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Is loperamide safe to use long term for the treatment of chronic diarrhea in IBS patients?

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Safety of Loperamide

Loperamide (anti-diarrhoea medication such as Dioraleze or Imodium) is often the go-to treatment for diarrhoea. As the medication only acts on the digestive tract, there appears to be little risk associated with long-term or frequent use of Loperamide, and the medication is considered to be a relatively safe, well-tolerated option for dealing with diarrhoea.

There are precautions to be followed however, if you take them long term and/or suffer from inflammatory bowel disease (IBD).

A prescription is required for

  • a child under 12 years old
  • a child aged 12 to 17 years old with IBS or long lasting diarrhoea
  • an adult aged 18 years and older with long lasting diarrhoea

Precautions

Amongst other precautions,

  • Do not take any more Loperamide and drink plenty of water if you become constipated. If you are told to take Loperamide long-term, wait for the constipation to go before taking more.

  • Do not take more than the recommended amount. Too much loperamide can cause serious heart problems (including a fast or irregular heartbeat).

  • You must never take Loperamide for more than 48 hours without seeking advice from your doctor or gastroenterologist.

  • Seek medical advice if you have blood in your poo and/or a temperature (more than 38°C).

People who suffer from IBD

This is different to IBS

You should not take Loperamide without permission from your doctor. The use of anti-diarrhea medications such as Imodium places IBD patients at risk for the development of toxic megacolon, a potentially life-threatening disorder.

Sources

A.D.A.M.: "Toxic Megacolon."

American College of Gastroenterology : "IBD."

NHS : "Imodium (Loperamide)"

VeryWell Health: "Imodium (Loperamide)"

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  • The question is about IBS. Did you intentionally answered about IBD?
    – Jan
    Commented Jul 19, 2018 at 9:31
  • Yes @Jan. I mentioned IBD because there is specific risk with this condition. The general safety and risks is associated with IBS and other conditions Commented Jul 19, 2018 at 18:09

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