I have IBD (specifically, ulcerative colitis) and associated spastic colon. Since I travel frequently for a living “traveler’s diarrhea” is a very real fear for me, as I have ZERO bowel control during such an attack. As a result, I’m a frequent user of Loperamide HCl (Immodium), and it seems to work adequately, if I start using it early enough on my travel day. Unfortunately, it can sometimes work TOO well, and I may not even have a movement the next day. Also, if I have unanticipated flight delays (about 15-20% of the time, on average) I may actually exceed the recommended max dosage of 4 pills in 24 hours (though I’ve never exceeded 5/24). My question is, what long-term issues might I experience from this? I realize laxatives can create “lazy” bowels, but what about loperamide? Also, aren’t there prescription anti-diarrheals that are more effective? I’m leary of those to some extent, because I would not want to exceed a prescription dosage under ANY circumstances, regardless of how bad of an “episode” I was having, and that could create a rather embarrasing situation, if I couldn’t keep control during a critical point of a flight when lavatories are unaccessible.
BUMP!
I could really use a reply to this, if any of you MD-types are out there…?
IANAD, but I’ve taken Imodium on a regular basis for irritable bowel syndrone for several years.
I have not noticed any negative effects, aside from gas if I take too much.
Robin
You have my sympathy. Well, the, I?m no doctor, more like a fellow sufferer. At one time, I was aking the damn stuff every day, just so as to get to work. But when I realised that the label/enclosed leaflet advised only to use it for a short period, well, I then had a pretty rotten time for a while. I shan?t bother giving you any TMI detail - I bet you can imagine all tll well. 
So, I?m sort of just bumping this up, as I shall also be interested to see replies.
I asked my Doctor a few months back being concerned that I may be taking Imodium too often for my IBS, she said that there was nothing to worry about taking it for long periods so long as you do still go with reasonable regularity.
There’s a fairly new version that’s a white caplet that’s helps with the gas.
IANAD, but when I was first experiencing similar symptoms from lactose intolerance my doctor convinced me to start taking a fiber supplement (Metamucil) daily to help me in controlling the effects. It allowed me enough control to be able to find a ‘landing place’, as it were, before explosively decompressing.
If you’re not doing this, you might want to ask your doctor if it would help you.
Just a thought.
I’m also well acquainted with Imodium, BTW, but one pill would usually stop me from doing anything for about 24 hours, but when it wore off, Katy bar the door!
There’s a newer prescription drug called Zelnorm, but it’s only been studied for IBS in women.
My mom has IBS. She also has had gall bladder problems. I found an article about a medication that worked for both - she showed it to her doctor, tried it and it worked like a charm. I don’t think it was Zelnorm, but I will ask her next time I talk to her & get back to you. (Tried to find it, but of course it is nowhere to be found…)
Zelnorm is for IBS. The OP’er has IBD. Very different.
I am not aware of any problems associated with the chronic use of Imodium. I’ve a number of patients on it, with the GI consultant’s approval.
QtM, MD
I use that now, and all it does is make it easier for the gas to, ah, be expelled.
Robin
Thanks, all, for the replies and support! Especially you, Qadgop…
Oh, and if you’ve got the time, would you be able to expand a little bit on the differences between IBS and IBD? I would be very interested…
Thanks!
Oh, yeah…forgot to mention…with Ulcerative Colitis, fiber is a DEFINITE no-no! I have to avoid consuming any shrubbery at ALL costs…
…which sucks, since I LOVE raw cauliflower and broccoli with ranch dip…and popcorn…and salads…god, for a fresh chef salad…(suffering with UC for 7 years and counting…)
Colestid? I take it after meals. It works on bile or something.
And I’m another one who has to take Imodium daily, or else I can’t leave the house.
Irritable bowel syndrome (aka spastic colon): A spectrum of symptoms, usually involving recurrent abdominal pain and diarrhea often alternating with periods of constipation) often associated with emotional stress. In the past often referred to as a “functional illness” (aka it’s all in your head). These days some sort of abnormalities in intestinal smooth muscle or intestinal nerve networks are suspected. Aggravating but only rarely life or health threatening. Often can be managed quite well with a high fiber diet, and occasionally with antispasmodics. Many other therapies are offered, with mixed results.
Inflammatory bowel disease: Actual cellular inflammation of the colon. The two most common IBD’s are Ulcerative colitis and Crohn’s disease.
In the former (UC), large patches of the (mainly) distal large bowel’s mucosal lining are inflamed, causing pain, diarrhea, bloody stools, and occasionally fever. Sometimes the entire colon from appendix to rectum becomes involved. May have severe and life-threatening complications. Anti-inflammatory agents are often helpful. Nicotine in patch form may actually be helpful.
Ulcerative Colitis
In the latter (Crohn’s), large granulomas may form thruout the length of the bowel, penetrating the bowel wall, and occasionally causing the bowel to open into the stomach, abdominal cavity, outside world, bladder, vagina, or ureter. This disease is more likely than UC to have severe complications and need surgical intervention. Anti-inflammatories are of some use, as is the monoclonal antibody remicade. Antibiotics are useful here too. Interestingly, nicotine aggravates this disease.
Crohn’s
Not to minimize the plight of the IBS sufferers, but if given a choice between having IBS and IBD, pick IBS!
Qadgop, you are a treasure on the Boards, and I thank you!