From the Guidelines
Functional diarrhea is a type of functional gastrointestinal disorder characterized by loose, watery stools without abdominal pain, occurring in at least 25% of bowel movements over a period of at least three months, as defined by the Rome II Diagnostic Criteria 1. The condition typically results from altered gut motility, where food moves too quickly through the intestines, preventing proper water absorption. Key features of functional diarrhea include:
- Abnormal stool frequency, with more than three bowel movements per day
- Abnormal stool form, with loose or watery stools
- Absence of abdominal pain or other symptoms Management of functional diarrhea includes:
- Dietary modifications, such as increasing soluble fiber (found in oats, bananas, and apples) and reducing trigger foods like caffeine, alcohol, and artificial sweeteners
- Over-the-counter medications like loperamide (Imodium) at 2-4mg after each loose stool (not exceeding 8mg daily) to help slow intestinal transit
- Psyllium supplements (1 teaspoon mixed in water 1-3 times daily) to add bulk to stool
- Stress reduction techniques, as stress can worsen symptoms through the gut-brain connection It is essential to note that if symptoms persist beyond a few weeks or are accompanied by warning signs like blood in stool, weight loss, or nighttime symptoms, medical evaluation is necessary to rule out other conditions like inflammatory bowel disease or microscopic colitis, as recommended by the American Gastroenterological Association 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Definition of Functional Diarrhea
- Functional diarrhea (FD) is characterized by chronic or recurrent diarrhea not explained by structural or biochemical abnormalities 2.
- It is a type of functional gastrointestinal disorder, and its diagnosis is primarily a diagnosis of exclusion 2.
Differentiation from Other Conditions
- FD needs to be distinguished from diarrhea-predominant irritable bowel syndrome (IBS), which is characterized by abdominal pain as a primary diagnostic criterion 2.
- FD must also be differentiated from organic causes of chronic diarrhea, such as intestinal infection, bacterial overgrowth, and inflammatory bowel disease 2, 3.
Pathophysiology
- The pathophysiology of FD is complex and not fully understood, but it may involve visceral hypersensitivity, abnormal gut motility, and autonomous nervous system dysfunction 4.
- Psychological factors, such as stress and anxiety, may also play a role in the development and exacerbation of FD 2, 4.
Treatment Options
- Treatment of FD typically involves a comprehensive approach, including dietary and lifestyle modification, pharmacologic therapies, and alternative modalities 2.
- Dietary modifications may include increasing fiber intake and removing dietary triggers 2.
- Pharmacologic therapies may include anticholinergic, antispasmodic, antimotility, and antidiarrheal agents, such as loperamide 2, 5.
- Gut-directed psychological therapies, such as cognitive-behavioral therapy, may also be beneficial in managing FD 6.