Antidiarrheals
- Loperamide
- Safest of all the antidiarrheal drugs
- In Immodium
- Diphenoxylate
- Codeine
- **If having an active flare, should not be used. Inflammation is driving the diarrhea, it will only mask the issue. This can cause build up of more inflammation and increase the risk of severe inflammation, delay meds, colon dilation, and perforation.
Bile salt binders
- Bile salts are absorbed in the ileum, which is the most common site of inflammation in Crohn’s
- Chronic inflammation in the ileum or surgery where ileum is removed can cause bile salts to go unabsorbed until they’re taken up in the colon – causing irritation to the colon lining
- Irritation = water to be secreted, producing diarrhea
- Bile salt binders trap these molecules in the feces and prevent them from irritating the colon
- Common bile salt binders:
- Cholestyramine (Questran)
- Colestipol (Colestid)
- Cholesevem (Welchol)
- Effective for treating diarrhea because of ileal disease or previous ileal resection
- Can also trap vitamins that would be absorbed by the body, ADEK