Drugs used in the treatment of diarrhoea – ORS

For those who are confused:

In diarrhea, Anti-diarrhea medications like Loperamide/Imodium are NOT first-line.

Antibiotics like Flagyl, tetracycline and amoxicillin are NOT first-line.

The first aid advice is REHYDRATION- with water or ORS. This is the standard practice all over the world.

There is NO medical school anywhere in the world that trains doctors or any health professional to ROUTINELY throw Imodium or Flagyl at every case of diarrhea- regardless of the context or other specific findings.

It is quack pharmacists and native doctors that tell you this.

What we know as health professionals is that the BIGGEST challenge in diarrhea- regardless of cause- is FLUID (AND ELECTROLYTES) LOSS.

And that’s exactly why the biggest first line advice is FLUID REPLACEMENT with water, ORS or simple non-sugary drinks.

I hope this is clear.

Treatment of diarrhoea
First aid for diarrhea/treatment of diarrhoea

The commonest causes of diarrhea are viruses like norovirus or rotavirus, bacteria like E. coli and also parasites. And in a lot of cases, most cases actually, the diarrhea stops on its own.

The only problem is the repeated watery stools and the fluid loss- hence you need ORS.

In some people, simple anxiety, change of environment, new food, food poisoning or even some other medications can all trigger diarrhea. It is point blank quackery to blindly routinely offer antibiotics like Flagyl to every single person that has diarrhea.

That’s actually not appropriate.

As a matter of fact, the medical evidence is going towards letting the toxins out of your system and not trying to block it or slow it down- except the stools are too many, too distressing and too stressful.

Otherwise it’s far better/beneficial to let the stool and toxins out.

I’ve never heard anyone that is a competent professional anywhere that wants to throw loperamide at every diarrhea case. The evidence is more robust that it is better to let the body flush the stools/infective organisms out- But you want to block it all with loperamide? Shame.

Does that mean Loperamide is useless? Absolutely not. As I said, loperamide is considered if the diarrhea is not improving at all after a few days or is quite very distressing for the person.

But the medical consensus is that: Loperamide/Imodium is NOT first-line for diarrhea.

How about antibiotics?

Is it absolutely useless? In the overwhelming majority of diarrhea cases, yes. And the reason is simple: Most diarrhea cases resolve on its own and do not require any extensive medical investigations that will ever suggest any need for antibiotics.

However in some few cases:

People with severe abdominal pain

People with blood or mucus in stool

People who recently travelled

People with high fever, shortness of breath, looking pale, quite drowsy, very weak, and unable to drink anything by mouth

They need hospital admission.

And even in the hospital, the MAIN treatment offered is FLUID REPLACEMENT into their veins- to replenish all they lost through the repeated watery stools.

And if the stools and blood tests suggest they will benefit from antibiotics, the hospital/doctor will give it.

And the stool test result also says what antibiotics is best. That is where the difference lies between recognising the specific cases that requires antibiotics and a blind mindless routine prescription of Flagyl, Tetracycline or any other antibiotic for every case of diarrhea.

The quacks who are preaching Imodium and Flagyl at every case of diarrhea do not have your best interests at heart. These quack online pharmacists and roadside chemists are only interested in selling you their fake drugs. Even at the very expense of your life.

It is a proven fact that routine misuse of antibiotics in unnecessary situations like simple diarrhea can lead to antibiotic resistance. This means if you fall sick and need the antibiotics, it won’t work and you may lose your life. This is what these charlatans want for you.

This is why some men get some serious chest infection and no antibiotic seems to work. This is why some ladies get some horribly smelling vagina discharge and the same Flagyl (metronidazole) they now need will fail. Because you have misused this antibiotics for every simple cough and diarrhea.

On a final note:

If you have diarrhea, go and buy ORS. That’s all you need. It would go under a week. Just keep rehydrated. If it persists, or you can’t drink again, or you get high fever, blood/mucus in stool, become weak/drowsy- call a doctor.

I hope this clarifies the issue.

Thank you

This article on the treatment of diarrhoea was written by:

Yours sincerely,

Dr Olufunmilayo


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