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Loperamide, sold under the brand name Imodium, among others, [1] is a medication of the opioid receptor agonist class used to decrease the frequency of diarrhea. [ 5 ] [ 4 ] It is often used for this purpose in irritable bowel syndrome , inflammatory bowel disease , short bowel syndrome , [ 4 ] Crohn's disease , and ulcerative colitis . [ 5 ]
Loperamide is a μ-opioid receptor agonist that works in the intestines. [1] Although it is an opioid , it has no effects on the central nervous system . It reduces diarrhea by slowing the transit time of contents through the intestinal tract thereby allowing more water to be reabsorbed from the intestinal lumen .
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]
Electrolyte solutions, while not true antidiarrheals, are used to replace lost fluids and salts in acute cases.; Bulking agents like methylcellulose, guar gum or plant fibre (bran, sterculia, isabgol, etc.) are used for diarrhoea in functional bowel disease and to control ileostomy output.
An antipropulsive is a drug used in the treatment of diarrhea. It does not address the underlying cause (for example, infection or malabsorption), but it does decrease motility. Examples include diphenoxylate, loperamide, and eluxadoline.
[7] [19] [20] The medication loperamide may be used to help with diarrhea while laxatives may be used to help with constipation. [7] There is strong clinical-trial evidence for the use of antidepressants, often in lower doses than that used for depression or anxiety, even in patients without comorbid mood disorder.