# Imodium Tolerance? Or worsening IBS?



## Murph (Jul 26, 2010)

Hi, I have had IBS-D for the past 10 years. Imodium has always worked. If I took 1 or 2 in the morning, I would not have to use the bathroom the rest of the day, no matter what I ate. It was something I could always count on.Lately, past 6 months or so, this is not working anymore. When I go out to dinner, 1/2 the time, I end up getting diarrhea about 2-3 hours after finishing dinner. At home, I'm fine. I usually take 1 per day on regular days, and on days I'm going out to dinner, I take 2. Saturday, I took 1 in the am as I was going shopping, and then 2 at 3pm before dinner. I ate dinner at 7pm, and granted, it was a fatty meal with Asian foods (big trigger). At 9pm, I ended up with diarrhea which was so much fun to try to explain my every 5 minute bathroom trips to my friend! Luckily, I ALSO have overactive bladder, so I blamed it on that! Anyway, I NEED to be able to count on the Imodium again. If I cut back, and take it only 1-2 times per week, will I get my tolerance level back? Or, are my symptoms just worsening and I may need more imodium? I do plan to really watch what I eat when I go out from now on. No more heavy fatty spicy meals! Before, with Imodium, I could eat whatever, and never worry. So, any suggestions? I am planning to buy some probiotics, peppermint oil capsules, and calcium and add those to my daily regimen and see if they help. I am so disheartened. I had a great routine going and felt normal again. Now, I'm back to major anxiety over going out and eating. It is very worry inducing when your "magic pill" stops working!


----------



## overitnow (Nov 25, 2001)

I have never taken Immodium, so I cannot say if your experience is IBS or Imm related. What I can say is that while I have pretty well eliminated all but the most benign of my bowel problems for a long, long time, I will still get occasional reactions to some foods, although it is fairly difficult to pin them down when I am at home and in the midst of my "usual" diet and habits. As I understand it from a visit to the IBS Center in Seattle, those triggers presumably add to the inflammatory load and briefly overcome the anti-inflammatory effects of the flavonoid supplement I use. Then my poops soften and become more urgent, after which things will return to normal. You may be experiencing something similar, where some of the foods you are eating are simply supplying a greater load of diarrhea causing colon inflammation than your usual dosing of Immodium can neutralize. From my own experience, unless this is gall bladder related, it is better to seek approaches that affect your internal chemistry/biology than just to keep drying up the effects of the problem. Of course, if I hadn't been lucky enough to stumble on a treatment for myself, I am less sure that I would be so confident in that advise. I did chase my triggers for 10 years and the D only got worse, so for me, that was an unproductive approach. Mark


----------



## Friday (Dec 9, 2008)

My doctor told me it was my IBS worsening and not my digestive system 'getting used' to the imodium. We just have to hope he is correct! It does seem that there are no studies that prove that we can get an imodium tolerance. There's more on this on the forum somewhere, search for it as I know it's come up before and you may find it useful/encouraging.


----------



## petra (Feb 2, 2009)

Murph said:


> Hi, I have had IBS-D for the past 10 years. Imodium has always worked. If I took 1 or 2 in the morning, I would not have to use the bathroom the rest of the day, no matter what I ate. It was something I could always count on.Lately, past 6 months or so, this is not working anymore. When I go out to dinner, 1/2 the time, I end up getting diarrhea about 2-3 hours after finishing dinner. At home, I'm fine. I usually take 1 per day on regular days, and on days I'm going out to dinner, I take 2. Saturday, I took 1 in the am as I was going shopping, and then 2 at 3pm before dinner. I ate dinner at 7pm, and granted, it was a fatty meal with Asian foods (big trigger). At 9pm, I ended up with diarrhea which was so much fun to try to explain my every 5 minute bathroom trips to my friend! Luckily, I ALSO have overactive bladder, so I blamed it on that! Anyway, I NEED to be able to count on the Imodium again. If I cut back, and take it only 1-2 times per week, will I get my tolerance level back? Or, are my symptoms just worsening and I may need more imodium? I do plan to really watch what I eat when I go out from now on. No more heavy fatty spicy meals! Before, with Imodium, I could eat whatever, and never worry. So, any suggestions? I am planning to buy some probiotics, peppermint oil capsules, and calcium and add those to my daily regimen and see if they help. I am so disheartened. I had a great routine going and felt normal again. Now, I'm back to major anxiety over going out and eating. It is very worry inducing when your "magic pill" stops working!


----------



## petra (Feb 2, 2009)

sorry-was going to post but things have changed quite a bit since last time I visited here. How do you delete a post? Anyway, just wanted to say that I take 8-10 imodium per day so I wouldn't worry too much about intolerance at low levels. Also just a comment to Murph-just interested why would you blame multiple bathroom trips on an overactive bladder-really I understand why but it is interesting why we feel that is more acceptable. We need to change our/others thinking really.


----------



## springtime (Jul 30, 2010)

Hi Murph,I don't have advice for you, unfortunately, but I just wanted to say that I can totally relate. I took three Immodium today in the morning since I had an interview at 9 am, and just like for you, it usually keeps me from running to the bathroom all day. However, at around 4 pm, I went to the store and I had a horrible urgency on my way back home. Thankfully, I made it home, but it was very disheartening to say the least. I was also wondering, like you, if I was developing a tolerance for it, but probably not since I purposefully don't take it every day, only if I have something going on that day. Anyway, I hope Immodium keeps working for us and this was one of those rare incidents!!Sincerely,Julia


----------



## jmc09 (Oct 5, 2009)

Julia you shouldn't refrain from taking it every day if you need it.My consultant said imodium are completely harmless evenin large doses.You can take as many as necessary.But I do think a tolerance can build over time based on my own experiences,I take 8-12 a day when 18 months ago I could take 2-4 a day.


----------



## pferdlieben (Jul 31, 2010)

I used to be able to take imodiun and it would stop. Starting 2 years ago, it stopped working. My Dr told me it's just because your body grew a tolerance to it because sadly I had to take it so much.So now to help counteract an episode, I take tums before I eat and pepto after I eat. Sometimes it really helps.


----------



## Siea (Jun 21, 2010)

pferdlieben said:


> I used to be able to take imodiun and it would stop. Starting 2 years ago, it stopped working. My Dr told me it's just because your body grew a tolerance to it because sadly I had to take it so much.So now to help counteract an episode, I take tums before I eat and pepto after I eat. Sometimes it really helps.


What is tums and pepto?Might be something worth trying...


----------



## Kathleen M. (Nov 16, 1999)

Tums is a calcium based antacid. Calcium compounds tend to be constipating.You've never seen the Pepto Bismol commercials? It is also a diarrhea treatment.If anyone takes a lot of pepto bismol (close to the max dose) on a regular basis you do need to take drug holidays from it once in awhile as you can get Bismuth poisoning if you take a lot every day without a break.Drug tolerance (if it does happen with Imodium and it is hard to know as IBS can get better and worse over time if you take zero medications) isn't typically permanent. A few days to a week or two off the Imodium should reset things. It doesn't mean that drug will never work ever again for the rest of your life.


----------



## jmc09 (Oct 5, 2009)

Kathleen M. said:


> Drug tolerance (if it does happen with Imodium and it is hard to know as IBS can get better and worse over time if you take zero medications) isn't typically permanent. A few days to a week or two off the Imodium should reset things. It doesn't mean that drug will never work ever again for the rest of your life.


This is a great quote Kathleen and is very true as I once tried Lomotil for about a week but it didnt work. I then went back to Imodium and they worked better temporarily.The only downside to this is if Imodium are the only drugs that work for you then you have no choice other than to keep increasing the dose.


----------



## Kathleen M. (Nov 16, 1999)

If you can, every so often, have a day or two where you don't have to go anywhere or do anything you can take a mini-holiday to help "reset".I know that can be a hard thing for a lot of people to do, but every so often we all need a day like that.


----------



## Friday (Dec 9, 2008)

Drug tolerance (if it does happen with Imodium and it is hard to know as IBS can get better and worse over time if you take zero medications) isn't typically permanent. A few days to a week or two off the Imodium should reset things. It doesn't mean that drug will never work ever again for the rest of your life.[/quote]Am so pleased to hear this - is there medical evidence to show this or have you found this helps Kathleen? I've been worried that my system will get used to using imodium and thought that it would take months of not taking it before it would work again. Had thoughts that this would mean I'd be housebound for a few months whilst I stopped taking imodium!


----------



## sunspot19 (Aug 31, 2007)

I see lots of posts where people appear to develop a tolerance over time, but are there some people who with just 1 or 2 immodiums a day have been ok for an extended period? I am currently attempting a break myself as I noticed even with one immodium morning and night (a regimen I had since summer of '08), I finally seem to be having worsening symptoms again, and worried I may be becoming tolerant.Of course as soon as I stopped, my nasty and chronic diarrhea has returned with a vengeance, so I am just trying to hold on another day or so and then jump back on. Immodium otherwise has been a complete life saver.I am just wondering if i am overthinking this and just should keep on with my regimen (regardless how mornings or evenings were, I never had midday nastiness when I take immodium)...I was also alternatively trying L-Glutamine during my break, but this has not helped at all - in fact it may be exacerbating my symptoms.


----------



## Murph (Jul 26, 2010)

I used imodium daily for years without any problems. I truly think now that it was worsening IBS, not tolerance. When I went off of it for 5 days or so, I had horrible diarrhea, like 7 times a day. Before, on days I would be off of the imodium, it was only 1-3 times a day. Nothing like this. So, I either had a bug, or it was just a bad period. I started calcium 5 days ago. I did 3 days of 1/2 tabs 3x daily. Yesterday I did 1/2 tab in the am and 2 whole tabs at lunch and dinner. Today I started on the 3 whole tabs. So far, no problems at all. Yesterday I even ate taco bell for lunch, steak n shake for dinner and a cookie before bed. No diarrhea at all. I still have a bit of urgency in the am, but go once or twice in the am and that's it for the day. I have had a few episodes of cramping where I *think* I'm going to be running to the bathroom, but it fades away withing a minute or 2, and that's that. NO bathroom trip after. I am not going to be sure this is working until around my next period (worst time ever for me). But, compared to my log over the past few weeks, it is a drastic improvement! I've cut down on the imodium too, from about 10 per week to 2-3 per week only if I'm going out for a prolonged period. I am afraid to let my guard down though. This seems TOO easy!


----------



## sunspot19 (Aug 31, 2007)

Murph, that is impressive. Though I'd still try to be a bit careful if you can. Isn't worth it to overstress the body and then overcome whatever you are now doing as your regimen that is working.I broke down a few hours ago and finally had two immodiums to get me thru the rest of the day. I still feel happy I was able to stay off immodium for a little over a day and a half, but I couldn't believe how fast my terrible D came back. By this afternoon I was pure water and when I tried to go out the symptoms just started.I just hope even the 1 1/2 days off were good enough to be a reset. I really do. If I can I will try this again. In the meantime, the search goes on for a far more permanent solution. I may stay off the glutamine for a few days and everything else until my body gets back in synch.If I knew for the rest of my life immodium would just save me, I feel I'd be done. But I just have this strong and deep concern that over time it will lose its efficacy and I will be back to the drawing board.Sigh.


----------



## Friday (Dec 9, 2008)

sunspot19 said:


> Murph, that is impressive. Though I'd still try to be a bit careful if you can. Isn't worth it to overstress the body and then overcome whatever you are now doing as your regimen that is working.I broke down a few hours ago and finally had two immodiums to get me thru the rest of the day. I still feel happy I was able to stay off immodium for a little over a day and a half, but I couldn't believe how fast my terrible D came back. By this afternoon I was pure water and when I tried to go out the symptoms just started.I just hope even the 1 1/2 days off were good enough to be a reset. I really do. If I can I will try this again. In the meantime, the search goes on for a far more permanent solution. I may stay off the glutamine for a few days and everything else until my body gets back in synch.If I knew for the rest of my life immodium would just save me, I feel I'd be done. But I just have this strong and deep concern that over time it will lose its efficacy and I will be back to the drawing board.Sigh.


----------



## Friday (Dec 9, 2008)

Can totally relate to that, I wish we could feel secure knowing that imodium will work for us all the time but it seems not. I didn't take one this morning (took one at lunchtime yesterday) and was hit with a bad bout of diarrhoea this afternoon.It's really getting me down.


----------



## Bachelard (Aug 21, 2010)

Imodium is safe to take in high doses. I'm not sure I understand the reluctance of some here to take it daily or in higher doses.On the other hand, a tolerance does develop over time, so I assume keeping your dose at a conservative level may help prolong its effectiveness. In my own experience, none of the available medications work well for long periods.When I first received my diagnosis, about 30 years ago, I was prescribed Lomotil. Its effectiveness waned after a few years.Then, as it happens, I was prescribed a tricyclic antidepressant for depression. To my amazement, my IBS completely disappeared for the 3 or 4 years I took it.Then, when my medication was switched to Prozac, my IBS reasserted itself. At that time I began using something akin to Paregoric. I can't recall its name. (It was OTC, although you had to sign for it.)That worked for several years. Then, my doctor put me on Dicyclomine. That worked a year or so. Then she suggested I add Imodium. That worked quite well for several years. Then I substituted Lomotil for the Imodium. That worked well. At this point, I happened to see a new gastroenterologist, who, to my surprise, suggested I try a low dose of a tricyclic antidepressant. This shocked me because I'd been telling doctors for years that my IBS disappeared when I was on one, and they dismissed it as an anomaly. So, I went back on a low dose. It actually did diminish my symptoms pretty radically. Unfortunately, it had a horrible effect on my urination, so I had to discontinue it. So I have continued the dicyclomine and Lomotil combination. I take two dicyclomine and three Lomotil 45 minutes to an hour before lunch and dinner and it pretty much alleviates the problem. (If I eat breakfast, I do the same, but I rarely eat much in the morning. I might take 1 dicyclomine and 1 lomotil.)The point is that none of these drugs seem to work forever, but most of them don't present problems in higher doses. Even taking 7 Lomotil a day, I'm pretty far from the maximum dose. I've also learned that, at least in the case of Lomotil, I might develop a tolerance to a drug but the tolerance isn't necessarily permanent.EDIT: I just looked up the maximum daily Lomotil dose and found 20 mg. That's well below what my dr. calls the max, so I dunno.


----------

