Disease Encyclopedia|Gastrointestinal|Diarrhea|Antidiarrheal Medicines


So what is diarrhea? How it occurs? & what’s treatment of diarrhea?

diarrhea
Diarrhea is the opposite of constipation so When the contents of the intestines contain too much fluid, or movement through the GI tract is too rapid, fluids cannot be absorbed and an excessive volume reaches the large intestine. This results in sudden initiation of stretch receptors and rapid evacuation of the colon, causing diarrhea. Thus, diarrhea presents the opposite problems to those associated with constipation. When fluid balance and GI motility are restored, bowel movements return to a normal pattern. Diarrhea is usually defines as more than three loose or watery bowel movements per day without any known cause. This rapid movement of fluid through the GI tract is often accompanied by gas, cramping, or general abdominal discomfort.


Traveler’s diarrhea is a common condition when an individual travels to areas with relatively poor sanitation. It is most commonly caused by ingestion of contaminated foods or water that contains fecal Escherichia coli, which produces an endotoxin, but other bacteria or viruses are also known to cause diarrhea. Uncooked foods and unpurified water should be avoided to lessen the risk of accidental ingestion of contaminated substances.
Diarrhea that is suspected of being caused by bacterial organisms, other than traveler’s diarrhea, requires referral to a physician for proper diagnosis and treatment with prescription antibiotics. Diarrhea caused by viruses is frequently of short duration, and oral fluids should be used to prevent dehydration.

Individuals who have profound diarrhea or chronic diarrhea lasting more than 48 to 72 hours should consult a physician.
Ingestion of substances that can create increased osmotic pressure in the bowel may cause diarrhea if they are used in large quantities or for long periods of time. Magnesium-containing dietary supplements and xylitol,
mannitol, and sorbitol sweeteners in candy, gums and foods are common substances that may cause diarrhea.

Treatment of Diarrhea
Adsorbants
Drug category and usage
Antidiarrheal drugs reduce or stop symptoms associated with diarrhea. Kaolin is the only monograph adsorbant and it helps to firm stools within 24 to 48 hours.
Monograph ingredient
Kaolin suspension.
Mode of action
Adsorbant drugs adsorb water in the GI tract to create a semisolid mass, thus lessening the amount of fluid that reached the large intestine. This may both reduce the frequency of bowel movements and make them less watery
Warnings and precautions
Adsorbant drugs should not be used without consulting a physician if stools are bloody or black or there is mucus in the stool, or if a fever is present. If other medications are being taken, kaolin should be taken either 3 hours before or 3 hours after the other drugs. A physician should be consulted if the diarrhea gets worse or if it lasts for more than 48 hours. Plenty of fluids should be drunk to prevent the dehydration caused by diarrhea.

Electrolyte solutions or juices that do not contain an excess of glucose or sugar are better sources of fluid than plain water. Caffeine and alcoholic drinks should be avoided because they cause excess urination with additional fluid loss.
Recommended dose
Adults and children over 12 years of age should take 26 g of the product after each loose bowel movement or every 6 hours; it should not be taken for more than 2 days. Children under 12 years of age should not take the product without the supervision of a physician.

Bismuth subsalicylate
Drug category and usage 
Bismuth subsalicylate may be used to control or relieve the symptoms of diarrhea or traveler’s diarrhea; it reduces the number of bowel movements and helps to firm stools.
Mode of action
Bismuth subsalicylate is an astringent and coats the mucosa. It produces some effect because it has adsorbant properties, but it also has antisecretory effects, which reduces the amount of fluids entering the GI tract.
Warning and precautions
Bismuth subsalicylate should not be used without consulting a physician if stools are bloody or black, if there is mucus in the stool, or if a fever is present. There may be a temporary darkening of the tongue and stools from use of this drug.
Bismuth subsalicylate does not contain aspirin, but it may cause an adverse effect in an individual allergic to aspirin; it should not be used in children or teenagers who have or are recovering from chickenpox or flu-like symptoms (Reye’s syndrome warning); those taking anticoagulants (blood thinning drugs) should consult their physician before use.
Those with diabetes, gout, or arthritis should ask a physician or pharmacist before using this product. If ringing in the ears or a loss of hearing develops, stop using the drug. If symptoms get worse or diarrhea last for more than 48 hours, a physician should be consulted. Plenty of fluids should be drunk to prevent dehydration caused by diarrhea.
Recommended dose
Adults and children over 12 years of age may take 1050 mg bismuth subsalicylate every 30 to 60 minutes but should not exceed 4200 mg in 24 hours; bismuth subsalicylate should not be used for more than 2 days. Children aged 9 to 11 years may take one-half the adult dose (525 mg); children aged 6 to 8 years may take 350 mg; children aged 3 to 6 years may take one-sixth of the adult dose (175 mg); children under 3 years of age require recommendation by physician.

Loperamide
Drug category and indications
Loperamide is an anticholinergic drug that is used to reduce or stop diarrhea, including traveler’s diarrhea.29
Rx–OTC switched drug
Loperamide.
Mode of action
Anticholinergic drugs block the action of the peripheral parasympathetic nervous system and reduce GI motility. This allows more time for absorption of fluid from the GI tract and reduces the watery stools.
Warnings and precautions
Loperamide should not be used for more than 48 hours or in individuals who have an elevated body temperature greater than 101_F (38.3_C); use of this drug may cause a rash. Loperamide should not be used in children under 6 years of age.
Recommended dose
The dose of loperamide for adults and children aged 12 years and over is 4mg after the first loose bowel movement and 2mg after each loose bowel movement thereafter. The maximum daily dose is 8 mg.
Children between 6 and 11 years of age may take 2 mg after the first loose bowel movement and 1mg after each loose bowel movement thereafter. The maximum daily dose is 4 mg. When the liquid formulation is used, the measuring device in the packaging should be used for exact measure for children’s doses.

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