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Which Anti-Diarrheal Drugs Work Best?

Diarrhea is a common condition. But there are anti-diarrheal drugs that can ease your symptoms. They help keep you from losing too much fluid. They also replace nutrients you may have lost. You can get them with or without a prescription.

What Is Diarrhea?

It’s watery poop that sends you to the bathroom three or more times a day. You might get belly cramps or feel sick to your stomach. There are a few different types:

  • Short-term, or acute, diarrhea usually goes away in a day or two
  • Persistent diarrhea goes on for 2-4 weeks
  • Ongoing diarrhea may come and go, but your symptoms will last a month or longer

Some common causes include:

Tell your doctor if you get diarrhea a lot. You may have a medical condition. Treatment depends on what’s causing it.

Are Over-the-Counter Drugs Right for You?

They usually work for sudden or short-term diarrhea. You shouldn’t use them for more than 2 days. Be sure to read the directions. The dose is different for adults and older children. Ask your doctor before you give anti-diarrheal drugs to younger kids. Popular over-the-counter (OTC) options include:

Loperamide. Poop can’t move through your intestines as fast when you take this drug. It’ll come out less often and more solid when your body has time to absorb water.

Bismuth subsalicylate. This drug can ease inflammation and protect your intestines from germs. It may ease other symptoms like nausea or an upset stomach.

Are There Side Effects?

OTC anti-diarrheal medicine doesn’t usually cause problems. But like other drugs, there’s always a chance you could have unwanted side effects. Some are mild, while others are more serious. Check with your doctor if you get symptoms like:

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Bismuth subsalicylate can make your tongue or poop dark. These changes typically go away once you quit using the drug. Very high doses of loperamide can cause serious heart problems or even death.

You may have more side effects if you take other drugs at the same time. Some medicine may not work as well if you take them with OTC anti-diarrheal drugs. Talk to your doctor if you have questions.

Should You Take a Prescription?

Your doctor may prescribe medicine to help control your symptoms if you often have diarrhea because of irritable bowel syndrome (IBS-D). These medicines include:

Alosetron (Lotronex) is for some women with really serious IBS-D. Your doctor may give it to you if nothing else works. It could cause serious side effects, like constipation and less blood flow to your colon.

Eluxadoline (Viberzi) can slow down gut contractions. That might ease your pain. But you shouldn’t use it if you don’t have a gallbladder. It could lead to pancreatitis. That’s when your pancreas is inflamed.

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Rifaximin (Xifaxan) is an antibiotic that works on certain bacteria in your gut. You’d likely only take it for 2 weeks. It’s sometimes used to treat traveler’s diarrhea.

New IBS-D drugs are in the works. Ask your doctor if there are more options you can try.

Inflammatory bowel diseases, like Crohn’s disease or ulcerative colitis, can cause ongoing diarrhea. Your doctor will give you another kind of prescription to manage those conditions.

Who Shouldn’t Take Anti-Diarrheal Drugs?

Don’t try to treat your diarrhea at home if you have signs of an infection. Talk to your doctor first if you have a fever or there’s blood in your poop. You may need an antibiotic or other medicine to get rid of bacteria or parasites.

Don’t take bismuth subsalicylateif you’re allergic to aspirin. Teenagers or kids with chickenpox or flu-like symptoms shouldn’t take it either. It raises their chances of Reye’s syndrome. That’s a rare condition that can hurt their brain and liver.

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Don’t give anti-diarrheal drugs to babies or young kids. Ingredients like bismuth, magnesium, and aluminum can build up in their little bodies. The doctor can tell you which drugs are safe for children under 12.

Don’t take bismuth salicylate or other anti-diarrheal drugs if you’re pregnant without talking to your doctor first.

Are There Other Ways to Treat Diarrhea?

A probiotic may help. They’re pills or food with “good” bacteria or yeast in them. They can replace “bad” bacteria that live in your gut. More research is needed to know if they soothe diarrhea. Ask your doctor if they’re right for you.

Not eating foods you have a hard time processing may stop diarrhea. If you’re not sure what to avoid, talk to a registered dietitian nutritionist (RDN). They can help you figure out the problem foods.

When Is Diarrhea an Emergency?

Call your doctor if you have a high fever or your diarrhea gets worse after a couple of days. Tell them about any medicines you’re taking or if you have other health conditions. Get help right away if you or a loved one also has:

  • Blood or pus in their poop
  • Thrown up a lot
  • More than six loose stools in one day
  • Serious belly or rectal pain
  • Confusion or a dizzy feeling

WebMD Medical Reference Reviewed by Minesh Khatri, MD on May 28, 2020

Sources

SOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): “Treatment for Diarrhea,” “Definition & Facts for Diarrhea,” “Symptoms & Causes of Diarrhea.”

Cleveland Clinic: “Diarrhea: Management and Treatment,” “Probiotics.” 

FamilyDoctor.org: “Anti-diarrheal Medicines: OTC Relief for Diarrhea.”

Mayo Clinic: “Loperamide (Oral Route),” “Bismuth Subsalicylate (Oral Route),” “Current and future treatments for irritable bowel syndrome associated with diarrhea.”

Cureus: “Loperamide Overdose.”

DailyMed: “Anti-Diarrheal Loperamide HCL,” “Kaopectate -- bismuth subsalicylate tablet.”

FDA: “Medication Guide: Lotronex,” “FDA Drug Safety Communication: FDA warns about increased risk for serious pancreatitis with irritable bowel drug Viberzi (eluxadoline) in patients without a gallbladder,” “How to Treat Diarrhea in Infants and Young Children.” 

American College of Gastroenterology: “Irritable Bowel Syndrome.”

American Family Physician: “Rifaximin (Xifaxan) for Irritable Bowel Syndrome,” “Over-the-Counter Medications in Pregnancy.” 

KidsHealth.org: “Reye Syndrome.”

UpToDate: “Patient education: Acute diarrhea in adults (Beyond the Basics).

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