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Imodium or loperamide?

Posted by ~traci~, on Sat Dec 03, 2011 1:52 am
I was told by a doctor that it was dangerous for ostomy patients to use Immodium or Loperamide . Has anyone ever heard this? If so Why cant we? Im trying to slow down the liuid stools so I dont get dehydrated? any hints or tips???
Reply by krbg11, on Sat Dec 03, 2011 5:04 am
my stoma nurses reccomended eating salty chips and other types of absorbing foods to help slow things a bit have you tried that? they also told me to stay away from things like imodium but im  ot sure why exactly
Reply by Bill, on Sat Dec 03, 2011 6:41 am
Hello traci,
Many years ago I had a long discussion with one of my consultants about the fact that Immodium in tablet form was too much for me so she prescribed Loperamide in liquid form so that I could make the necessary adjustments for myself.   I made accurate measures of it by using a 5ml syringe with minor measurements on the side.(she also provided this)   The reasons for caution on these drugs is obvious as they can cause severe constipation (blockages) very quickly.  However, if you know how your body reacts and you know what effect your diet has, I cannot see any reason why this shouldn't be an answer to the problem of looseness.  As with all these things it is as well to discuss the problems and possible solutions with the doctors first.   However, if you are confident within yourself about the whole matter then any 'reasonable' medical person should  allow for some experimentation.   On a personal level, by the time I have explained to them all my previous experiementations and gadgets I have made, along with a detailed explantion of the successes and failures, I find that they are only too willing to let me 'play' with the drugs as an alternative.  
Best wishes    Bill
Reply by littlewheel, on Sun Dec 04, 2011 12:50 am
did the doc say why? I had my ileo over 20 years ago, and have taken it ever since.
Reply by g, on Sun Dec 04, 2011 1:26 pm
did they say why ?? i take between 6 and 8 loperimide a day to help things happen to tend to get used to your body and no when to in crease or decrease amount hun never done me any harm
hope this helps
g x
Reply by Primeboy, on Sun Dec 04, 2011 5:50 pm
I have been taking up to 8 pills of Imodium (a brand name for loperimide) for years. I took it when I had UC, when I had a J-Pouch, and now with an ileostomy. None of my GI docs ever questioned it. I also took it in conjunction with lomotil and, more recently, with DTO. Almost all my output is liquid so I took it in hopes of cutting down on dehydration. Anyway, after 18 months as an ileostomate, I decided to stop taking loperimide because I felt it was not making that much of a difference with my liquid output. A funny thing then happened. I started to lose a little weight, not much, but maybe 2 pounds a month. I guess the loperimide kept the nutrients (and the bad carbs) in my system a little longer than needed. In all my years taking the drug, I never had any issues with blockage or constipation. I don't think there are any hard and fast rules on this drug other than if it works use it; if not, don't.   PB
Reply by DH, on Sun Dec 04, 2011 7:35 pm
My doctor recommended that I take imodium for my diarrhea because it's one of the side effects of my chemo.
Reply by banshie3by5, on Mon Dec 05, 2011 7:36 pm
For the similiar reasons as to why IBD folks aren't suppossed to take asprin or NSAIDS anymore, it's about gut-health.  It also depends on which doctor you ask.  See Wikipedia's defn of Loperamide for a full explaintion regarding contradictions and adverse effects.

Rather than using another chemical medicine, It is better to use absorbing foods such as saltine crackers and minute rice, according to nursing studies in relation to both colo- & ileo- ostomates.  

And, again, it's a matter of personal belief.
Reply by Sandy, on Mon Dec 05, 2011 9:37 pm
I was prescribed loperimide
by my doctor for the loose stool ,I stopped taking it because,it caused cramping to my stomach.
Reply by ccurtains, on Mon Dec 05, 2011 10:17 pm
Rice helps a little.  But I discovered by accident, that eating 2 or 3 marshmellows also slowed down the flow for a few hours.  Worth a try.
Reply by lilac, on Tue Dec 06, 2011 12:41 am
I am not certain why your doctor has told you that, perhaps it is different depending on your situation, I had my colostomy 6 yrs ago and have been taking antidiarrhea meds since. I can take up to 12 per day. I also use codeine to stop the loose movements. Diarrhea is directly related to the foods eaten. The more starch (bread, potato, pasta, bagels, rice) the more solid the stool. I find that low fat triscuit crackers help alot, I eat them throughout the day.  Having constant loose stools creates so many problems with skin irritation and low potassium (causing a racing heart) that it has to be controled some way and it was through alot of trial and error that I have finally managed to control it.  Watch your gasey vegetables and fruits as well, they do not fair well with me.  If at any time I can be of help to you let me know, it will  be a long hard road but if you learn to be aware of everything you eat and eliminate those things that bother you too can prevail.  (Also be very careful with fats, I cannot tolerate mayonnaise or oils) Good Luck       Nikki
Reply by hometown, on Tue Dec 06, 2011 3:14 am
I hope this helps you.  I was suffering with profuse diarreah during chemo, and I kept waiting for it to go away on its own.  Well I was so weak I could hardly get out of bed before I made a phone call to my oncologist.  I told him I had at least 15 all liquid pass in the bag and how i was so weak.  He told me to take immodium and if need be i could take up to 10 in a day.  I guess all doctors have their own way of treating this condition, but the immodium did slow down the diarreah for me and no side affects.  I hope this information helps you     Joyce
Reply by Optimist, on Tue Dec 06, 2011 4:41 am
ummm my ostomy nurse and doctor told me to take it and said it was perfectly safe (if you don't go over the daily limit)... i've never heard of it being bad for gut health, ever. i know nsaids can be bad, like advil, but i have never heard of lomotil or immodium being a problem. i have tried just changing my diet and it is not enough. i have to take two each morning and two each night. (it is a cumulative effect so i can miss a dose and it's not that big of a deal, but if i stop for a long time then it takes a few days to get back on track).  it makes a huge difference for me in the number of times i use the bathroom and also it makes output less watery so the bag doesn't do the instant fill ups and leaks are less of a disaster (but i've only had a couple anyways).
Reply by Lecia, on Tue Dec 06, 2011 11:13 am
I have taken immodium only if I have diarrhea. Lately though I haven't had it. Sometimes I go on a BRATT diet which is Bananas, Rice, Applesauce, Toast, and Tea. I Eat Bananas and apples every day. I haven't heard that immodium is a nono. My dr. suggested Milk of Magnesia. I didn't like the taste and it really didn't help me. In the morning I wake up with a bagful of ,what looks like chestnuts. I also eat a lot of salads and instead of tomatoes I cut up an apple.Tomatoes,seeds and dairy products are a nono for me.So I buy Lactose free milk.and instead of ice cream I buy frozen fruit bars.I hope this helps you.Also go online to Ostomy Nutrition. It gives you things you can have and things to avoid. Also it tells you the culprits that cause diarrhea and how to relieve constipation.
I hope you print this all out so you have it on hand.
Reply by Bunkie, on Tue Dec 06, 2011 1:04 pm
I know it is ok to take as I took it in the beginning to slow things down during the day so I didn't have to empty so often..But now I have problems with adhessions and blockages so I stopped. If you have no problems with food or blockages it is fine..Now I can only eat soft purified foods as everything gets stuck. I already had a surgery for a full blockage as the adhesions strangled my intestines right up to the stoma..very I get partial blockages so I don't take it..I have to deal with the watery stools..I sometimes add ebsorbent packets in the bag..this helps alot
Reply by dround, on Tue Dec 06, 2011 7:21 pm
New to this group so my first post. My own personal experience of this issue is that I've only tried Imodium once since my ileostomy and I ended up in hospital with a scary blockage.

However, I took it because I had a high liquid output and stomach pains and it seemed a sensible thing to do. However, in all probablility I had a problem with the blockage anyway that my consultant thought was probably connected with adhesions. Since then I have steered very clear of using Imodium. I think I've read that taking it has its risks for people with an ileostomy and it is probably not a good idea if you have a high output as it probably means that the  small intestine is responding to a blockage by producing lots of fluid to try to shift it and the Imodium acts to damp this down.

However, some people have clearly taken it without problem and we are all clearly different. However, the pain I had with the blockage was the worst I've ever experienced but then I am only a bloke and I am sure lots of women would say that nothing beats childbirth!

Reply by Tony, on Wed Dec 07, 2011 9:14 am
I have been using Loperamide since my ileostomy in 2006 on my doctors recomendation, I only use it when things get a bit sloppy 2 morning + 2 at night this usually does the trick, I also have a bowl of porridge every morning which gives me a smooth discharge.
Hope this helps
Best regards  Tony
Past Member
Reply by Past Member, on Wed Dec 07, 2011 9:37 am
I use loperamide to help slow down my ileostomy. My onocologist prescribed it for me. That said, beware it can cause pancaking due to thick output. Take only 1 and don't forget to drink lots of fluid to prevent dehydration.
Reply by Mister 1976, on Fri Dec 09, 2011 6:19 am
Ho ho ho David
Imodium is Loperamide so if Doc has advise use it get it on prescription matey.  I use it as and when needed - although that is quite often due to Spina Bifida and lack of spinal sense in digestive system.  I need to take maximum if I've had a lot of chocolate - so stocked up for Christmas.
Past Member
Reply by Past Member, on Sat Dec 10, 2011 11:28 am
AS an ETRN I have seen many ileostomates use Immodium with helpful results--thickening watery stool and slowing of transit time. I have to encourage them to go slowly- and legally they need to ask their physician first--but small people use 1 tab (2 mg) in the AM and 1 tab in the PM and watch consistency of output. Larger people may need more tablets but need to observe the results at all times- stopping Immodium if stool becomes too thick--and diet certainly effects this.
Reply by ilsn2u, on Sun Dec 11, 2011 6:11 pm
When I had my surgery in December of 2006, my WOCNs told me to take 2 Immodium 4 times a day, which I continue to do unless I happen to eat a lot of thickeners (potatoes, bread)--then sometimes I cut back to 6 a day instead of 8 a day.  In any case, as an ileostomate, and the loose stools that come with that diagnosis, I can't imagine why you can't take Immodium.  And loperamide is the generic name for Immodium...same exact stuff.  Immodium works by slowing down the output...I take something else to help thicken the output (also told to me by my WOCNs).
Reply by reddog, on Sat Jan 07, 2012 7:38 pm
Had an ileo 1yr. ago. I've found that taking 1 to 2 tablespoons full of Metamucil or other brand of psyllium thickens my output very promptly. I also found that apples, applesauce, pears, and bananas work well too. You have to keep a high level of fiber in your diet. Works for me.
Reply by nick sands, on Thu Jul 11, 2013 3:04 pm
same medicine loperamide is immodium
Reply by gutenberg, on Wed Jul 17, 2013 10:29 pm
Strange thing that: I know some people who refuse to take loperamide and will only take Imodium and there's no way in hell I can convince them they are the same medicine, its always one works better than the other so now I leave that topic alone and besides if my doctor prescribes loperamide I don't have to pay for them, can't beat that.
Reply by nick sands, on Sat Jul 20, 2013 10:08 am
all the hell u have to do is look on immodium package it says active ingredient loperimide it is the chemical name immodium is just a brand name all meds have chemical name and generic meds are often referred to by chemical name.with all of the nurses that are on site iam surprised no one has said anything e.g. warfarin chemical name coumadin is trade name,anti-coagulative.
Reply by gutenberg, on Sat Jul 20, 2013 11:47 am
I think you nailed it Nick. It has been my experience if you have a good relationship with any pharmacist they will go out of their way to help you through the maze of trade names and generic ones. I'm reminded of a situation quite a while ago when I had asked the pharmacist for a bottle of Tylenol No. 1, and she asked in a low voice if I didn't want acetaminophen No. 1, and when I asked her what the difference was she whispered "about 200%'', well now that's something I picked up on real fast.
I'm reminded of a show I watched on TV by an investigative reporter, he took you through the process of manufacturing Vitamin C, and as these pills were coming out of the machine and being deposited in these brown bottles, and these bottles had no labels on them and so he followed the production batch to another plant where all these different labels were put on the bottles and shipped to different outlets, and then the fun part, each store had a different price for the 100 tablets, ranging from $3.99 to $14.99, then when he went to talk to the head of the company that was charging the $14.99 it was an interview to behold, it took all my willpower not to laugh but this man talked and talked and tried to explain why their product was better, even after being shown the footage of the tape of the process, but this guy really had his shit down good and wouldn't admit that they were just ripping of people, a really good program and the other two things that got a shit kicking were car batteries, same process, 300 to 600 cold amps, same battery different label, and the other object of his investigation was mattresses, $499.00 up to $1200.00, talk about expensive labels. Ed
Reply by lilac, on Mon Nov 02, 2015 7:08 pm

Hi Lilac, I live in the next town over from Oceanside.  We are the same age and seem to share the same problems.  I too am a bit of a recluse.  It is hard to be social when you are so aware of your "bag related issues".   I have tried believe me.  I could tell you many stories of my attempts at normalcy and what  has occured.  I am married and have 2 children and 4 grandchildren.  The kids and grandkids are my life and I see them rarely.  One set due to divorce and the other set because of distance and teenage social life.  Its hard and depressing.  I too have an in home business and spend most of my days lonely.  I would love to get together with you for lunch and chat.  Let me know if you are interested and we will arrange something.  Nananed 

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