Chronic diarrhea medical therapy

Chronic diarrhea Microchapters
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Case #1

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]

Overview

Antidiarrheal drugs can be broadly defined as agents that minimize the symptoms of diarrhea by improving stool consistency, reducing stool frequency, or reducing stool weight.

Medical Therapy

Antidiarrheal drugs are prescribed depending on the underlying mechanism for example, in a patient with Zollinger ellison syndrome (ZES) where hypersecretion of gastrin is the underlying cause of the diarrhea, proton pumps inhibitors can be used. Below are some of the drugs that can be used in the treatment of chronic diarrhea and some of their mechanisms of actions. Some drugs have numerous mechanisms of action and can thus be found under more than one sections.

Inhibitors of intestinal transit time

• Opiates
  • Loperamide
  • Eluxadoline
  • Diphenoxylate
  • Difenoxin
  • Codeine
  • Opium
  • Paregoric
  • Morphine
• Encephalinase inhibitor
  • Racecadotril
• 5-HT3-receptor antagonist
  • Alosetron
• α2-Adrenergic agonist
  • Clonidine
• Somatostatin and analogs
  • Octreotide
  • Lanreotide
  • Pasireotide
• Calcium channel blocker
  • Nifedipine

Pro-absorptive agents

• Glucose, amino acids
  • Oral rehydration solution
• α2-Adrenergic agonist
  • Clonidine

Antisecretory drugs

• Somatostatin and analogs
  • Octreotide
  • Lanreotide
  • Pasireotide
• Enterocyte apical membrane chloride channel inhibitors
  • Crofelemer
• Berberine
• Calcium channel blockers
  • Nifedipine
• Calmodulin inhibitors
  • Chlorpromazine
  • Trifluoperazine
• Calcium-sensing receptor ligands
  • Calcium
• Nicotinic acid
• Lithium
• Zinc
• Bismuth
• Nonsteroidal antiinflammatory drugs
• Corticosteroids
• Teduglutide

Intraluminal agents

• Adsorbents
  • Clays
• Bile acid-binding resins
  • Cholestyramine
  • Colestipol
  • Colesevelam
• Fiber

References

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