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The Clinical Use of N-Acetylcysteine in Gastrointestinal Disorders

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The Therapeutic Use of N-Acetylcysteine (NAC) in Medicine

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Abstract

N-Acetylcysteine (NAC) is both a prescription medication and over-the-counter supplement that has been widely used in medicine. Its potential is being realized in other areas of medicine including gastrointestinal (GI) disease. NAC was first studied in GI disease in the 1960s in the context of cystic fibrosis for ileus, abdominal pain, and fat malabsorption. It was then researched in the context of acute and chronic liver failure, pancreatitis, liver surgery, and improving visualization for endoscopy. Some areas of GI disorders have adequate number of good quality trials to make recommendations. Overall, there are mixed but promising findings in the treatment of non-acetaminophen-induced liver failure, particularly acute liver failure. The effectiveness of NAC may depend on the etiology of chronic liver failure, and currently there are active clinical trials on the use of NAC for the treatment of alcohol-induced hepatitis and in the prevention of iatrogenic-induced liver injury, particularly as a result of antituberculous medication, liver failure and in the development of fatty liver. Two other areas that are very promising is in improving outcomes in liver transplantation, particularly when treating the donor liver, and in improving visualization in endoscopy. NAC does not appear to have a role in the treatment or management of pancreatitis. The use of NAC in treating abdominal discomfort and ileus in patients with cystic fibrosis is promising, but it is based on uncontrolled observational studies. Overall, there appear to be many potential uses for NAC in GI disorders, but for other disorders, further studies are needed to define the dosing and/or better define the subpopulation of patients which would most benefit from the treatment.

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Authors and Affiliations

  1. Barrow Neurological Institute, Phoenix Children’s Hospital, University of Arizona College of Medicine – Phoenix, Phoenix, AZ, USA

    Richard Eugene Frye

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  1. Richard Eugene Frye
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Correspondence to Richard Eugene Frye .

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  1. Barrow Neurological Institute, Phoenix Children’s Hospital, University of Arizona, College of Medicine – Phoenix, Phoenix, AZ, USA

    Richard Eugene Frye

  2. IMPACT SRC, Deakin University & Barwon Health, Geelong, VIC, Australia

    Michael Berk

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Frye, R.E. (2019). The Clinical Use of N-Acetylcysteine in Gastrointestinal Disorders. In: Frye, R., Berk, M. (eds) The Therapeutic Use of N-Acetylcysteine (NAC) in Medicine. Adis, Singapore. https://doi.org/10.1007/978-981-10-5311-5_17

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  • DOI: https://doi.org/10.1007/978-981-10-5311-5_17

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  • Publisher Name: Adis, Singapore

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  • Online ISBN: 978-981-10-5311-5

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