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Lomotil for Diarrhea

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Posted 6/12/2013 2:11 PM (GMT 0)
So I just got out of the hospital. I was there since Friday. The Dr. gave me Lomotil for my constant diarrhea. Anyone else take this? I'm worried about the atropine in it and my high blood pressure. I take atenolol for my HBP but still doesn't atropine raise it?
Posted 6/13/2013 7:27 PM (GMT 0)
I don't know...you should call your doc or do a search on the med to see if it's contraindicated in hbp and the med you're taking.

I was prescribed it during my first diarrhea episode about 3 years before diagnosis. I was definitely stoned (but lost 17 pounds by that time) and the best part...had not ONE pain in my body..lol.

Are you on meds for your UC as well?

q
Posted 6/13/2013 9:03 PM (GMT 0)

quincy said...
I don't know...you should call your doc or do a search on the med to see if it's contraindicated in hbp and the med you're taking.

I was prescribed it during my first diarrhea episode about 3 years before diagnosis. I was definitely stoned (but lost 17 pounds by that time) and the best part...had not ONE pain in my body..lol.

Are you on meds for your UC as well?

q

I did end up doing a lot of searching about it and I'm not finding anything bad about it and HBP. The atropine is only like 1/40 therapeutic dosage. They mainly put it in there so people don't iv a ton of it. I read that, chemically, it is very closely related to Demerol. They say it doesn't cross the blood brain barrier very well like other opiates/opioids though.

Imodium is also an opiate, but does not cross the blood brain barrier on its own at all, only affects receptors in the digestive system from what I read.

I guess that is why imodium is OTC and lomotil is a schedule V controlled substance.

Yes, I take Pentasa 1Gram 3xday and I am on another 10 day round of cipro and flagyl PO after 5 days cipro and flagyl IV.

When I take the lomotil I definitely feel that it is an opiate but I also get a little speedy off of it like I do with certain pain meds.

What was the quantity you were prescribed? I am supposed to take 2 of them 3xday, but they only wrote the script for a 30 count. This will suck if I have to call for a refill and go to the pharmacy every 5-6 days.

I wanted to add that I have a better diagnosis now. I seen Pancolitis on my chart while I was in the hospital for 5 days. What's weird is my biopsies came back negative. So my GI took more biopsies and is doing the genetic blood testing for IBD(UC/Crohn's).
Posted 6/13/2013 11:53 PM (GMT 0)
FYI:
My GI would not prescribe Lomotil for me because of the possibility of a condition called "mega colon" which is described under side effects of Lomotil.
Posted 6/14/2013 12:05 AM (GMT 0)

ItsAlwaysSomething said...
FYI:
My GI would not prescribe Lomotil for me because of the possibility of a condition called "mega colon" which is described under side effects of Lomotil.

Yeah but my diarrhea is so bad that I can't be far from a bathroom at anytime. Since I have been taking the lomotil I have actually been able to leave the house and for the first time in months eat out without worrying about explosive diarrhea immediately after.

Nothing OTC works.

With this I am having more solid BMs and about 1-2 times a day. Before with imodium(loperamide), all my BMs were very loose and at least 10-12 times a day and sometimes more. I was scared to death to leave my house, but now I can get out.

I feel like I have some of my life back now with this lomotil. I wish they had prescribed it for me a lot sooner than just this last week.

Only problem is I am only getting 30 at a time. I need to get my doc to give me a month supply...I guess 180 count since 2 of them 3x a day does the trick with no constipation.
Posted 6/14/2013 12:12 AM (GMT 0)
I was in the same situation 10 years ago when diagnosed so I understand how you feel. Just concerned about possible effects of long term use of lomotil.

Have you tried diet modification?
After gradual improvement during the past 10 years,
I noticed a significant difference when I gave up lactose, gluten and sugar.
Slippery elm powder at night also helped with "urgency".
Best of luck to you :-)
Posted 6/14/2013 12:52 AM (GMT 0)
I started on a low fat/carb diet and I am avoiding dairy, gluten and sugar.

I think the only effects of long term use is opiate dependance, which I already take pain meds everyday for a few years now. I regularly take 100mg(2x50mg) Tramadol tablets 3xday. If I am hurting really bad I have Vicodin and Percocet in my med cabinet to replace a dose of Tramadol with only if really needed. I try to avoid those stronger opiates as much as possible.

I'm trying not to take my maximum dosage of the Lomotil regularly(2 tabs 3xday). I wait to take 2 of them until I have my first loose BM of the day. I take 1-2 before I leave the house depending on how much I have taken that day to help avoid urgency and accidents while away from a restroom. Usually I will take 2 around dinner time because after a larger meal I always have violent diarrhea within a half hour. There have been days when I only had to take the initial 2 tabs and I was okay for the entire day.

I have not experienced any constipation. My BMs are still a little soft most of the time, but kinda close to being normal and most days down to 1-3 BMs per day. This has been since starting the Lomotil. Before the Lomotil I was having BMs that were mostly water and mucous and up to 12-15 or more times a day.
Posted 6/14/2013 1:17 AM (GMT 0)
I take it if I am having a bad day. I think my script says one every 8 hours as needed. My doctor wrote a 30 day supply so it ended up being 90 pills. She wrote it last August and I have used maybe a quarter of them.
Posted 6/14/2013 1:24 AM (GMT 0)
Markh...I cannot remember the dosage....that was 27 years ago. I clearly remember the NO pain and being stoned.

q
Posted 6/14/2013 2:43 AM (GMT 0)

sherbear46 said...
I take it if I am having a bad day. I think my script says one every 8 hours as needed. My doctor wrote a 30 day supply so it ended up being 90 pills. She wrote it last August and I have used maybe a quarter of them.

This is OT, but do you take the hydroxyzine for anxiety and/or panic attacks? How does that work for you? I've tried that and buspar both and couldn't handle the side effects. The hydroxyzine knocks me out for hours and I feel groggy kinda the same feeling I got when I used to take seroquel. It just made me too tired all the time and I couldn't function normally because of it. The buspar caused extreme dizziness, which my dr. said should go away after 2-4 weeks but after 2 months it was still really bad. To the point that I would fall into stuff while walking because I couldn't keep my balance.

I took 1mg Klonopin 3xday for 10-12 years and it worked great with absolutely no side effects whatsoever. Now my new doc has me taking 5mg Valium 2xday, which doesn't work as well as the Klonopin for general/social anxiety and preventing panic attacks. I am trying to get him to put me back on at least 1mg Klonopin 2xday but having trouble. He is actually talking about lowering my Valium to 5mg 1xday which I know is going to be bad. I am really dreading having more frequent panic attacks and not being able to be around large amounts of people in public. I also do not have any side effects from the Valium either.

So I pretty much feel like I can't leave my home due to both the diarrhea and the panic disorder. The Lomotil is helping with the diarrhea so I am a little more comfortable leaving home when I have that, but I am starting to feel agoraphobic because leaving home and being around people is my main trigger for panic attacks.

Also, when my anxiety levels are high or I am having panic attacks, the diarrhea gets really bad. There have been multiple times in the last couple months that I am having a panic attack and crapping my brains out on the toilet at the same time. I have almost zero quality of life right now
Posted 6/14/2013 2:15 PM (GMT 0)
Well I am starting to think my GP is a quack. He is only a PA and the nurse in my GI doctor's office actually called him that(quack). He called in the lomotil for 2 tabs 3xday, but only for a quantity of 30 to last a month, which made no since to me at all considering right now I can't leave my house without it.

I called my GI and he called in a quantity of 180/month with 3 refills and that nurse suggested I look for a new GP and one that is an MD not a PA.

So I guess I should have just called the GI in the first place, but he had told me before he doesn't prescribe narcotics. He didn't have a problem calling in a large amount of this lomotil with refills though.
Posted 11/12/2013 2:14 AM (GMT 0)
I have taken lomotil 2.5 mg 3x a day for 7 years. My doctors keep asking "does it even help?" It does a little. I've been on it so long it seems like its loosing its effectiveness but I definitely do not go without it. Its definitely mood altering and I have extreme dry mouth and I clench my teeth a lot. My last GI doctor mentioned this isn't a good long term anti-diarrheal cause it changes your gut. Anyways, whenever I have the urge and take a lomotil I may still have the diarrhea but the feeling that an urge brings on goes away. I go to the bathroom 20 + times per day still but if I don't have to walk around with my butt cheeks clenched that's a good thing.
I get 100 2.5 mgs tabs per month so that's not enough to take 2 tabs 3x per day so I think I might try doubling up for a couple of days.
Curious to know how it has helped all of you :)
Posted 11/12/2013 2:19 AM (GMT 0)
What about rectal meds? Have you tried any?
Posted 11/23/2013 4:01 PM (GMT 0)
I am still taking the lomotil 2.5mg. I take 2 tablets 3x a day regularly and it helps a lot more than OTC Loperamide(Imodium). It also seems to help some with abdominal pain and cramping/urgency. I still have 2-5 soft stools a day so that it a huge improvement over 15+ liquid stools a day.

The lomotil seems to be losing some effectiveness for me as well since I have been taking it regularly for at least 6 months now. Since I still have soft stools and getting progressively more often the longer I am on the Lomotil, I am considering speaking with my GI doc about something a little stronger. I know there is something called Motofen that is similar to Lomotil, but a bit stronger. I don't know if he would be up for it but I have a feeling after a few more months the Lomotil won't be working very well for me. Sometimes I have to take Imodium along with the Lomotil just to try and get my BM's a little more normal.

I hope that my doctor can get me on the right meds soon so that I won't need the narcotic diarrhea meds, but until then I definitely cannot go without the Lomotil and the added Loperamide when needed.
Posted 11/23/2013 4:11 PM (GMT 0)
and you're not using rectal meds because?

Have you also tried using fibre supplements?

Have you had food allergy testing to see if something there's going on in that direction?

You were on flagyl....did you have c.diff or other infection as well?

It's not good you're on that type of med continually without knowing the reason as to the why you're having continual diarrhea.

q

Posted 11/23/2013 4:18 PM (GMT 0)
My doctor hasn't ever mentioned anything about rectal meds.

I do make sure that I get a lot of fiber in my diet and I have had no testing for food allergies.

My doctor has done a lot of tests and for now the diagnosis is Pancolitis & Diverticulosis.

I had the Promethius blood test done recently and I am awaiting the results to see if they confirm either UC or Crohn's.

Every time I have a flare-up, the doctors say that testing shows significant inflammation in my colon, high white blood cell counts, low potassium and positive results for blood in my stool which is visible as well. I've never lost so much blood that tests showed I was anemic.

The doctor isn't 100% sure of the diagnosis yet, especially if the genetic blood tests return negative for IBD's. I will just have to wait until those results come in and we will go from there.

One new thing I found out during my last appointment was that some type of hernia was found in my upper digestive system and a small amount of acid reflux.

EDIT: C.Diff tests have always been negative. I was on the cipro and flagyl because my white blood cell count was really high. I haven't had to take any antibiotics since the flare-up back in May-June.
Posted 11/23/2013 4:30 PM (GMT 0)
well, since you've been here since May and we've mentioned rectal meds....it's time YOU asked for them.

q
Posted 11/23/2013 4:32 PM (GMT 0)
I will be sure to ask my doctor about it at my next appointment. Thanks for your help!
Posted 11/23/2013 4:33 PM (GMT 0)
Are you afraid to use them....or willing?
Are you in the US, Canada or other?

q
Posted 11/23/2013 4:36 PM (GMT 0)
I am willing to try anything. If it will help I will do it.

I am in the US.
Posted 11/23/2013 4:39 PM (GMT 0)
Since you're in the US, I'd suggest Rowasa or the generic.

One thing...your doc might say that the retention enemas won't reach your whole colon (which has nothing to do with the reason you'd be using them).
They treat the rectum/sigmoid and possibly beyond.  The oral 5ASA doesn't treat the rectum....and according to your last scope, some things have improved nicely.  Time to deal with the parts that haven't.

They maybe be a good use to your diverticulosis as well.

Great on not having c.diff, it's good you're being checked.

Could any foods be partly a culprit? (and no...I'm not meaning UC-related..just that some foods can increase bms, loose stool, diarrhea, etc)

Is the Pentasa oral the only 5ASA you've tried?

q

Posted 11/23/2013 4:52 PM (GMT 0)
Yes, the Pentasa is the only mesalamine or 5ASA(whatever that means) medicine I have ever been prescribed. The Pentasa are the capsules with the tiny beads of meds inside them. I know they are reaching my entire colon because a little bit of the small beads make their way out in my stool. Not a lot, but it makes me think the meds are working on my entire colon.

Another issue I have is a terribly large hemorrhoid that swells and protrudes out and bleeds a lot. Earlier in my life(late teens/about 10 years ago), the hemorrhoid got so large that it completely blocked me from having a bowel movement. A doctor I had then did a procedure to cut and drain blood or whatever came out so that I could have a BM. It has never gotten that bad since but it isn't small by any means. When I have a lot of BM's it gets very large and sometimes I have to wait for it to calm down before I can finish my BM.
Posted 11/23/2013 4:55 PM (GMT 0)
You certainly have a lot to deal with....and even with the hemmie, the doc didn't even give you ANY rectal meds or external/internal topical ointments, etc?

The beads, while in your stool....remember that stool develops via process in the colon, so whatever is in there will come out. But the med won't sit in the rectum long enough to deal with the inflammation.

The enemas, 4g, would be your best bet for now....if you have improvement, just imagine!

q
Posted 11/23/2013 10:51 PM (GMT 0)
The only thing I have that is topical, an ER doc gave it to me, is a tube of lidocaine gel to use when that area gets raw from too many BM's.

Other than that, I use PrepH wipes and the PrepH cream.

What did you mean by "4g"? I am taking 1g Pentasa 3x daily. Did you mean 4g of a mesalamine daily or were you referring to some type of rectal med?
Posted 11/23/2013 10:58 PM (GMT 0)
The standard dosage for a mesalamine enema is 4g. It's 4g of mesalamine in a liquid suspension that you insert rectally.

What do you take the opiate painkillers for? You need to control the inflammation, not just the bowel movements. If you're having diarrhea while you're on daily opiates (or, if you need Lomotil in addition), you already have a significant tolerance built up. Stopping the diarrhea without controlling the inflammation doesn't control your cancer risk, which is high due to pancolitis. It doesn't protect the rest of your body from the effects of inflammation, like PSC (liver disease). And ultimately it leaves you at a high risk of developing toxic megacolon.
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