Empiric Treatment of Chronic Diarrhea

Abstract

Diarrhea occurring for 4 or more weeks is deemed chronic. In an ideal world, it would be easy to identify and direct therapy to the underlying pathophysiology that is leading to chronic diarrhea, however, this is not always possible. Oral rehydration solutions play an important role in treating dehydration, which is one of the first aspects of chronic diarrhea that must be dealt with. Various medications can be used to help ameliorate the symptoms of chronic diarrhea or to treat the underlying mechanism involved. Some of these agents include silicates, bulk-forming agents, opiates, enkephalinase inhibitors, anticholinergics, somatostatin analogues, calcium channel blockers, and alpha 2- adrenergic agonists. Lastly, probiotics can be used in treating antibiotic-associated diarrhea, travelers' diarrhea, diarrhea-predominant IBS, ulcerative colitis, and in the prevention of pouchitis. For a more detailed discussion of the various treatment options available please refer to the corresponding chapters.