# Kaopectate?



## Persistance (Jul 11, 1999)

Would this work as a mild alternative to Immodium when you don't want the dilemma of either having awful D or being stopped up? I don't hear it mentioned anymore.My problem is my current Chemotherapy has done this to my stomach to where I have no appetite and have been drinking medical liquid supplements and trying to retrain myself to eat something in between, via this RD at the AIDS project nearby. A bowl of oatmeal in the morning. Toast and applesauce or rice in the after-noon, evening. Yes, it is very scary. When the Immodium wears off, back it comes.Does anyone drink Pedialyte?And is waking up sweaty more a symptom of dehydration or of the cramping from the D?


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## KCTony7 (Jan 18, 2004)

I've tried Pedialyte in practically all the different varieties of how they sell it and I can't develop a taste for it.When I'm really feeling depleted I just stick with Gatorade


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## Persistance (Jul 11, 1999)

The sugar in that causes me more D. Didn't used to, but I have a bunch of new conditions.


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## flux (Dec 13, 1998)

Judy







The old Kaopectate is actually clay, sort of a super fiber, if you will.


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## Kathleen M. (Nov 16, 1999)

They reformulated Kaopectate so now most , if not all of them are the same ingredient as Pepto Bismol, so there are the same issues that goes with that as with Pepto (long term heavy used can cause bismuth toxicity). I always like the old kaopectate better than pepto and was sad they changed the formulation.I think generally both Kao and Pepto are milder as far as how much of an anti-diarrheal effect they have.There are a lot of reasons for the waking up sweaty thing, that would be hard to pin down. I don't know if your treatments can effect hormone levels or not (but some of the cancer treatments do block hormones and that can cause night sweats just like regular menopause does).K.


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## Persistance (Jul 11, 1999)

Hi, Flux!No, but this just happened once. It was after the Immodium was kind of wearing off, and I was crampy, and the D was wanting to come back (as it did in the morning).I don't know what to do when the D starts happening, because it'll be no matter what I eat, and it will just go on until I take another Immodium (last time I took three within a few hours, so it took me days before it really came back, but I was getting nauseous. God help me, I am not always nauseous, so god help me as to what is happening). I know I have other issues, what with this dreadful chemo pill I take daily, but still, there ought to be some regular rules or something I can follow. I think my digestive system, from just doing liquids for so long -- is probably ruined.Sounds like Kaopectate, if it's a super fiber, might be too hard on the system? And you can't really use it regularly?


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## Kathleen M. (Nov 16, 1999)

The problem is that is the old Kaopectate, the new version is the same active ingredient as Pepto Bismol. Over time at high doses bismuth can cause toxicity (and I don't know how those Nervous system effects work with regards to people in weakend conditions...that is I am concerned it may be easier to take too much)I've seen a fair number of people looking for things similar to the old kaopectate and it doesn't seem easy to find. http://www.accessdata.fda.gov/scripts/cdrh...nter.cfm?id=265 is some FDA infor on it.d-free was talking about a product that was calcium and a different clay mixed (name escapes me) but I don't know if you can get just a clay product anymore. I'd be concerned about very high calcium intake if your kidney function is at all messed up.K.


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## Persistance (Jul 11, 1999)

Oh, dear. I just had some delivered. No wonder i don't hear it talked about much anymore. This is going to sound wierd, but if I took two Immodium the morning of the first spurts of D (because one didn't work after an hour), and then it still seemed like it was going to come out, but I didn't take anymore.Yet in the next few days, it's all hardened and won't come out at all. No BM can't be good for you, can it?This is the crazy part of the question: what would happen on the second or third day if you started taking Colace or something?


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## Persistance (Jul 11, 1999)

P.S. Okay. I just talked to the dietician at the Project AIDS and Cancer who I've been working with.She said that if I had, say, a three-day buildup from having taken Imodium, then naturally, it would have to all come out for a few days (or something) and that if I let it go and just drank Pedialyte or a lot of fluids, it would eventually stop that volume. Is that correct?'Cause she was saying I am going to get myself (if I am not already) into this cycle where my bowel is totally dependent on meds. I was hoping the cup of oatmeal I have been eating for the last three weeks would help, but apparantly not enough.


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## Kathleen M. (Nov 16, 1999)

I think the thing is if one dose doesn't stop you up do not take more and more until you are stopped up.Because if you stop yourself up too bad then you get the 3 days with no BM, it is hard to pass and you may get diarrhea that is trying to push it out.If the diarrhea is regular I would tend to do more of the way they usually recommend for IBS-D.Find the lowest dose of Imodium that you take 2X a day (morning and night) that allows you to keep having a BM nearly every day. Stopping yourself up for days isn't usually such a good thing. You may need to get the liquid and start very low and work up.Equalactin fiber is supposed to be for normalizing the D and C thing, I think the directions are with less water for D and with plenty of water for C and maybe that would help as well??K.


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## Persistance (Jul 11, 1999)

Kath, I don't take it every day (the Immodium), I just take it when the downpour starts again. Cause it stopped up after two yesterday. So maybe I will just try one.What liquid? (God, I never thought I'd be back posting on the IBS board again!)Now -- I tried the Benefiber I have in the house a week or so ago, half a T (half of what they recommend*) "into at least 4 oz of water" it said, and the next morning, D. It's a soluble fiber. Could have been a coincidence. A website says the Tablespoon amount is for a laxative effect. I think I tried it two-three days in a row. Then the AIDS dietician said "Well, that was too much for your system."Is Equalactin better? I thought they all were for normalizing bowel function. The new GI I saw recommended fiber too, but I've been scared ever since. If you say it is better, I might try again.


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## Kathleen M. (Nov 16, 1999)

I only know what they say, not any good studies...just the promotional lit. It is the one that talks the most about using for D vs just using for laxative effects, but maybe they are the only ones that picked up on it for that.Imodium usually comes in capsules and liquid. The liquid you can titer out into lower amounts, like for kids doses.In any case I would cut back the amount you take even if doesn't immediately make the diarreha stop. If you get constipated it is more than your system can handle. And it may be it takes awhile to get fully in effect and if you may have another BM or two before the drug has a chance to get into your system, so then you take too much to compensate for the lag time. If you can predict these things before the diarrhea hits taking a 1/2 dose before hand might help (and then move up if that is not effective and not stopping you up too badly)Fiber may help, but some people do not handle it well.And with the chemo if it is a drug reaction or something that may make it really hard to deal with as the system gets so mucked up with everything.It is hard to know which way to recommend things with this..Have you tried the Calcium, if you can take it? That regularly seems to help some people firm things up a bit.K.


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## Persistance (Jul 11, 1999)

I didn't (Calcium) because I thought it would do bind, or I mean, back up, like Imodium. It doesn't?I'll get the liquid Imodium, too.Yeah, it's hard to know how to advise with this. The GI said she didn't want to start with the meds (like Reglan -- hearing about the side effects scare me to death) and all their side effects. My oncologist knows NOTHING, except a few weeks ago she said "I want you up and eating early...blablabla..." and sent me to the GI.The dietician at the AIDS project seems to know the most. I ate string beans al dente that they sent me the other day, and boy, did that hurt my gut later. But she said, when you reintroduce these things into your system, that is what happens. It's all this damn experimentation.BTW, does being backed up make anybody else nauesous (or, if not actually nauseous, kind of with indigestion -- I can't seem to distinguish it all), or is that just me and my SINGULAR symptoms again?


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## Kathleen M. (Nov 16, 1999)

Some people with constipation talk about nausea, but that is also a symptom of a lot of cancer treatments and maybe even the sickness itself.Calcium does bind up the stool but it doesn't stop the colon muscles from moving things along, so I thought it might be gentler and more like what Kaopectate should do.Have you tried doing the coming off an intestinal surgery approach to getting back to food.After you are good with liquids only (which is sounds like you are) then you go to the BRAT diet.BananasRiceApplesauceToast. White toastAfter that start adding back other things, but I would start with well cooked veggies, lean proteins, canned/cooked fruits.I would work with any food you may have known from the past as a not causing diarrhea food rather than experiment with things of lesser known aspects to you.And work on smaller portions. Heck you might check Heather's www.eatingforibs.com site and see if her rules work for you. She has worked out what works for a lot of people and maybe it will help you?K.


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## bonniei (Jan 25, 2001)

Hi Judy, sorry to hear about your problems. It is no fun dealing with diarrhea when you also have your other illness to deal with. I read that ," Indomethacin, a cyclooxygenase blocker that inhibits prostaglandin production, occasionally may be useful in neuroendocrine tumors, irritable bowel syndrome, and food allergy and is most useful in patients with diarrhea caused by *acute radiation*, AIDS, and villous adenomas of the rectum or colon. Cyclooxygenase blockers may be harmful in inflammatory bowel disease" Goldman: Cecil Textbook of Medicine, 22nd ed., Copyright ï¿½ 2004 W. B. Saunders CompanyThe brand name for this drug is Indocid and it a NSAID. Perhaps you could ask your doc for this and see how you fare. I am not sure what the side effects are but something to think about and discuss with your doc, especially if you are not able to manage it with the common anti-diarrheals. Just know that there are options and don't get too distressed overit if you can.


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## Persistance (Jul 11, 1999)

Thank you Bonniei. I will look into it.Kath -- well, the Cytoxin pill I take daily is known for decreasing appetite and causing nausea. The decreased appetite is always there, but the nausea isn't. It isn't there when I have D, or am cleaned out, or the first day of the Imodium -- that's what is so funny. It seems to appear the days when I am either backed up (I guess that's what it is), or my colon is full and wanting to get something out.Yean, the BRAT stuff seems to be all I can tolerate besides the high-calorie medical drink. I can't seem to eat more than two small "meals" a day without feeling bloated or bad (by meal, i mean, the oatmeal, and then later in the day,like two pieces of toast and applesauce). That's I guess because I only drank the medical drinks for two months. The dietician told me today I am over-stressed about this and impatient to rush it and made me feel bad because she HAD given me rules --now she goes, "Can't you decide what works best for yourself?" She had even said "I want you to eat one half a banana a day.." Which I had added, although not sure, but do they cause gas?Yeah, maybe the adding back in. The AIDS people bring me little bins of canned peaches (ugh) which I should give a try, and cooked (but not cooked enough) veggies, so I have to put them in the microwave. I didn't have a lot of diarrhea when I was healthy, my IBS was thankfully mild -- in fact, two days before I started this awful treatment, I was eating brownies and pizza and ice cream. Fruit drinks didn't sit well with me, though -- bloated me.


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## Kathleen M. (Nov 16, 1999)

Yep, if you haven't been eating real food for awhile it will take time and patience to get back to eating food again. Kinda like you had a gastric bypass operation...there is not that much capacity anymore (although not for the same reason) and you just need to be gentle with yourself and patient with your progress. Even just an "inch" of progress a day is moving forward. But if you keep trying to take it a foot at a time, you will genererally only cause yourself set backs.Generally bananas are pretty well tolerated even with the gas thing, I think that is why they are in the BRAT diet. They never seem to bother me much. (they are high glycemic index among the fruits which means most of the sugars get absorbed, and what you put in your blood doesn't get in the colon, I think riper is better for the higher glycemic index thing)K.


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## Persistance (Jul 11, 1999)

I am so grateful for your knowledgable answers on here, Kath. And your understanding.I just finished nearly a week of being stopped up -- from two Immodium on Tuesday! Yesterday and the day before, it started getting loose, but mostly, it was trapped in there -- until this morning I had to run out of bed. Same old pattern.OK -- I don't know where to put this question, but maybe you can answer if for me: if Caltrate doesn't affect muscle or motility like Imodium (gee, I didn't know that), do you have any idea of what anti-enemics like like Zofran and -- mostly -- Anzemet -- would do?I don't really need an Anzemet pill or infusion for nausea with my infusion of Avastin each two weeks (the nausea comes with the daily Cytoxan pill I take -- or, as we've been saying, the effects from not eating because of the pill side effects). The doctor -- who has no idea how to treat ANY of this -- was throwing mud against the wall to order it and I refused it last time and didn't get that sick feeling. It seemed like it made me feel sick during and after infusion. Maybe just because it comes with a side effect of constipation. Have any idea how these work to cause C? I wonder, is it a motility thing like with Imodium or just a binder thing like Caltrate or Calcium?


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## Kathleen M. (Nov 16, 1999)

I think Zofran is one of the setrons (same class of drugs as Lotronex).Imodium acts on the opiod receptors in the gut and that slows it down.Ok, just checked Zofran is a setron and they work on a specific serotonin receptor (the 5-HT3) one and one of this class Lotronex is marketed for IBS-D. When it went off the market some people found Zofran (for nausea) and Remeron (for depression) also worked in a similar way for them.Looked up the Anzemet and is it also a setron (works on the 5-HT3 receptor) Constipation is listed as a potential side effect.Hope this helpsK.


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## Persistance (Jul 11, 1999)

Okay, thanks. Dyspepsia is also a side effect listed, and I get that. I just can't imagine why the time I got it (Anzemet) infused, I felt so bad. The pill form wasn't so bad. Anyway, so if I took the remaining Zofran I have around the house (they're $900 copay with my insurance!) it potentially could help with those 5HT3 receptors but not cause the type of C problems of Imodium (the only problem being that these two drugs are not made for every day. They don't work after the fact. They are made for delayed, post-Chemo nausea, so you take them during and for 3 days after Chemo, that's it. Not for a pill you take every day. Even the doctor didn't seem to get this. But the pharmacists do. Well, anyway, now I am getting off track and talking about nausea....thank you.


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