PlanetRx - Learn More - Product Advice - Diarrhea Treatments

No one has a "cast iron" stomach

You have to be careful about what you consume. You've probably heard not to drink the water in some foreign places. But who warned you about triple-spicy chili, a funky piece of week-old pie, or the toll that eating a whole bowl of cherries might take? So there you are, and diarrhea strikes. Yikes!

Luckily, diarrhea medications can bring relief and even be used as a preventive measure for people who are traveling or have sensitive stomachs. Most over-the-counter products have both liquid and tablet formulations, which are considered equally effective. Next time diarrhea strikes, you can strike back.

Some Causes of Diarrhea

Food contamination: bacterial contamination of food may produce symptoms that last two days to three weeks, depending on the type of bacteria. Medication is taken to relieve symptoms.
Food digestion problems: food allergy or inability to digest certain foods can cause diarrhea.
Viral infection: viruses can infect the intestines and cause diarrhea as a symptom, which lasts two to eight days depending on the virus. Medication is taken to relieve symptoms.
Protozoal infection: some protozoans can cause infection, with diarrhea as a symptom. Unlike viral or bacterial infections, protozoal infections must be cured with drugs.
Antibiotics: antibiotics can kill intestinal bacterial, disrupting the normal flora which results in diarrhea. Chronic use of antibiotics may result in diarrhea due to drug-resistant bacteria.

Choosing Foods

When you have diarrhea choose mild and bland foods that help firm stools. Safe choices are easy if remembered as "BRAT":

Bananas
Rice
Applesauce
Toast

Foods that can aggravate diarrhea:

Those containing caffeine
Dairy products
Fruit juices
Fatty or fried foods
Alcohol
Spicy foods

It's Time to See a Physician

You should consult a physician if any of the following apply:

There is blood in the stool, which appears black or red.
Stools appear mucus-like or slime-like.
In adults, if the diarrhea has lasted for more than seven days
In children, if the diarrhea has lasted more than 48 hours.
A fever greater than 101? F is present.
More than five percent of your (or your child's) body weight has been lost.
Extreme abdominal pain

Don't Forget About Dehydration

Excessive diarrhea can lead to dehydration. Make sure you drink adequate liquids if you have diarrhea. But don't drink only water -- sports drinks should be used to replace lost electrolytes and glucose. If your child has diarrhea, there are oral rehydration therapies available that have the proper electrolyte concentration to help your child feel better. Be aware of these dehydration signs:

Muscular cramps
Irregular heartbeat
Fatigue
Disorientation
Confusion
Sunken eyes
Dry mouth
Blue skin
Sensation of cold in arms and legs
Unconsciousness

Absorbents

The nonprescription antidiarrheal medication used most. Works by nonspecifically absorbing material from the gastrointestinal tract -- including nutrients, toxins, and bacteria -- to relieve diarrhea.

Bismuth compounds

Bismuth salts like bismuth subsalicylate and bismuth subnitrate are thought to coat the digestive tract and protect it from irritants. However, since most anti-diarrheals are taken after the diarrhea starts, the efficacy of bismuth salts in treating diarrhea has been questioned. Since coating agents work in a preventive manner, coating the system after the infection has already occurred may not be useful.

Antiperistaltic

Slows the smooth muscle contractions of the colon. Having fewer cramps allows the fecal matter to pass through the colon more slowly, giving the body more time to reabsorb water from the stool. Also helps relieve pain from cramping. Some experts believe that the slowing action of cramp relievers may slow the recovery from diarrhea because the bacteria causing the episode remain in the system longer.

Ingredient		Description
Absorbents
Attapulgite	?	Unlike other antidiarrheal ingredients, attapulgite also relieves cramps associated with diarrhea. Very absorbent. In addition to improving consistency of stools, also decreases number of stools passed. Nontoxic with almost no side effects.
Kaolin (conditionally approved)	?	Safe. Has absorbent properties, but less so than attapulgite. Effectiveness in decreasing number of stools is unproven.
Pectin (conditionally approved)	?	Safe in low doses. Has absorbent properties, but less so than attapulgite. Effectiveness in decreasing number of stools remains unproven.
Polycarbophil	?	The only over-the-counter antidiarrheal approved for use by young children. Synthetic resin which acts like an absorbent.
Bismuth Compounds
Ingredient		Description
Bismuth Subsalicylate (conditionally approved)	?	May offer some preventive action when taken daily -- while traveling, for example. Should not be used in children and teenagers who have or are recovering from the flu or chicken pox, due to the potential for a rare but serious illness called Reye's syndrome.
Antiperistaltic
Ingredient		Description
Loperamide	?	Effective and widely used. Slows intestinal movement while increasing movement of water through the intestine. Few adverse reactions.

FDA-Approved Uses

General antidiarrheals

Reduces the number of episodes of diarrhea.

Improves the consistency of loose, watery stools into more formed bowel movements.

Relieves cramps associated with diarrhea.

Dealing with Dehydration

When you have diarrhea, your body loses more fluid than it normally would. Because of this, your body also loses precious electrolytes.
Small children and older adults are most affected, because they are more sensitive to water and electrolyte imbalances.
When you have diarrhea, it is important to drink fluids to replace lost water. But you must also replace lost electrolytes. Sports drinks and specialized rehydration therapies are available to help maintain your electrolyte balance.
Sodas and other carbonated beverages are not good choices because they often contain caffeine, which could cause more water loss.

Toothbrush, Extra Underwear, Bismuth Subsalicylate (Taking Care of Traveler's Diarrhea)

Moving to new and distant places exposes you to new and distant microbes, which can cause diarrhea.
Bismuth subsalicylate is the only over-the-counter medication recognized to prevent traveler's diarrhea.
The adult dose is 2.1 grams per day (two tablets or 30 ml four times per day) taken with meals for the first two weeks of travel.
For bouts of acute diarrhea during travel, two tablets or 30 ml may be taken every 30 minutes for up to five doses. Do not exceed eight doses every 24 hours.
Prophylactic treatment with bismuth subsalicylate has been shown to be effective for up to 65% of adults.

Recommended Dosage

Drug	Adults & Children Over Age 12	Max. Daily	Children Ages 6 to 12	Max. Daily	Children Under Age 6	Max. Daily
Bismuth Subsalicylate
Bismuth Subsalicylate	Up to 525 mg every 0.5 to 1 hr or as needed	4200 mg	Refer to package or consult a physician		Refer to package or consult a physician
Absorbents
Drug	Adults & Children Over Age 12	Max. Daily	Children Ages 6 to 12	Max. Daily	Children Under Age 6	Max. Daily
Charcoal	Up to 520 mg every 1 hr	4.16 grams	Refer to package or consult a physician		Refer to package or consult a physician
Kaolin & Pectin Combination	15 to 30 ml after each loose bowel movement	120 ml per 12 hrs	Refer to package or consult a physician		Refer to package or consult a physician
Attapulgite	1.2 to 1.5 grams after each loose bowel movement	9 grams	600 to 750 mg after each loose bowel movement	4.5 grams	Refer to package instructions or consult a physician
Antiperistaltic Agents
Drug	Adults & Children Over Age 12	Max. Daily	Children Ages 6 to 12	Max. Daily	Children Under Age 6	Max. Daily
Loperamide	4 mg initially. Then 2 mg after each loose bowel movement. For no more than 2 days.	8 mg	Refer to package or consult a physician		Refer to package instructions or consult a physician
Polycarbophil
Drug	Adults & Children Over Age 12	Max. Daily	Children Ages 6 to 12	Max. Daily	Children Under Age 6	Max. Daily
Polycarbophil	1 gram up to 4 times per day	4 grams	500 mg 3 times per day	1500 mg	Refer to package or consult a physician

Warnings

Absorbents

Consult a physician before using or do not use if you have:

Allergy to attapulgite, kaolin, or pectin
Bloody stools
Intestinal blockage
Kidney impairment
Liver impairment

Or if you:

Are administering to a child or infant

Or if you are taking:

Chloroquine (Aralen): decreases chloroquine absorption and effects
Digoxin (Lanoxin): decreases digoxin absorption and effects
Lincomycin (Lincosin): decreases lincomycin absorption and effects

Bismuth subsalicylate

Consult a physician before using or do not use if you have:

Allergy to aspirin, salicylates, or any NSAIDs
Allergy to bismuth compounds
Kidney impairment
Stomach ulcers

Or if you:

Are giving to a child or teenager with a viral illness, due to the risk for Reye's syndrome
Are a pregnant or nursing mother
Are a senior; you may require a lower dosage
Are giving to an infant or are debilitated; there is an increased chance of fecal impaction
Have symptoms that do not improve after two days

Or if you are taking:

Aspirin (Ecotrin): increased aspirin toxicity
Tetracycline (Sumycin): may decrease tetracycline absorption and effects
Warfarin (Coumadin): may increase risk of bleeding

Loperamide

Consult a physician before using or do not use if you have:

Acute diarrhea caused by food poisoning microorganisms
Colitis (inflammation of the colon)
Intestinal blockage
Bloody stools

Or if you:

Are pregnant or nursing
Are a senior; you may require a lower dosage
Are giving to a child
Have diarrhea accompanied by high fever and blood in the stool
Have symptoms that do not improve after two days

Or if you are taking:

CNS depressants, such as:
- Diazepam (Valium): increases antihistamine side effects
- Phenobarbital (Luminal): increases antihistamine side effects
Monoamine oxidase inhibitors (a class of antidepressants), such as:

Phenelzine (Nardil): may increase blood pressure
Tranylcypromine (Parnate): may increase blood pressure

Polycarbophil

Consult a physician before using or do not use if you have:

Allergy to polycarbophil or any component of polycarbophil products
Bloody stools
Intestinal blockage
Symptoms of dehydration

Or if you are:

Having diarrhea accompanied by high fever and blood in the stool
Have symptoms that do not improve after two days

Common Side Effects

None anticipated

Infrequent to Rare Side Effects

Absorbents

Constipation

Loperamide

Dizziness
Drowsiness
Dry mouth

Polycarbophil

Bloating
Gas

Effects of Overdose

Absorbents

Severe constipation

Loperamide

Constipation
Nausea
Stomach cramps
Very slow breathing
Vomiting

Polycarbophil

None anticipated

What to Do In Case of Overdose

Absorbents

It is unlikely that an overdose of this medication will cause life-threatening symptoms. If you are still concerned, please seek the advice of your health professional.

Loperamide

If you suspect that you or someone you know has taken an overdose of this medication, immediately STOP USING THE MEDICATION and SEEK MEDICAL HELP.

Polycarbophil

It is unlikely that an overdose of this medication will cause life-threatening symptoms. If you are still concerned, please seek the advice of your health professional.