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Treatment of diarrhea (diarrhea)
Medical expert of the article
Last reviewed: 04.07.2025
In severe diarrhea, fluid and electrolyte replacement is necessary to correct dehydration, water-electrolyte balance and acidosis. Parenteral administration of solutions containing NaCl, KCl and glucose is necessary. Transfusion of saline solutions to prevent acidosis (Na lactate, acetate, HCO -) is indicated if serum HCO - is less than 15 mEq/L. Oral administration of glucose and electrolyte solutions can be prescribed in cases of mild diarrhea, mild nausea and vomiting. In some cases, when large amounts of fluid and electrolytes are required, solutions are taken orally and parenterally simultaneously (e.g., in cholera).
Diarrhea is a symptom. If possible, the underlying disease should be treated, but symptomatic therapy is often necessary. Diarrhea can be reduced orally by loperamide 2-4 mg 3-4 times a day, diphenoxylate 2.5-5 mg (tablets or liquid) 3-4 times a day, codeine phosphate 15-30 mg 2-3 times a day, or painkillers (tincture of camphor opium) 5-10 ml 1-4 times a day.
Because antidiarrheal drugs may worsen C. diffilite-induced colitis - or increase the likelihood of developing hemolytic uremic syndrome in Shiga toxin-producing Escherichia coli infection, they should not be used in patients with bloody diarrhea of unknown etiology. Their use is possible in patients with watery diarrhea and no symptoms of general intoxication. However, there are a small number of observations confirming the data on an increase in the duration of excretion of putative bacterial pathogens during treatment with antidiarrheal drugs.
Psyllium or methylcellulose components provide bulking agents. Although the usual prescription is for retention of stool, bulking agents given in small doses reduce the fluidity of loose stools. Kaolin, pectin, and activated attapulgite absorb fluid. Osmotically active nutrients and peristaltic-stimulating drugs should be avoided.