DIARRHOEA Flashcards
Symptoms
Frequent, loose, watery stools
Associated symptoms
Cramps, nausea, flatulence and dehydration
Red flag symptoms
Unexplained weight loss
Rectal bleeding
Persistent diarrhoea
Systemic illness
Recent treatment with hospital antibiotics
Recent travel
Management - acute diarrhoea
Acute diarrhoea usually settles without medical treatment
Oral rehydration therapy (+ fluids)
Management - severe dehydration
can’t drink → hospital → IV fluids
If rapid control is needed / traveler’s diarrhoea →
Loperamide
Loperamide first-line treatment for patients with faecal incontinence
Faecal incontinence treatment
First line: loperamide
Loperamide licensing
OTC:
o >12 years old for the treatment of acute diarrhoea
o >18 years old for the treatment of acute diarrhoea in IBS
Rx: 4 yrs +
Loperamide - dose
Take 1-2 doses (2-4mg) at first, then one with every loose stool
max 8 doses (16 mg) per day
MHRA Warning: Loperamide
Serious CV reactions with high doses, misuse or abuse
- QT prolongation
- Torsades de pointes
- Cardiac arrest
- Fatalities
How is loperamide overdose treated?
Treat overdose with naloxone
Repeated treatment may be indicated
Monitor for 48 hours for respiratory depression
Loperamide - Side effects (common)
Dizziness
Flatulence
Headache
Nausea
Loperamide - Contraindications
Abx AC
Active UC
C.diff
Conditions where peristalsis is inhibited
Conditions where abdominal distention develops
Loperamide - avoid in
Blood diarrhoea
Inflammatory diarrhoea (fever, severe, abdominal pain)
Loperamide + simeticone
Anti-flatulence
Used for associated abdominal colic
