Diarrhea medications & treatments
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Diarrhea is a common condition characterized by loose watery stools that affect most people a few times a year. It is rarely serious and will usually go away within a few days. The cause of diarrhea is often unknown, but if it lasts more than a few days, that could be a sign of a more serious problem.
What is diarrhea?
Diarrhea is defined as having loose, watery stools three or more times a day. It can be classified according to how long the symptoms last which include:
- Acute diarrhea. This is the most common type that will usually go away on its own within a few days.
- Persistent diarrhea. This type usually lasts between 2 to 4 weeks.
- Chronic diarrhea. Lasts more than 4 weeks.
The most common cause of acute diarrhea is a caused by a virus. The two main causes are rotavirus in young children and norovirus in adults. Traveler’s diarrhea is caused by eating or drinking contaminated food or water. It is most often seen in developing countries.
Signs and symptoms of diarrhea other than watery, loose stools can include:
- Urgent need to have a bowel movement
- Abdominal pain
- Weight loss
- Nausea and vomiting
- Loss of bowel control
You should contact your healthcare provider if you have any of these more serious diarrheal symptoms:
- Diarrhea lasts for more than 2 days
- Signs of dehydration (feeling thirsty, decreased urination, rapid heart rate, dry mouth)
- Blood or mucous in your stools
- Black, tarry stools
- Fever of 102 F (39 C) or higher
What causes diarrhea?
The most common causes of acute diarrhea include:
- Viral infections such as rotavirus, and norovirus. Viral gastroenteritis is a common cause of acute diarrhea.
- Bacterial infections are usually caused by food poisoning or drinking contaminated water. Common bacterias such as E. Coli, Salmonella, Shigella, and Campylobacter are usually the cause.
- Medicines such as antibiotics, cancer drugs, and antacids containing magnesium can be the cause of acute diarrhea.
The most common causes of persistent and chronic diarrhea include:
- Food allergies or malabsorption.
- Gastrointestinal disorders such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), Crohn’s disease, celiac disease, and ulcerative colitis.
- Abdominal surgery, which can include your gallbladder, small intestine, large intestine, or appendix, among others.
- Thyroid disorders
- Autoimmune disorders
How is diarrhea diagnosed?
Most cases of diarrhea resolve on their own and are treated without seeing a doctor and finding out the cause. For more severe or chronic cases, your doctor may ask about your medical history, look at the medications you take, and perform a physical exam.
They may also order tests to find the cause of your diarrhea. Tests may include:
- Stool test to check for bacteria or parasites.
- Blood test to check for infections or diseases.
- Hydrogen breath test to check for lactose intolerance.
- Fasting test to rule out other food allergies or intolerances.
- Colonoscopy, upper GI endoscopy, or flexible sigmoidoscopy to look into your digestive tract and intestines to try and find the cause of your diarrhea.
What are some treatment options for diarrhea?
Most cases of acute diarrhea can be treated with over-the-counter (OTC) medications such as Imodium A-D (loperamide) or Pepto-Bismol/Kaopectate (bismuth subsalicylate). You will also need to make sure to stay hydrated. You should drink plenty of fluids, including water, fruit juices, sodas without caffeine, sports drinks, or other oral rehydration solutions that have electrolytes.
Treating infants and children with OTC medications for diarrhea can be dangerous. You should talk with your healthcare provider before giving them any medications or supplements.
Chronic or persistent diarrhea will typically depend on the cause. This can include avoiding certain foods, changes in medications, or adding medications to treat the underlying condition.
What are some anti-diarrheal medications?
There are several options for over-the-counter and prescription drugs to treat diarrhea. These include:
- Antidiarrheals. OTC options include loperamide and bismuth subsalicylate. Some prescription medications include Lomotil (diphenoxylate/atropine) and Mytresi (crofelemer)
- Antibacterials. These are prescribed to treat known bacterial infections and can include Xifaxan (rifaximin) and Aemcolo (rifamycin).
- Antiprotozoals. These are prescribed to treat parasitic infections and include Alinia (nitazoxanide).
- Another option for severe diarrhea includes the anticholinergic and opioid combination medicine Motofen (difenoxin and atropine sulfate)
What is the best medication for diarrhea?
The best medication for diarrhea will depend on the individual’s specific medical condition, medical history, medications that the individual is already taking that may interact with diarrhea medications, and potential response to the treatment. It is advisable to always speak with your healthcare provider about the best medication for you. The table below includes a list of the most prescribed and over-the-counter FDA-approved medications.
Best medications for diarrhea
|Drug name||Drug class||Administration route||Standard dosage||Common side effects
|Imodium A-D (loperamide)||Antidiarrheal||Oral||4mg after 1st loose stool, then 2mg after each additional one. Max of 16mg/day||Abdominal pain, constipation, nausea
|Pepto Bismol/Kaopectate (bismuth subsalicylate)||Antidiarrheal||Oral||525mg every 30min to an hour as needed. Max of 8 doses per day.||Abdominal pain, nausea, ringing in the ears, black or darkened tongue
|Xifaxan (rifaximin)||Antibacterial||Oral||200mg to 550mg 3 times daily for up to 2 weeks.|
|Headache, gas, abdominal pain, nausea
|Alinia (nitazoxanide)||Antiprotozoal||Oral||500mg every 12 hours with food for 3 days.||Headache, stomach pain, nausea, discolored urine
|Lomotil (diphenoxylate/atropine)||Antidiarrheal||Oral||2 tablets (5mg) up to 4 times daily.||Drowsiness, dizziness, dry mouth, headache, blurred vision
|Motofen (difenoxin/atropine sulfate)||Antidiarrheal||Oral||2 tablets after 1st loose stool, then 1 after each additional one. Max of 8 tabs per day.||Drowsiness, dizziness, headache, dry mouth, blurred vision, loss of appetite
|Mytesi (crofelemer)||Antidiarrheal||Oral||125mg twice daily.||Upper respiratory tract infection, cough, bronchitis, gas, nausea
Your healthcare provider will determine the dosage which is right for you based on your response to the treatment, medical condition, weight, and age. Other possible side effects may exist and this is not a complete list.
What are the most common side effects of diarrhea medications?
The side effects will depend on which class of medication you are taking.
Antidiarrheals commonly cause abdominal pain, nausea, headache, blurred vision, dry mouth, and loss of appetite.
Common side effects of antibacterials and antiprotozoals include headache, gas, nausea as well as urine discoloration.
What are some home remedies for diarrhea?
In many mild cases of diarrhea, changing your diet or fasting for a short time will relieve the symptoms. You need to make sure to replace any fluids you are losing with liquids such as water, sports drinks, pulp-free fruit juices, broth, or non-caffeinated soda.
You should avoid fried, greasy, or fatty foods and should instead try the BRAT diet:
- (R)ice (white rice)
- (T)oast using white bread
Some other foods to include in your diet include potatoes, noodles, skinless chicken or turkey, lean ground beef, fish, or yogurt.
Frequently asked questions about diarrhea
What symptoms will I have with diarrhea?
In addition to loose, watery stools, you may also have stomach pain, cramps, an urgent feeling that you need to use the bathroom, and loss of bowel control. If your diarrhea is caused by a virus or bacteria, you may have fever and chills, and bloody stools.
How long does diarrhea last?
Most cases of diarrhea last a few hours to a few days. If you are having diarrhea for more than 2 days, you should contact your doctor as this may be a sign of something more serious.
What is the fastest way to get rid of diarrhea?
Over-the-counter medications like Imodium A-D (loperamide) and Pepto Bismol (bismuth subsalicylate) can help decrease the number of bowel movements which can help relieve your symptoms.
What are some foods to avoid if I have diarrhea?
You should avoid any foods that you know upset your digestive system. Some of these foods you should avoid may include:
- Fried foods
- Greasy, fatty foods
- Milk and dairy products
- Spicy foods
- High fiber foods like whole-grain bread or cereal
- Raw fruits and vegetables
- Processed foods
Related resources for diarrhea
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.