How to Use the Drugs
No medicine is risk free. Ask a pharmacist or your healthcare professional if you are not sure how much medicine to take, how often to take it, or whether an interaction may occur with any other medicine you are taking. Always tell your health care professionals about all the medicines you are taking, including OTC and prescription medicines.
For mild or acute, short-lived diarrhea, most adults may treat themselves with:
- Diet adjustments
- OTC drugs
However, if your diarrhea is severe, prolonged, or accompanied with blood, high (101°F, 39°C) fever, or 10 lb (5kg) weight loss, you should consult a doctor. Special vigilance is required at the extremes of life.
You should use drugs only as necessary, and stop them when the diarrhea stops. In the case of loperamide, you should take the drug after each loose bowel movement. If your social life or business affairs are hampered by unpredictable diarrhea, loperamide may be taken before an event to prevent embarrassing trips to the toilet. Sedation, severe abdominal cramps, or other unexplained symptoms are indications to stop the drug and seek an explanation from your doctor.
Antidiarrheal drugs should be used cautiously and with a doctor’s supervision if the diarrhea is severe. Because they delay colon evacuation, opiates may prolong an intestinal infection (colitis), and in severe colitis, they may precipitate a paralysis of the colon with dire consequences.
For anything more than mild, short-lived diarrhea, a diagnosis is necessary in order to properly treat the underlying cause.
In every case, adequate hydration must be assured. For a short time, clear fluids may suffice, and ORT is available at any pharmacy for more prolonged or severe cases.
Severe watery diarrhea, bloody stools, fever, and weight loss are warning signs requiring a doctor’s assessment and perhaps intravenous fluids and salts.
Sometimes a bulking agent such as psyllium will help, but for moderately severe acute diarrhea, food must be forgone until the diarrhea subsides, or a doctor can make recommendations.
Used as directed, loperamide after loose bowel movements is the safest OTC medication for managing diarrhea. The maximum approved daily dose for adults is 8 mg per day for OTC use and 16 mg per day for prescription use. Never take more than recommended doses. A doctor should be consulted if they fail.
Severe diarrhea can be life-threatening, so caution is important, especially in the very young and very old.
Adapted from IFFGD publication #201 by W. Grant Thompson, MD, FRCPC, Emeritus Professor of Medicine, University of Ottawa, Ontario, Canada
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