Any health consequences from immodium mega dosing?

August 12, 2005 12:02 PM

Imodium Abuse Question: A rather obese person at work has cheerfully described how she regularly takes 20-30 imodiums at once to regulate her bowel movements.

I'm not sure if she has irritable bowel syndrome or some other GI disorder. She appears to use the imodium to stave off a need for repearted trips to the bathroom during the work day (and also when travelling). She has had to leave suddenly from work several times when the imodiums wore off and everything started to let go.

Holding off any judgement on her choice of continuing this regime, from a strictly medical perspective are there any health consequences of (ab)using imodium in this way?

posted by de void to health & fitness (22 comments total)

Well this is from a doctor talking to those with AIDS:

Immodium is pretty safe stuff. The major side effect is constipation if you take too much, and a little viracept can cure that. Other side effects of high doses could be dry mouth, sleepiness, blurry vision or urinary retention, but the last two are very rare. Up to 8 a day is usually considered safe, but some people take 12 or more.

I'm guessing if it is safe for people with devestating illness I don't think it would matter for her. Though I would ask why the hell is she bragging about this. I'm sure this can't be entirely healthy in the long run at high dosages -- but it is not your problem.
posted by geoff. at 12:11 PM on August 12, 2005

If I understand correctly how this stuff works (and this is a Theatre Arts major talking here :-), the active ingredient is not absorbed into the body from the intestine at all. So it's effect is limited to what can be done inside the intestine.

What makes you think that this person's physician is not aware of this practice?
posted by winston at 12:16 PM on August 12, 2005

Though I would ask why the hell is she bragging about this.

Yes, the deeper question here is: What kind of person would be proud of their bowel movements ...above the age of 3 or under the age of 80?
posted by thanotopsis at 12:19 PM on August 12, 2005

It is an opiate. Long term abuse can not be a good thing and I would wonder if sudden withdrawl would also be harmful. This woman likely has a psychological issue (severe anxiety can cause this) which is causing her gastric distress. She should see a doctor and find a way to get this monkey off of her back.
posted by caddis at 12:34 PM on August 12, 2005

I don't think "brag" is an apt description. She's not proud of it, but definitely isn't shy talking about it either.

I have no idea if her physician is aware of it, or even if she has one. I was just curious if this means of artifically regulating herself had any consequences.
posted by de void at 12:45 PM on August 12, 2005

She should see a doctor. Yes, technically it's an opiate, but it only works on the bowel, it's not a painkiller.
posted by gramcracker at 12:47 PM on August 12, 2005

It's a member of the opiate family but without the recreational side effects. There is one side effect that
may explain why she takes so much of it: it tones the
muscles of the intestinal tract and perhaps she thinks this causes her to look thinner.
Jeez, I would think at the dosage she's taking she would
never be able to have bowel movements, at least not
one that wasn't the consistancy of concrete. Ouch.
posted by bat at 12:50 PM on August 12, 2005

How could I forget that loperamide is a opioid! Of course that's why it works so well clogging the bowels. For those not in the know it should be mentioned that this is a very specific type of opioid only binding to the receptors in the intestinal tract and not crossing the blood-brain barrier (ergo, no effect to the central nervous system). It's odd she's taking so many, I assumed it was tolerence but this indicates that no such tolerence was recorded. She should consult a doctor definitely if she needs to take large amounts and wants to quit. I was under the impression that in certain cases loperamide was used to help ease withdrawal symptoms, but I can't recall any case in which it is the cause itself. Perhaps someone medically trained can shed light on this.
posted by geoff. at 12:50 PM on August 12, 2005

I'm not getting the connection between her being "rather obese" and your question about Immodium...?
posted by tristeza at 1:09 PM on August 12, 2005

I'm not getting the connection between her being "rather obese" and your question about Immodium...?

It's useful information if, like many drugs, a higher dosage is required for greater body weight.
posted by frykitty at 1:15 PM on August 12, 2005

If you're constipated all the time (don't have regular bowel movements 2-3 times a day) all those toxins can build up in your system and eventually enter you bloodstream. It makes you sick, and can lead to greater obesity among a ton of other things. This is what my doctor told me. And, yes, she should get some help for her anal retentiveness. If ya gotta go, ya gotta go. You shouldn't have to go home to go.
posted by brighteyes at 2:17 PM on August 12, 2005

Maybe she finds the equipment in a standard restroom inadequate. And I though the accepted range for being regular was more like 2-3 times every 2-3 days? Thrice daily seems too often, to me (I often go over one day without).
posted by Rash at 2:35 PM on August 12, 2005

2-3 times a day?! Do you have a bale of hay for breakfast?
posted by billybunny at 2:39 PM on August 12, 2005

The medical definition of constipation according to the NIH is a little more lenient than the one your doctor passed on to you, brighteyes, though the rest of the information seems okay.

some people believe they are constipated, or irregular, if they do not have a bowel movement every day. However, there is no right number of daily or weekly bowel movements. Normal may be three times a day or three times a week depending on the person

That said, there have been studies linking childhood obesity to both constipation and bowel incontinence which may be part of the problem your co-worker is grappling with Since obesity causes an increase in intra-abdominal pressure that could affect how her bowels work. One side effect of too much bowel-blocking, besides the obvious problem of having to leave work in a hurry is that if she has something she does need to get out of her [sickness, bad food, whatever] it will take longer and prolong illnesses. The (updated) warnings on the Imodium label are here. More, if you need it, at the FDA.
posted by jessamyn at 2:46 PM on August 12, 2005

I have found Americans tend to expect to have bowel movements significantly more than the average European expects. I wonder why this is.

In Europe I've heard everything from once a day to once a week being considered 'normal', whereas the typical American view has spanned from *four times a day* to perhaps once every few days. This also seems a lot more like the typical African view.
posted by wackybrit at 5:45 PM on August 12, 2005

Once a day max in Europe? Wow.

If this were my question, I'd want to know the effects of not going as often as one feels one should, as well as what precondition she may be masking. You can't just look at the side effects of the drug itself as studied on rats.
posted by scarabic at 7:28 PM on August 12, 2005

Sounds like it might be IBS or another type of bowel disorder. From what I understand, it is like an allergy and your intestines spasm and "push" the food through as fast as they can.
She should go see a gastroenterologist anyway. I think many obese people get discouraged because most regular doctors tell them just to lose weight with exercise and diet. The problem is, if they have a bowel disorder, "healthy" foods may be the worst things they can eat.
She may talk freely about it because she does not know what else to do and is looking for help. Good luck to her.
posted by Yorrick at 7:05 AM on August 13, 2005

Once a day max in Europe? Wow.

It's all rather anecdotal, but as a European I've never known anyone who consistently went more than that. Whereas when I've lived in America, I've experienced the opposite.

I am utterly convinced that upbringing is more than half responsible for bowel regularity, perhaps more responsible than diet. Perhaps American parents, on the whole, have a different attitude to the subject when raising their children? It's one of those icky questions I'd certainly be intrigued to know the answer to.
posted by wackybrit at 8:30 AM on August 13, 2005

If you're constipated all the time (don't have regular bowel movements 2-3 times a day) all those toxins can build up in your system and eventually enter you bloodstream.

This answer is one hundred percent incorrect. I had pointed that out yesterday, but jessamyn thinks that the burden of proof is on me despite brighteyes's extraordinary and dubious claim. Perhaps someone can posit the existence of unicorns on here someday and it will be up to the skeptics to search the world far and wide for years and say, "nope, still haven't found any unicorns."

So read this.

I would have hoped that AskMe was for real answers, not old wives' tales and anecdotal evidence.
posted by Optimus Chyme at 9:34 AM on August 13, 2005

Maybe this poor woman has a combo of IBS and she has a psychological issue that she can only go at home?

I have IBS; I just get up early and drink coffee. I have time to "get sick" and get well before I go to work. I've trained the thing to do it my way over time.

I have seen a few people who couldn't manage to go potty anywhere but at home, and they're sad. These people will do absolutely anything it takes to wait until they can get home.

Normal is whatever's normal for you, and if you're an adult, you will know what that is for you. I doubt that getting up at 4:45 to make a 9 o'clock curtain call is considered normal by most folks, but in my case, it's the best I can do.

I would not consider discussing this with anyone myself, but some families do things differently. Some families discuss these things growing up very casually, perhaps she was one of them.
posted by unrepentanthippie at 4:13 PM on August 13, 2005

Depending on how obese she is, she might not be able to 'clean up' after going to the toilet, so her issue with going other than at home might not be entirely psychological.

(Thankfully, I'd never thought about this before a couple of days ago, when a woman who'd had a gastric band was talking about her pre-surgery problems. Now I'd like to not think about it again until I'm really old, and can't care for myself.)

I just lost the game.
posted by The Monkey at 7:42 PM on August 14, 2005

With absolutely no medical training at all, I'd suggest that dropping the kids off at the pool between once and thrice daily is fine. Laying cable once a week seems very, very infrequent to me. All that faecal matter lying around just can't be doing you any good. Think of how much goes in, and how much is coming out. The amounts should surely be roughly equal (taking into account moisture loss from the body by urination, sweat etc). After all, we're just big tubes.

Speaking as a British vegetarian, I'm astonished at some of the deposition rates quoted here. Ow.
posted by ajp at 2:21 AM on August 15, 2005