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Calcium carbonate antacid tablets. An antacid is a substance which neutralizes stomach acidity and is used to relieve heartburn, indigestion, or an upset stomach. [1] Some antacids have been used in the treatment of constipation and diarrhea. [2] Marketed antacids contain salts of aluminum, calcium, magnesium, or sodium. [2]
Decreasing intestinal motility prolongs the transit time of food content through the digestive tract, which allows for more fluid absorption; thereby alleviating diarrhea symptoms and improving stool consistency and frequency. [4] Unlike other opiates, loperamide does not cross the blood brain barrier, so there is minimal risk for abuse. [5]
The evidence for antacids is weaker with a benefit of about 10% (NNT=13) while a combination of an antacid and alginic acid (such as Gaviscon) may improve symptoms by 60% (NNT=4). [60] Metoclopramide (a prokinetic) is not recommended either alone or in combination with other treatments due to concerns around adverse effects.
Didanosine has weak acid stability and is easily damaged by stomach acid. Therefore, the original formula approved by the FDA used chewable tablets that included an antacid buffering compound to neutralize stomach acid. The chewable tablets were not only large and fragile, they also were foul-tasting and the buffering compound would cause diarrhea.
Absorbents absorb toxic substances that cause infective diarrhoea, methylcellulose is an absorbent. Anti-inflammatory compounds such as bismuth subsalicylate. Anticholinergics reduce intestinal movement and are effective against both diarrhoea and accompanying cramping. Opioids' classical use besides pain relief is as an anti-diarrhoeal drug.
The salicylic acid is absorbed and therapeutical concentrations of salicylic acid can be found in blood after bismuth subsalicylate administration. Bismuth oxychloride and bismuth hydroxide are both believed to have bactericidal effects, as is salicylic acid for enterotoxigenic E. coli, a common cause of "traveler's diarrhea". [5]