Skip to main content
PMC home page
Gut logoLink to Gut
. 1989 Apr;30(4):492–495. doi: 10.1136/gut.30.4.492

Double blind trial of loperamide for treating acute watery diarrhoea in expatriates in Bangladesh.

F P van Loon 1, M L Bennish 1, P Speelman 1, C Butler 1
PMCID: PMC1434037  PMID: 2653972

Abstract

To determine if loperamide is effective and safe in treating watery diarrhoea, we randomly assigned 50 adult expatriates in Bangladesh with more than three unformed stools in the previous 24 hours and illness of less than 72 hours to receive loperamide or a placebo. On entry into the five day study patients took two capsules (one loperamide capsule = 2 mg) and one after each unformed stool up to a maximum of eight per day. The groups did not significantly differ in pretreatment features or pathogens identified. Mean number of stools on study day 1 was 2.6 in the loperamide group and 4.0 in the placebo group (p = 0.035); on day 2 it was 1.3 versus 3.4 (p less than 0.001). Differences in stool frequencies during the final three study days, or proportion of patients with cramps, nausea, or vomiting on any study day, were not significant. No serious side effects occurred in either group. We conclude that loperamide, by decreasing stool frequency during the early part of illness, may have a role in the symptomatic treatment of this self-limiting disease.

Full text

PDF
494

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen A. V., Ridley D. S. Further observations on the formol-ether concentration technique for faecal parasites. J Clin Pathol. 1970 Sep;23(6):545–546. doi: 10.1136/jcp.23.6.545. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Baddour L. M., Bisno A. L. Infective endocarditis complicating mitral valve prolapse: epidemiologic, clinical, and microbiologic aspects. Rev Infect Dis. 1986 Jan-Feb;8(1):117–137. doi: 10.1093/clinids/8.1.117. [DOI] [PubMed] [Google Scholar]
  3. Chow C. B., Li S. H., Leung N. K. Loperamide associated necrotising enterocolitis. Acta Paediatr Scand. 1986 Nov;75(6):1034–1036. doi: 10.1111/j.1651-2227.1986.tb10338.x. [DOI] [PubMed] [Google Scholar]
  4. Dean A. G., Ching Y. C., Williams R. G., Harden L. B. Test for Escherichia coli enterotoxin using infant mice: application in a study of diarrhea in children in Honolulu. J Infect Dis. 1972 Apr;125(4):407–411. doi: 10.1093/infdis/125.4.407. [DOI] [PubMed] [Google Scholar]
  5. DuPont H. L., Hornick R. B. Adverse effect of lomotil therapy in shigellosis. JAMA. 1973 Dec 24;226(13):1525–1528. [PubMed] [Google Scholar]
  6. DuPont H. L., Sullivan P., Pickering L. K., Haynes G., Ackerman P. B. Symptomatic treatment of diarrhea with bismuth subsalicylate among students attending a Mexican university. Gastroenterology. 1977 Oct;73(4 Pt 1):715–718. [PubMed] [Google Scholar]
  7. Ericsson C. D., Johnson P. C., Dupont H. L., Morgan D. R., Bitsura J. A., de la Cabada F. J. Ciprofloxacin or trimethoprim-sulfamethoxazole as initial therapy for travelers' diarrhea. A placebo-controlled, randomized trial. Ann Intern Med. 1987 Feb;106(2):216–220. doi: 10.7326/0003-4819-106-2-216. [DOI] [PubMed] [Google Scholar]
  8. Guerrant R. L., Brunton L. L., Schnaitman T. C., Rebhun L. I., Gilman A. G. Cyclic adenosine monophosphate and alteration of Chinese hamster ovary cell morphology: a rapid, sensitive in vitro assay for the enterotoxins of Vibrio cholerae and Escherichia coli. Infect Immun. 1974 Aug;10(2):320–327. doi: 10.1128/iai.10.2.320-327.1974. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Johnson P. C., Ericsson C. D., DuPont H. L., Morgan D. R., Bitsura J. A., Wood L. V. Comparison of loperamide with bismuth subsalicylate for the treatment of acute travelers' diarrhea. JAMA. 1986 Feb 14;255(6):757–760. [PubMed] [Google Scholar]
  10. Karrar Z. A., Abdulla M. A., Moody J. B., Macfarlane S. B., Al Bwardy M., Hendrickse R. G. Loperamide in acute diarrhoea in childhood: results of a double blind, placebo controlled clinical trial. Ann Trop Paediatr. 1987 Jun;7(2):122–127. doi: 10.1080/02724936.1987.11748488. [DOI] [PubMed] [Google Scholar]
  11. Kassem A. S., Madkour A. A., Massoud B. Z., Mehanna Z. M. Loperamide in acute childhood diarrhoea: a double blind controlled trial. J Diarrhoeal Dis Res. 1983 Mar;1(1):10–16. [PubMed] [Google Scholar]
  12. Merson M. H., Morris G. K., Sack D. A., Wells J. G., Feeley J. C., Sack R. B., Creech W. B., Kapikian A. Z., Gangarosa E. J. Travelers' diarrhea in Mexico. A prospective study of physicians and family members attending a congress. N Engl J Med. 1976 Jun 10;294(24):1299–1305. doi: 10.1056/NEJM197606102942401. [DOI] [PubMed] [Google Scholar]
  13. Minton N. A., Smith P. G. Loperamide toxicity in a child after a single dose. Br Med J (Clin Res Ed) 1987 May 30;294(6584):1383–1383. doi: 10.1136/bmj.294.6584.1383. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Owens J. R., Broadhead R., Hendrickse R. G., Jaswal O. P., Gangal R. N. Loperamide in the treatment of acute gastroenteritis in early childhood. Report of a two centre, double-blind, controlled clinical trial. Ann Trop Paediatr. 1981 Sep;1(3):135–141. doi: 10.1080/02724936.1981.11748077. [DOI] [PubMed] [Google Scholar]
  15. Schiller L. R., Santa Ana C. A., Morawski S. G., Fordtran J. S. Mechanism of the antidiarrheal effect of loperamide. Gastroenterology. 1984 Jun;86(6):1475–1480. [PubMed] [Google Scholar]
  16. Speelman P., Struelens M. J., Sanyal S. C., Glass R. I. Detection of Campylobacter jejuni and other potential pathogens in travellers' diarrhoea in Bangladesh. Scand J Gastroenterol Suppl. 1983;84:19–23. [PubMed] [Google Scholar]
  17. Vesikari T., Isolauri E. A comparative trial of cholestyramine and loperamide for acute diarrhoea in infants treated as outpatients. Acta Paediatr Scand. 1985 Sep;74(5):650–654. doi: 10.1111/j.1651-2227.1985.tb10006.x. [DOI] [PubMed] [Google Scholar]
  18. Yolken R. H., Kim H. W., Clem T., Wyatt R. G., Kalica A. R., Chanock R. M., Kapikian A. Z. Enzyme-linked immunosorbent assay (ELISA) for detection of human reovirus-like agent of infantile gastroenteritis. Lancet. 1977 Aug 6;2(8032):263–267. doi: 10.1016/s0140-6736(77)90951-5. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES