Can losartan cause diarrhea

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Losartan and Diarrhea: Investigating the Connection

Introduction to Losartan and Gastrointestinal Effects

Losartan, an angiotensin II receptor blocker (ARB), is widely used for managing hypertension. However, like many medications, it can have side effects, including gastrointestinal disturbances. This article explores the potential link between losartan and diarrhea, drawing on recent research findings.

Case Study: Sprue-like Enteropathy and Losartan

A notable case study highlights a severe instance of sprue-like enteropathy associated with losartan use. A 67-year-old man experienced chronic diarrhea and significant weight loss over nine months while on losartan. Despite extensive testing, no other cause for his symptoms was found. Upon discontinuing losartan, his diarrhea resolved within a week, and he regained weight over the following months. Follow-up biopsies showed significant improvement in his intestinal health, suggesting a direct link between losartan and his gastrointestinal symptoms.

Mechanisms of Losartan-Induced Gastrointestinal Disturbances

Research into the mechanisms by which losartan affects the gastrointestinal system provides further insights. A preclinical study using rat tissues demonstrated that losartan can modulate intestinal smooth muscle tone. The study found that losartan caused concentration-dependent contractions in the caecum and duodenum tissues. Additionally, losartan significantly reduced contractions induced by acetylcholine, carbachol, and potassium chloride, indicating that it interferes with pathways involved in gastrointestinal motility, particularly the cholinomimetic pathway.

Conclusion

The evidence suggests that losartan can indeed cause diarrhea, potentially through mechanisms involving the modulation of intestinal smooth muscle tone and interference with gastrointestinal motility pathways. While such adverse effects may be rare, they highlight the importance of monitoring patients on losartan for gastrointestinal symptoms and considering drug-induced causes in unexplained cases of chronic diarrhea. Further research is needed to fully understand the mechanisms and to optimize the therapeutic use of losartan.