Clinical Corner

Do you have a question about digestive health? We want to help.

If you or a family member is struggling with chronic or recurring GI symptoms, you probably know how challenging it can be to find reliable treatment information. We want to help you find ways to manage symptoms and understand why they occur.

Question – I will soon be travelling to several countries where finding safe drinking water will be a challenge. In the event I eat or drink something that would cause traveler’s diarrhea would it be wise to preventatively start taking a probiotic? Is it alright to take loperamide at the same time as taking a probiotic?

 

Answer – There is some evidence that taking a probiotic can help prevent travellers’ diarrhea although probiotics are notoriously variable in terms of their activity, with some being more effective than others with respect to this indication. I see no reason why you shouldn’t take loperamide with a probiotic should the need arise. Perhaps I should point out that diarrhea in gastroenteritis does serve a purpose of clearing out the germs that are causing the problem and, therefore, taking loperamide can sometimes delay recovery. I usually advise patients to take one of the glucose and electrolyte powders when they get travellers’ diarrhea and just use the loperamide for emergencies, travelling and to get home.

– Peter Whorwell, M.D.
Professor of Medicine and Gastroenterology
University of Manchester
Manchester, U.K.

Click the topics below to view more questions and their answers

Can probiotics be used to prevent traveller's diarrhea?

Probiotics are notoriously variable in terms of their activity... Go »

Is loperamide safe for long-term use?

Alternating diarrhea and constipation is always a difficult problem to deal with in patients with IBS... Go »

Is there diet advice for Barrett's Esophagus and GERD?

It is interesting that there are very few rigorously performed scientific studies that demonstrate
which foods worsen GERD. Some foods have been shown to increase gastric acid production, while others relax the lower esophageal sphincter (LES), the muscle at the bottom end of the esophagus... Go »  

Is an endoscopy recommended for GERD? If so, how often?

It is important for someone with chronic heartburn symptoms to have an endoscopy. The most important thing to look for is Barrett’s esophagus, a change in the lining of the esophagus that is associated with an increased cancer risk... Go »

Is it common for IBS symptoms to return after a person has been symptom-free for over a year?

Irritable bowel syndrome (IBS) is best thought of as a life-long disorder, just like migraine or asthma. You will always be predisposed to abdominal problems but that doesn’t mean to say they will be there all the time. ... Go »

How much of a concern is enterocolitis after treatment for Hirschsprung's disease?

Enterocolitis is a clinical diagnosis. The symptoms of early enterocolitis may be indistinguishable from a simple viral gastroenteritis: diarrhea, bellyache, a little fever, maybe some vomiting. Because enterocolitis can progress rapidly... Go »

What can be done about diarrhea and incontinence caused by a prescribed medication?

This may be one of those medical dilemmas that do not have a fully satisfactory solution. In the absence of specific details relating to the health problems and medications involved we can only relate to the questions raised in general terms. The first step in addressing this issue would be... Go »

Is nausea a symptom of IBS? If so, how is it treated?

Nausea is a common symptom reported by patients with IBS. In one of our studies conducted at UCLA, we found that about 4 out of 10 women (38%) with IBS and nearly 3 out of 10 men (27%) with IBS report nausea. Nausea may be due to several causes... Go »  

Can having a colonoscopy cause a change in bowel habit?

There is no straight-forward answer to this question. In my practice I see mostly patients with functional GI disorders and I have observed that it is not that uncommon for patients with IBS to say that colonoscopy seems to upset their condition... Go »  

I’ve read that rice, including rice milk and rice flour, is beneficial to people with digestive disorders like IBS because it is easier to digest. As an IBS sufferer, would my symptoms improve if I replaced some of the foods in my diet with rice-based alternatives?

If you have IBS, you may find that certain foods tend to be more bothersome than others. However, you need to make sure that your body is optimally nourished, even if you choose to cut back or eliminate some items from your diet... Go »

How long can a person go without having a bowel movement before seeking medical attention? Could this ever warrant a trip to the emergency room? 

Constipation is a symptom, not a disease. The exact definition of constipation is problematic. Patients and doctors often define constipation differently... Go » 

Can a person have 'constipated diarrhea'?

Pain and discomfort related to altered bowel habit are the hallmarks of IBS. But what is 'altered bowel habit'? The commonly used terms diarrhea and constipation mean different things to different people – and to physicians as well... Go » 

How can I determine if I received a thorough colonoscopy?

Your concern about receiving an adequate exam that will provide you reassurance for the next decade is justified.  I will briefly present some information that may be of assistance in choosing an endoscopist that can perform a colonoscopy exam that minimizes missed lesions... Go » 

Are osmotic laxatives containing polyethylene glycol (PEG) 3350 safe for long-term use?

Miralax®, and its generic equivalent Glycolax®, is one of several osmotic laxatives that increase water content of the stools in order to treat constipation. Osmotic laxatives actually make the colon function more effectively without directly stimulating the bowel to be more active. Thus, they do not override or artificially increase intestinal activity... Go »  

Is constipation and bloating related to menstrual periods? 

Many healthy women experience some change of bowel function at the time of their periods...Not surprisingly, women with irritable bowel syndrome (IBS) suffer even more trouble at this time of the month... Go »  

Is there a health benefit from high colonics?

Before we discuss whether or not there are potential benefits (and risks) of high colonics, it is important to understand the function of the colon... Go »  

Do proton pump inhibitors (PPIs) increase the risk of hip fracture?

Many patients were alarmed recently by news reports of a 44% increase in the risk of a hip fracture if they are taking a proton pump inhibitor (PPI)...Worldwide, PPIs have been available for over 20 years... Go »  

Can intense exercise lead to GI symptoms?

The well-documented beneficial effects that result from keeping up a regular exercise program include better sleep habits, stronger bones, fewer heart problems, and tighter glucose control in diabetes. However, in addition to these benefits, there is evidence that exercise can contribute to GI disorders including diarrhea and gastroesophageal reflux. Understanding why these happen during exercise can help to organize a plan to minimize symptoms... Go »  

Why do some antibiotics cause diarrhea and is this a cause for concern?

Antibiotic therapy is a common source of diarrhea in both hospitalized patients and outpatients. Approximately 20% of patients taking antibiotics will develop diarrhea... Go »