absorbents. absorbents are compounds that absorb water. absorbents that are taken orally bind water in the small intestine and colon and make diarrheal stools less watery. the two main absorbents are attapulgite and polycarbophil and they are both available without prescriptions. examples of products containing attapulgite are: donnagel. rheaban. kaopectate advanced formula. parepectolin. diasorb. examples of products containing polycarbophil are: equalactin. konsyl fiber. mitrolan. polycarb. one concern is that absorbents also can bind medications and interfere with their absorption into the body. for this reason it often is recommended that medications and absorbents be taken several hours apart so that they are physically separated within the intestine. antimotility medications. antimotility medications are drugs that relax the muscles of the small intestine and/or the colon. relaxation results in slower flow of intestinal contents. cramps due to spasm of the intestinal muscles also are relieved by the muscular relaxation. the two main antimotility medications are loperamide (imodium) which is available without a prescription and diphenoxylate (lomotil) which requires a prescription. both medications are related to opiates (for example codeine) but neither has the pain-relieving effects of opiates. diphenoxylate is a man-made medication that at high doses can be addictive because of its opiate-like euphoric (mood-elevating) effects. in order to prevent abuse of diphenoxylate and addiction a second medication atropine is added to loperamide in lomotil. if too much lomotil is ingested unpleasant side effects from too much atropine will occur. loperamide and diphenoxylate are safe and well-tolerated. there are some precautions however that should be observed. antimotility medications should not be used without a doctor's guidance to treat diarrhea caused by moderate or severe ulcerative colitis c. difficile colitis and intestinal infections by bacteria that invade the intestine (for example shigella ). their use can lead to more serious inflammation and prolong the infections. diphenoxylate can cause drowsiness or dizziness and caution should be used if driving or performing tasks that require alertness and coordination. antimotility medications should not be used in children younger than 2 years of age. acute diarrhea should improve within 72 hours. if symptoms do not improve or if they worsen a doctor should be consulted before continuing treatment with antimotility medications. bismuth compounds. many bismuth-containing preparations are available around the world. bismuth subsalicylate (pepto-bismol) is available in the united states. it contains two potentially active ingredients bismuth and salicylate (aspirin). pepto-bismol is well-tolerated. minor side effects include darkening of the stool and tongue. there are several precautions that should be observed when using pepto-bismol. patients who are allergic to aspirin should not take pepto-bismol. pepto-bismol should not be used with other aspirin-containing medications since too much aspirin may be ingested and lead to aspirin toxicity. the aspirin in pepto-bismol can accentuate the effects of anticoagulants particularly warfarin (coumadin) and lead to excessive bleeding. it also may cause abnormal bleeding in people who have a tendency to bleed because of genetic disorders or underlying diseases. the aspirin in pepto-bismol can aggravate stomach and duodenal ulcer disease. pepto-bismol and aspirin-containing products should not be given to children and teenagers with chickenpox influenza and other viral infections because they may cause reye's syndrome. reye's syndrome is a serious illness affecting primarily the liver and brain that can lead to liver failure and coma with a mortality rate of at least 20%. pepto-bismol should not be given to infants and children younger than 2 years of age.
how is diarrhea treated?