Literatus: Truth about side effects

AMONG patients, the popular term “side effects” has been associated negatively to mean “adverse” effects. But if you will come to think of it, these two meanings are not the same.

Literally, “side effects” simply means “effects on the side,” or effects not related to the therapeutic effects that the drug has been formulated for.

Conversely, “adverse effects,” the term commonly used among drug inserts and clinical studies, means “effects that are adverse to the person taking it.” (Take not that certain drug inserts also use “side effects” instead of “adverse effects.”)

The case in point is the anti-obesity drug, Orlistat, chemically referred to as tetrahydrolipstatin because it is an inhibitor of pancreatic enzymes (called lipases) that digest, or break down, dietary fats in the gastrointestinal tract.

One of the established side effects of Orlistat is steatorrhea, or an increased level of fats in the feces. The stools look oily and loose. Usually the person also experience excessive flatus, or bloating in the stomach. While these conditions may be discomforting to some people, these do not pose any danger. The presence of so much fat in the stool is simply a result of fats unabsorbed from the intestines because of the prohibitive action of Orlistat.

Steatorrhea, we may say is a side effect. But is it an adverse effect? Technically, no, it is not. It does not pose any danger.

One “adverse” consequence however if we may use that word relates to the absorption of fat-soluble vitamins such as A, D, E, K and the beta-carotenes. Since these are fat-soluble, inhibition of fats in the intestines also prevents the absorption of these vitamins through the intestinal lining. That means, if you have deficiency in these vitamins the last thing you want to do is take Orlistat.

A potential adverse effect of orlistat came up in a 2006 animal study that linked the drug to the so-called aberrant crypt foci, which are lesions found in the colon that are believed to be one of the earliest precursors of colon cancer. The study came out in Cancer Letters, noting such developments among laboratory rats. But scientifically speaking, that is far from being confirmed as dangerous also to humans.

Many times our fears arise simply because we fail to understand fully situations that caused such fears. And it is a truism in communication that what we hear does not necessarily mean what it supposed to mean as communicated to us. We interpret everything what we perceive. And from that interpretation, we can make errors that unnecessarily cause us negative thoughts and feelings. And needless to say, that how it is to be human.