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Anti-Diarrheal Drugs

From Project Inform

January, 1999

Treat the Symptoms

A number of over-the-counter medications and certain foods can temporarily help slow the diarrhea. However, these may just mask the problem without solving it. Identifying the cause(s) of diarrhea is critical to successful treatment, and symptom management should generally be considered only a "Band-Aid" solution.

Antidiarrheal medications: Imodium (loperamide), Kaopectate and Pepto-Bismol are over-the-counter drugs that can offer some relief for mild-to-moderate diarrhea. Lomotil (diphenoxylate) can help with moderate diarrhea, but must be prescribed by a physician. In the most severe cases, physicians may prescribe tincture of opium or other narcotics. These drugs reduce muscle contractions in the intestines, thereby slowing the movement of food and liquid through the gut. Still another option is octreotide (Sandostatin), a synthetic hormone that also slows movement through the intestines. These drugs are covered in this section.

However, if there is an infection causing the diarrhea, antidiarrheal drugs may prevent it from being cleared and may actually worsen the problem, resulting in a potentially life-threatening situation. Therefore, they should be used with the utmost care. If the diarrhea does not go away in a few days despite using these medications, consult a physician.

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  • Bulking Agents (like Metamucil) and soluble fiber sources can help slow diarrhea by helping absorb liquids in the intestinal tract and causing bulking of stools. This approach is particularly useful with some drug-induced diarrhea. In general, soluble fiber is found in the "inside" or pulp parts of fruits and vegetables. Foods high in soluble fiber include oatmeal, white rice, grits, cream of wheat, bananas, soft breads (not whole grain), and applesauce, among others.

  • Avoid insoluble fiber: Insoluble fiber is generally found in the outer skin of fruits and vegetables. This type of fiber doesn't absorb water and prompts the intestines to move it along as quickly as possible, thus intensifying diarrhea. It is also best to avoid typical "roughage" like lettuce, whole grain rice or wheat, and the skins of fruits or vegetables as these help clean out the intestines and can aggravate the bowels and intensify diarrhea.

  • Restoring the "friendly flora": Certain "friendly" bacteria and yeast (meaning that they don't cause infections) may help restore the environment of the gut. These natural bacteria -- Acidophilus, various digestive enzymes, and S. Boulardii -- are often destroyed by commonly used antibiotics.

    Other treatments in development include thalidomide, DEHOP (diethylhomospermene) and Bovine Colostrum (Sporidin-G is currently in phase II/III clinical trials).

    Although antidiarrheal medications are helpful, people should be cautious because these drugs may prevent infection-causing agents from leaving the body, thereby prolonging the problem if it is infectious in nature.



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    This article was provided by Project Inform. Visit Project Inform's Web site to find out more about their activities, publications and services.
     
     

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