Background: Methylnaltrexone (MNTX) is a peripherally acting µ-opioid receptor antagonist indicated for opioid-induced constipation (OIC), which can be a serious consequence of opioid analgesia. We evaluated whether baseline osmotic agent (eg, milk of magnesia, polyethylene glycol, lactulose, sorbitol) or stimulant (eg, senna, bisacodyl) use affects the efficacy and safety of MNTX among a subgroup of [...]

Case Presentation: A 70-year-old male with a history of type 2 diabetes mellitus complicated by neurogenic bladder with indwelling catheter and severe peripheral vascular disease status post bilateral below knee amputations (BKAs) presented with watery diarrhea and nausea for 1 day. Both amputations were in the preceding four months. He required multiple rounds of antibiotics [...]

Case Presentation: A 78-year-old man with heart failure, chronic kidney disease, and hereditary spastic paralysis was hospitalized with hyperkalemia to 7.7 mmol/L. He was admitted a month prior with heart failure and discharged on lisinopril with a new prescription for spironolactone. The patient had decreased appetite, limited oral intake, mild nausea, and no vomiting with [...]

Case Presentation: We present a 55-year-old male with a history of chronic constipation refractory to extensive bowel regimens, disimpactions and colonoscopies. Patient presented to the Emergency Department with 5 months of constipation and a history of long periods of constipation since birth, sometimes lasting a year. On exam, patient’s abdomen was distended with decreased bowel [...]