Functional Diarrhoea

In this variant, the problems are noticeably different. Patients complain of frequency and particularly urgency of bowel movements and of passing several stools in rapid succession, usually first thing in the morning.

In its most severe form, sufferers become housebound because the urgency is so great that their lifestyles revolve around knowing exactly where the next lavatory is.

Main symptoms:

- the passage of several stools in quick succession, usually first thing in the morning and then no further bowel action that day or defaecation after meals.
- The first stool of the day is usually formed; the later ones are mushy,
looser or watery
- Urgency of defaecation
- Anxiety, uncertainty about bowel function causing concern about travel or going out
- Exhaustion after what sufferers often refer to as 'the morning rush'.

Loperamide (e.g. Imodium) is the mainstay of treatment. In this variant of IBS, the rate of movement of contents through the small intestine and right side of the colon is increased. Imodium slows the rate of movement of contents through these regions of the gut. Codeine phosphate and lomotil have been used but in our experience are less effective.

Imodium should be taken on a regular basis once the optimum dose has been defined. A single drug capsule first thing in the morning is often effective but higher doses taken throughout the day may be needed. Sometimes a lower dose (e.g. 1 mg in liquid form taken first thing in the morning) may be required.

Trycyclic antidepressants have also been shown to reduce the rate of movement of contents through the gut and low doses of amitriptyline and particularly chlomipramine and Anafranil at night can be highly effective in combating the urgency and frequency that characterises this variant of IBS and are particularly effective at alleviating the early morning rush

 


IBS ResearchUpdate.org Current Page:
Main Variants Of IBS - Functional Diarrhoea