Diarrhea, characterized by loose, watery stools, is a common and often temporary ailment. While it usually resolves on its own within a few days, it can cause discomfort. Various medications can help manage symptoms.
Over-the-Counter Anti-Diarrhea Medicines
For many cases of acute diarrhea, over-the-counter (OTC) medications offer effective symptom management. Loperamide, commonly found in products like Imodium A-D, works by slowing down contractions in the gastrointestinal tract. This allows intestines more time to absorb water and nutrients, leading to firmer, less frequent bowel movements. Loperamide is an effective OTC option for acute, non-infectious diarrhea, with effects often noticed within an hour.
Another common OTC option is bismuth subsalicylate, available under brand names such as Pepto-Bismol and Kaopectate. This medication decreases the flow of fluids and electrolytes into the bowel, reduces inflammation, and can even kill organisms that might cause diarrhea.
Prescription Anti-Diarrhea Medicines
When over-the-counter options are not sufficient or when diarrhea is more severe or persistent, a doctor might prescribe stronger medications, including:
Diphenoxylate/atropine (Lomotil) is a prescription-strength opioid derivative that slows intestinal movement. Atropine is included to discourage misuse by causing unpleasant side effects if taken excessively.
For irritable bowel syndrome with diarrhea (IBS-D), eluxadoline (Viberzi) may be prescribed. It acts on specific opioid receptors in the gut to reduce bowel contractions and abdominal pain, with minimal bloodstream absorption.
Cholestyramine, sometimes prescribed for bile acid malabsorption, binds to bile acids in the intestine, preventing their reabsorption and reducing diarrhea caused by their presence.
For bacterial infections, antibiotics like rifaximin might be prescribed, especially for traveler’s diarrhea. Rifaximin inhibits bacterial RNA synthesis, targeting gut bacteria due to its poor absorption.
Important Considerations for Anti-Diarrhea Medicine Use
It is important to use anti-diarrhea medicines carefully and be aware of situations where they might not be appropriate. These medications should generally be avoided if diarrhea is accompanied by a fever, bloody stools, or severe abdominal pain, as these symptoms can indicate a bacterial infection or other serious condition where slowing the gut could be harmful. In such cases, the body needs to expel the infection.
Regardless of medication use, maintaining proper hydration is paramount to prevent dehydration, which can occur rapidly due to fluid and electrolyte loss from diarrhea. Oral rehydration solutions (ORS) are particularly effective as they contain the correct balance of water, salts, and sugar to replenish lost fluids and electrolytes.
Common side effects of anti-diarrhea medications can include constipation, dizziness, nausea, and dry mouth. If symptoms worsen, diarrhea persists for more than two days, signs of dehydration develop (such as excessive thirst or decreased urination), or if there is severe abdominal pain, bloody stools, or a high fever (above 101-102°F or 38-39°C), medical attention should be sought promptly. Always follow the dosage instructions on OTC product labels or a doctor’s specific orders for prescription medications.