Pepto Bismol works differently than Imodium or lomotil. It also has some antibacterial qualities, so a good choice if you think you've picked up a bug. Follow the directions on the container and increase the dose only if necessary. You can take Imodium too, taking 1-2 four times a day, but again, start small, and increase gradually. It takes a few days for the level to build up. People make the mistake of continuing to take more when it does not work in a couple of hours. Do not take more than 8 a day (16 mg).

Lomotil dosing will be set by your doctor.

If you have C. diff, you do not want to slow things too much, because that increases the contact between the toxin and your mucosa.

The main thing is to stay on top of the fluid output and not get dehydrated.

Jan

jan imodium..what do you mean it takes few days to build up..so are you saying just take everyday or in my case evening because lol thats when all hell usually breaks loose..it needs to be taken on regular basis to build up and work???and with imodium you think we can take as much as up to 8 over the day(evening)?

got cdif test back negative..think i am dealing with just my S.I.B.O.

Yes. Studies show that once you figure out your daily dose. You can take divided doses or one daily dose. I used to take mine twice a day, but mostly because I was taking other medications anyway twice a day. Now I only take one Imodium a day, so I don't divide that dose. But, bottom line, you can take up to 16 mg in a single daily dose.

Jan

I also usually take 2 Loperamide, prescription Imodium, daily around noon when I have a fruit protein smoothie. When things change as thet do from time to time I take more and like the prescription caplet form better as it works faster and I don't take too many. I'm an impatient person - so it fits my personality,

jan.wow thanks may have hit on something i have overlooked that might really help in my unpredictable intestines issues..imodium...kind of never registered that my going so much and mostly at evening on was considered diarrheah duh!!! past two days doing better with taking imodium ...
does the daily dosage not only build up as you say but than help allow for how many you need regularly/kind of confused on that..i started off toward evening with two and than added one each time after a b.m but only up to 4 ...you take just one pill for whole day/and do you have a time you do it/should i to aim for a daily amount at certain time in day?i seriously think or hope between that and diet i get some sense of regular control..

do you take anything for firming as wel..again never thought much about how it came out as long as i did not have pain etc..but wondering if thats maybe in order too//maybe consistency and amount of times i go factor into my overall issues of sibo/diet..

if you do recommend maybe firming agent my concern is sugar (i avoid if possible) medimucil for example has lot of added sugar..

anyway..any more input on this would be appreciated..

temarie so use your imodium as safe guard in event or if you eat something that might trigger off more output hmmm?

For the first 5 years or so I needed 6-8 Imodium a day. But that was before I knew I had chronic cuffitis. Once that was treated, I still needed Imodium, but less. I then was able to reduce to 4 a day. Now, 18 years later, I am down to 1 a day, but I also take Norco daily for my arthritis, so that is sort of a replacement.

I don't know if there is a best time of day to take it, as there will be a constant serum level after a few days where the level builds up. If it helps, the peak is about 4-5 hours after you take it. So, if you take it twice a day, about 12 hours apart, you are pretty much covered. When I was taking more, I took it when I first got up in the morning and around dinner time.

Imodium slows the gut and increases water absorption, so it thickens some just because of that. But many people want thicker stool to help reduce urgency and leaks. This is where the fiber supplements come in. Both Metamucil and Citrucel come in sugar-free varieties, so that should not be a big deal, but they still have a small amount of carb calories. Another option is the capsules, which have none. You'll have to take more for the same result, so it will be more expensive that way. I was put on Metamucil right after surgery, but it gave me too much gas and cramps. So then I tried Citrucel, which was better, but it did not reduce my frequency at all. It just made it thicker and more bulky. Since I was not having any issues with continence, I gave up on it because it was more hassle than I was interested in.

Other fiber options are chia seeds and apple pectin. You just have to look a little harder to find them.

Jan

thanks jan i really really appreciate the imodium input..i mean the light bulb just went off (7 years later) to busy thinking pouchitis to concentrate on and awful pain,then the diagnosis SIBO and dealing with on going antibiotic usage that worked and than did not,and cliff and so on...never thought i could control the output just figures it was what it was..but now i feel hopeful again to reinstitute something i only did when first had operation..and now with your info understanding it builds up and to use regularly..it might even help that constant need to go to bathroom every time i eat too!!!

since i normally go a lot in 24 hours i am going to try your idea of one in morning ,maybe one in afternoon and one at night (maybe little overkill maybe not!)see what happens with diet of low carbs continued..

will update..if it is not right mix will try another ..maybe do not need the firming either as with less going may be enough of improvement..thank you,thank you!!can not believe i missed this clue all along!!!duh!!

jan one more clarification..you started 6to 8 than down to four but was that one at a time or doubled up.?thinking on,one and one but recall shen suggesting 2 at first ,than one and so on one time when i asked about slowing up..unfortunately it did not register at time as a continual thing..

Hard to remember, but I think I adjusted the dose up or down by 2s in the higher doses, but one at a time at lower levels, like less than 4. Once a year I'd come off of it completely for a few days to see if I still needed it, and adjust the dose when resuming it.

Jan

Rebecca, I'm also taking at least 3 Norco daily for pain and it slows my system plus I take an antispasmodics as needed when the cramps just won't calm down. Then there is the Augmenten antibiotic I take off and on for IPS, which I hate to take. It also firms up my stool too. I have chronic cuffitis and IPS as well as chronic abdominal pain.

I'm sure I'd be taking more Loperamide (Imodium) if not for the Norco, antispasmodic and Augmenten.

I quit Metamucil before I was a year out. I took the caplet form so I didn't have to drink it mixed up and that way it was easier to drink it with less water. In our position we are to drink less water than the directions call for.

It sounds like you've had a real "light bulb" moment and I hope all of this plus your sibo diet have you feeling better soon

temarie and jan thanks..i think the trick is figuring out my correct dosage and when..that seems to be first challenge..think i was off to think one morning afternoon ,night..

i think i probably should start high jan like you did 6 to eight..but jan do i then go two,two two and so on if i understand you correctly?sorry if i seem to repeat...or divide up only few times in day..

thanks

really think there is something to this..just need to figure out!!!

I started out with 4 times a day, then later settled on twice.

Jan

jan thanks with your patience with all this questioning..you are being soooo helpful

pressing your patience once more..did you get up a lot at night?i have always gotten up no less than three times a night(thats on good night !) so wondering if saving some of those dosages for really late or during sleeping hours might be worth it..you mentioned imodium peaked in 4 or 5 hours what does that mean?i presume taking it does not kick in for some
time and it kicks in ?

Once I settled on the daily dose, timing did not seem to matter much. Although the peak is 4-5 hours it does not mean the trough is super low. It has a long half-life, and that is why the level builds up over several days. So, if I took it at breakfast and dinner, it was about 12 hours apart. I still get up during the night, but I did have some years where I slept 6 hours or so, but then I got older...

Still, I wake up rested in the morning, so that is what matters to me.

Jan

thank you,thank you for your patience and getting back each time..much appreciated..with you input i will figure it out how i will do my eight pills..but mostly hoping it makes a difference i was missing..will keep everyone updated because i love to share if i think i can help someone else with my experience..

so lucky to have you jan on this site..you are an amazing warehouse of knowledge and information...

I've increased mine Loperamide to 4 per day, since I've just quit taking Augmentin antibiotic. I might increase it to 6 after a few days. The antibiotic is prescribed for IPS when things get worse. Loperamide is prescribed for the same reason. I've never taken the 8 per day my Mayo GI's written the prescription for and am thinking I need to do this and maybe it will keep me from needing the Augmentin. I just have to experiment. My diet is pretty constant so will be changing one thing.

Thanks for bringing the subject up Rebecca and as always for your help too Jan.

I have damaged sphoncters, sop really need to thicken to maintain some sembalance of continence, but I take 2 immodium, 8 metamucil capsules, and 1 30mg codeine about 3 times/day, right before each meal.

I would start low and then titrate up until you figure out the dose and pacing that works best for you.