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Lee KJ. Pharmacologic Agents for Chronic Diarrhea. Intest Res. 2015;13(4):306-12doi: 10.5217/ir.2015.13.4.306.
Lee, K. J. (2015). Pharmacologic Agents for Chronic Diarrhea. Intestinal research, 13(4), 306-12. https://doi.org/10.5217/ir.2015.13.4.306
Lee, Kwang Jae. "Pharmacologic Agents for Chronic Diarrhea." Intestinal research vol. 13,4 (2015): 306-12. doi: https://doi.org/10.5217/ir.2015.13.4.306
Lee KJ. Pharmacologic Agents for Chronic Diarrhea. Intest Res. 2015 Oct;13(4):306-12. doi: 10.5217/ir.2015.13.4.306. Epub 2015 Oct 15. PMID: 26576135; PMCID: PMC4641856.
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Intest Res. 2015 Oct;13(4):306-12. doi: 10.5217/ir.2015.13.4.306. Epub 2015 Oct 15.

Pharmacologic Agents for Chronic Diarrhea.

Intestinal research

Kwang Jae Lee

Affiliations

  1. Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.

PMID: 26576135 PMCID: PMC4641856 DOI: 10.5217/ir.2015.13.4.306

Abstract

Chronic diarrhea is usually associated with a number of non-infectious causes. When definitive treatment is unavailable, symptomatic drug therapy is indicated. Pharmacologic agents for chronic diarrhea include loperamide, 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists, diosmectite, cholestyramine, probiotics, antispasmodics, rifaximin, and anti-inflammatory agents. Loperamide, a synthetic opiate agonist, decreases peristaltic activity and inhibits secretion, resulting in the reduction of fluid and electrolyte loss and an increase in stool consistency. Cholestyramine is a bile acid sequestrant that is generally considered as the first-line treatment for bile acid diarrhea. 5-HT3 receptor antagonists have significant benefits in patients with irritable bowel syndrome (IBS) with diarrhea. Ramosetron improves stool consistency as well as global IBS symptoms. Probiotics may have a role in the prevention of antibiotic-associated diarrhea. However, data on the role of probiotics in the treatment of chronic diarrhea are lacking. Diosmectite, an absorbent, can be used for the treatment of chronic functional diarrhea, radiation-induced diarrhea, and chemotherapy-induced diarrhea. Antispasmodics including alverine citrate, mebeverine, otilonium bromide, and pinaverium bromide are used for relieving diarrheal symptoms and abdominal pain. Rifaximin can be effective for chronic diarrhea associated with IBS and small intestinal bacterial overgrowth. Budesonide is effective in both lymphocytic colitis and collagenous colitis. The efficacy of mesalazine in microscopic colitis is weak or remains uncertain. Considering their mechanisms of action, these agents should be prescribed properly.

Keywords: 5-hydroxytryptamine type 3 receptor antagonists; Bile acid sequestrants; Chronic diarrhea; Loperamide; Parasympatholytics

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