Loperamide occasionally produces a rash.
Other rare adverse effects are fever, abdominal cramps, and bloating.
Loperamide occasionally produces a rash.
Other rare adverse effects are fever, abdominal cramps, and bloating.
The commonest cause of acute diarrhoea is food poisoning, the organisms involved usually being STAPHYLOCOCCUS, CLOSTRIDIUM bacteria, salmonella, E. coli O157 (see ESCHERICHIA), CAMPYLOBACTER, cryptosporidium, and Norwalk virus. A person may also acquire infective diarrhoea as a result of droplet infections from adenoviruses or echoviruses. Interference with the bacterial ?ora of the intestine may cause acute diarrhoea: this often happens to someone who travels to another country and acquires unfamiliar intestinal bacteria. Other infections include bacillary dysentery, typhoid fever and paratyphoid fevers (see ENTERIC FEVER). Drug toxicity, food allergy, food intolerance and anxiety may also cause acute diarrhoea, and habitual constipation may result in attacks of diarrhoea.
Treatment of diarrhoea in adults depends on the cause. The water and salts (see ELECTROLYTES) lost during a severe attack must be replaced to prevent dehydration. Ready-prepared mixtures of salts can be bought from a pharmacist. Antidiarrhoeal drugs such as codeine phosphate or loperamide should be used in infectious diarrhoea only if the symptoms are disabling. Antibacterial drugs may be used under medical direction. Persistent diarrhoea – longer than a week – or blood-stained diarrhoea must be investigated under medical supervision.
Diarrhoea in infants can be such a serious condition that it requires separate consideration. One of its features is that it is usually accompanied by vomiting; the result can be rapid dehydration as infants have relatively high ?uid requirements. Mostly it is causd by acute gastroenteritis caused by various viruses, most commonly ROTAVIRUSES, but also by many bacteria. In the developed world most children recover rapidly, but diarrhoea is the single greatest cause of infant mortality worldwide. The younger the infant, the higher the mortality rate.
Diarrhoea is much more rare in breast-fed babies, and when it does occur it is usually less severe. The environment of the infant is also important: the condition is highly infectious and, if a case occurs in a maternity home or a children’s hospital, it tends to spread quickly. This is why doctors prefer to treat such children at home but if hospital admission is essential, isolation and infection-control procedures are necessary.
Treatment An infant with diarrhoea should not be fed milk (unless breast-fed, when this should continue) but should be given an electrolyte mixture, available from pharmacists or on prescription, to replace lost water and salts. If the diarrhoea improves within 24 hours, milk can gradually be reintroduced. If diarrhoea continues beyond 36–48 hours, a doctor should be consulted. Any signs of dehydration require urgent medical attention; such signs include drowsiness, lack of response, loose skin, persistent crying, glazed eyes and a dry mouth and tongue.... diarrhoea
For adults with acute diarrhoea, short-term symptomatic treatment can be achieved with antimotility drugs such as codeine phosphate, co-phenotrope or loperamide hydrochloride. Adsorbent drugs, for example, KAOLIN, should not be used in acute diarrhoea, but bulk-forming drugs – ispaghula or methylcellulose
– can help to control the consistency of faeces in patients with ileostomies and colostomies (see ILEOSTOMY; COLOSTOMY), or those with diarrhoea caused by DIVERTICULAR DISEASE.
Irritable bowel syndrome, malabsorption syndrom, ulcerative colitis, Crohn’s disease and diverticular disease are often accompanied by diarrhoea; for more information on these conditions, see under separate entries.
ANTIBIOTICS may sometimes cause diarrhoea and this side-e?ect should be borne in mind when the cause of the condition is being investigated.... antidiarrhoeal treatments
Traveller’s diarrhoea is an all-toocommon a?iction of the traveller, which basks in a multiplicity of names: for example, Aden gut, Aztec two-step, Basra belly, Delhi belly, Gippy tummy, Hong Kong dog, Montezuma’s revenge, Tokyo trots, turista. It is caused by a variety of micro-organisms, usually E. coli. Some people seem to be more prone to it than others, although for no good cause. Obvious preventive measures include the avoidance of salads, unpeeled fruit and ice cream, and never drinking unboiled or unbottled water. If diarrhoea occurs, co-phenotrope and loperamide are often used to reduce the frequency of bowel movements in adults. Prophylactic antibacterial drugs are not advisable.... travel sickness
In most acute cases of diarrhoea, the only treatment recommended is oral rehydration therapy.
Antidiarrhoeal drugs include adsorbents, bulk-forming agents such as kaolin, and antimotility drugs (including the opioid drugs, morphine and codeine, and loperamide), which slow movement through the intestine.
None of these drugs are suitable for children.... antidiarrhoeal drugs