I guess I am one of those who need Imodium long term. I have tried to stop it, but the frequency is high enough to interfere with normal life. But, I do need less than I did during the first few years post op.
No way am I plugged up, since my frequency is 6-10 times a day even with 4 Imodium a day and daily Vicodin. I do agree that we should not be trying to achieve the same low frequency that folks with a healthy colon enjoy (once or twice a day). I think that just promotes bacterial growth that is counter productive.
As to the spasms; yes I do notice more of a crampy sensation when I do not take Imodium. Probably has more to do with its overall effect in slowing the gut than actually being an antispasmodic. The thing about antispasmodics like Levsin and Bentyl though, is that they have side effects that are probably more troublesome than any associated with Imodium. They are in the same class as scopalomine, and can cause dizziness and a "dopey" sensation. I guess you just have to pick your poison, so to speak, and decide what inconvenience is acceptible to you.
Jan