1.4 Acute diarrhoea

General guidance

The first line of treatment in acute diarrhoea, as in gastro-enteritis, is prevention or treatment of fluid and electrolyte depletion. This is especially important in infants and in frail and elderly patients.

• Antimotility agents may be useful in adults for short-term symptomatic relief.
• Antispasmodics may be useful in the management of abdominal cramp associated with diarrhoea, but they should not be used as a primary treatment.
• Antidiarrhoeal drugs should not be prescribed in the presence of untreated chronic inflammatory bowel disease.
• Antibiotics are unnecessary in simple gastro-enteritis, even if a bacterial cause is suspected.

Recommended drugs

Children and adults

Oral Rehydration Salts (Ors) £

Adults

Loperamide Hydrochloride £

Codeine Phosphate £

Drug Traffic Light Key:

Green – On Formulary

Amber – Restricted use, see local guidelines

Purple – Specialist use/initiation

Red – Non Formulary

Relative Costs Key (where indicated):

£££££ - high

£££ - moderate

£ - low