Would anyone know why norvir or protease cause diarrhea?

[mecch]

So I know it can happen.
I had perfect BMs on sustiva and on intelence.  Also always good BMs up to seroconversion.  Since I was treated within months, i would think my digestive track is in pretty good order.  Seems to be the case on NNRTIs.

So was just wondering if anyone knows the mechanism by which norvir or intelence causes diarrhea?  For me there seems to be no pattern.  Just a few times a week I have it and then most of the time not.

The only solution is more medicine?  

I found these two more "natural" suggestions by googling:

Shaman Botanicals Normal Stool Formula has been tested in numerous clinical trials and appears to be very effective against diarrhea. Although fairly expensive, this product may be worth trying if the diarrhea isn't being controlled by other means. You can find out more about SB Normal Stool Formula through buyer's clubs such as AIDS Treatment Initiatives in Atlanta, or select pharmacies such as CPS.

Oat Bran lessened diarrhea in 84% of a study of 51 people on protease inhibitors who suffered from diarrhea. This study, reported on in Positively Aware, showed an either moderate or dramatic improvement in diarrhea after two weeks of treatment with oat bran tablets. The participants took either two or three Solgar brand unprocessed oat bran tablets, with best results coming from taking the tablets a half-hour before meals or right after each protease inhibitor dose.

http://www.thebody.com/content/art32500.html

Anyone want to pipe in another.

I love my meusli - which is basically oats. Maybe thats the key? Going to prepare a bowl now!

[Assurbanipal]

Fiber!

At least for me that seems to be the difference.  Apples, pears, walnuts, raw veggies, bran and whole grain cereals....

[mecch]

(Thanks, eating an apple, waiting for his muesli to soak up the milk).  Why did you switch to Prezista?  I went off Intelence, switching to Prezista, due to a rash that developed after a year.  

[Assurbanipal]

(Thanks, eating an apple, waiting for his muesli to soak up the milk).  Why did you switch to Prezista?  I went off Intelence, switching to Prezista, due to a rash that developed after a year. 

I got to undetectable on Kaletra/Truvada, but then after a few months rebounded to a persistent very low viral load that wouldn't go away.  And I wanted off Kaletra because it was raising my cholesterol and off Truvada because of the osteoporosis.  So I switched to Epzicom/Isentress.  But Isentress blew up my labs and my leg and arm muscles were really sore so they were worried about rhabdomyolosis.  That's how I wound up on Prezista.

While the diarrhea was a little harder to control on Kaletra (which has twice the Norvir), I found fiber worked pretty well for me on it too, I just needed to be more rigorous about it.

[Matty the Damned]

Fiber!

At least for me that seems to be the difference.  Apples, pears, walnuts, raw veggies, bran and whole grain cereals....

++ to this.

I just use psyllium husk. Two teaspoons in water at night.

There is much to be said for the well formed stool.

MtD

[mecch]

I think I can find ways to prevent the diarrhea with fiber and/or drugs, but I was wondering about the mechanism. 

I have read different suggestions - maybe the protease inhibitors are actually damaging the bowels/intestines causing leakage or release of excess water.  Or maybe this leakage is no big deal and diet can make up for it?

See what I mean?  Are protease going to damage my intestinal tract, which heretofore seems fine? 

[Boze]

I've read that probiotics are recommended to combat diahrea for HIV+

1. http://www.medscape.com/viewarticle/587386
2. http://www.crohns.net/Miva/education/archive/0804_Archive_Probiotics_help_diarrhea_in_HIV_Women.shtml