Diarrhea (OTC Treatment)


  • Diarrhea = an increase in stool frequency
    • Loose, watery stools
    • May be acute or chronic
      • Viruses are the cause of most acute diarrhea  (rotavirus vaccine cures this the majority of the time)
      • Traveler’s diarrhea is usually bacterial in nature
      • May also be caused by parasites, food intolerances (lactose), medications (like antibiotics)
  • Lactose intolerance:  congenital disorder that consists of an inability to metabolize milk or dairy products (no lactase enzyme)
    • May use OTC products like Dairy Ease
    • Lactose intolerance is a spectrum, there is no absolute spectrum
    • Undigested lactose causes diarrhea
  • Diarrhea prevention–wash hands, avoid raw fruits/veggies, drink bottle water
    • Food poisoning is rare
    • Doesn’t cause medical intervention normally
  • See a doctor if you have it more than 3 days, severe pain in the abdomen/rectum, fever over 102, black stool, dehydrated
  • Treatments for diarrhea:
    • Loperamide  (imodium): synthetic opioid that stimulates mu-opioid receptors in the GI circular musculature that inhibits gastric propulsion
      • Can’t pee, can’t shit, can’t see, can’t spit
      • May cause drowsiness, dizziness  (side effects aren’t frequent)
      • Don’t take if you liver impairment, bloody stools or high fever
    • bismuth subsalicylate (BSS): reduce the frequency of unformed stools & increase stool consistency & relieve abdominal cramping
      • May darken stool or tongue or dental appliances
      • Ppl who shouldn’t take bismuth subsalicylate:  kids w/ chickenpox or flu, ppl with allergies to aspirin, if diarrhea is accompanied by high fever by more than 2 days
    • Probiotics (usually lactobacillus–culturelle)
      • Supposed to reestablish normal flora in the digestive tract
      • Potency is measured by Colony Forming Units (CFUs)
      • Not considered effective by the FDA
      • Don’t have many side-effects, but probably don’t want to give to the immunocompromised
        • Bifantis (aka Align, probiotic)
          • Not FDA approved but like other probiotics it delivers NF to help improve a bacterial imbalance
        • Colon Health (acidophilus, bifidium, longum)
          • Probiotic that is used to help with gas, bloating and other GI irregularities
    • Some diarrhea can be resolved by doing nothing, leaving bowel alone for a few hours (fasting)
      • Or eating bland or low roughage (jello, soups) foods
  • Dehydration is noted by dark urine, lightheadedness, dry mouth, lethargy,  muscle weakness
    • To resolve, you want to drink fluids slowly & gradually for a long period of time
      • Only need to worry if dehydration symptoms last longer than 1 day
        • Oral rehydration solutions are not recommended for all cases of acute diarrhea

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