Management of diarrhoea

 

Treatment: According to the Scottish palliative care guidelines the following non specific treatment is

recommended for relief;

•  Loperamide (opioid drug) is given at dose of 2mg daily after each loose motion with

a maximum daily dose of 16mg. Codeine can be used as an alternative at 10-60mg

four hourly if the former is not having any effect and can be combined with

loperamide under specialist advice.

Side effect include central actions caused by codeine but this is uncommon.

 

•  Pancreatic enzyme supplements can be given for diarrhoea due to malabsorption i.e. in steatorrhoea and impaired fat abdorption.

• Infections caused by clostridium difficile should be treated with metronidazole (400mg three times daily)or vancomycin (125mg four times daily)

•  Faecal impaction is treated with manual evacuation of the impacted faeces or with macragol

• Diarrhoea caused by excess bile salt i.e illeal resection can be treated with colestyramine which binds to the bile salt to prevent watery diarrhoea

 

 

Advice:

•  Glucose can help the bowel to absorb fluids so di-oralyte can be helpful in drying up

excess fluids.

•  Milk should be avoided because it contains lactose and especially

where the cause of diarrhoea is due to an infection, it may aggravate the diarrhoea.