The study found that the duration of diarrhoea was significantly shorter in the group of patients receiving Enterosgel® compared to the control group of patients (27 hours vs 39 hours respectively). Enterosgel® was well tolerated and safe with no serious side effects.
Dr Preeti Pandya, a GP from The Village Practice, Thornton medical centre was the chief investigator and helped design the study. She says: “Acute infectious diarrhoea is a common condition especially in young children. NHS guidance suggests that you can usually treat yourself or your child at home by drinking plenty of fluids or taking an oral rehydration solution which can alleviate dehydration, although this has no effect on the duration of diarrhoea. We know that Enterosgel® can adsorb bacterial toxins, so it can help remove the causes of diarrhoea and reduce its duration, and this may especially benefit vulnerable groups of patients, such as children and the elderly.”
When used to treat chronic diarrhoea associated with irritable bowel syndrome, ENTEROSGEL has been shown to lead to normalisation of stool frequency and decrease of abdominal pain.
A 2016 clinical study investigated Enterosgel use in the prevention of gastrointestinal adverse reactions in 90 patients with uterine or cervical cancer, treated by external pelvic radiotherapy. Compared to patients who weren’t taking Enterosgel, patients in Enterosgel group had less diarrhoea and nausea and lower weight loss. Suggesting Enterosgel could be recommended as a supportive treatment during pelvic radiation, because it is well tolerated and effectively reduces gastrointestinal problems and weight loss.
The cause of chronic IBS diarrhoea is more complex and multi-factorial and probably includes immune activation, changes to the gut microbiome, increased gut secretion and, in some patients, bile salt malabsorption. The immune proteins released, the bacterial breakdown products of the micro-environment, together with fat molecules and bile acids can all contribute to the development of diarrhoea in these patients. All these molecules are targets for Enterosgel, and research confirms effective adsorption.
EVIDENCE OF HOW ENTEROSGEL WORKS FROM LAB STUDIES
A recent study published in the journal Scientific Reports tested ENTEROSGEL’S adsorption or binding capacity for bacterial toxins, bile acids and pharmaceutical drugs.
Bacterial toxins
Enterosgel was tested for removal of bacterial toxins released from Clostridium difficile, Shigella and E.coli, which can cause inflammation and damage to the mucosal cells lining the colon resulting in diarrhoea. ENTEROSGEL adsorption of these molecules was compared to an activated carbon (Charcodote) which is used orally to treat cases of poisoning. The results showed that ENTEROSGEL has substantial adsorption or binding capacity for these bacterial toxins (see Figure 1).
Figure 1. Graphs showing remaining concentration of C.difficile toxin A and Shigella toxin after mixing with Enterosgel, Charcodote and positive control (no adsorbent) for 60/120 minutes (mean + sem).
Bile acids
The adsorption or binding capacity of ENTEROSGEL was also tested for the 4 most common bile acids, the levels of which can be raised in the intestines of patients with IBS. The results showed that ENTEROSGEL also adsorbed these molecules but to a lesser extent. This was calculated as potentially removing up to 10% of the bile acids produced daily, thereby helping patients with excess levels.
Pharmaceutical drugs
The study tested the adsorption of 2 common drugs; cetirizine (antihistamine) and amitriptyline (antidepressant) and showed that ENTEROSGEL had a much lower rate of adsorption of these drugs than the Charcodote carbon. As most drugs are adsorbed rapidly by the body within 1 hour, this finding suggests that ENTEROSGEL is safe to use in combination with other drug therapies, as long as patients leave at least a 1 hour gap between administration.
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