Diarrhoea: Drug treatment, Anti-Diarrhoeal drugs, Mechanism of action of opioids

Drug treatment of diarrhea:

Antidiarrhoeal drugs may be used safely in patients with mild to moderate acute diarrhea. However they should not be used in patients with bloody diarrhea, high fever, or systemic toxicity because of risk of worsening the underlying condition. They should also be stopped in patients whose diarrhea is getting worse despite therapy. 

Anitidiarrhoeal drugs are also used to treat chronic diarrhea caused by inflammatory bowel disease or inflammatory bowel syndrome.

 

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Antidiarrhoeal agents:

1. Opioid agonists (loperaminde, diphenoxylate)
2. Colloidal bismuth compounds
3. Kaolin and pectin
4. Bile salt binding resins (Cholestyramine, colestipol, colesevelam)
5. Octreotide                  

    

How do opioids work?

They act on presynaptic cholindergic nerves in the submucosal plexus and myenteric plexus to increase the colonic phasic segmenting activity which increases the colonic transit time and fecal water absorption. They also decrease mass colonic movement and gastrocolic reflex and gut secretions.

Note: In the making of the above article, following books were used:

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