Doubleblind trial ofloperamide fortreating acute waterydiarrhoea inexpatriates inBangladesh

SUMMARY Todetermine ifloperamide iseffective andsafeintreating waterydiarrhoea, we randomly assigned 50adult expatriates inBangladesh withmore thanthree unformed stools inthe previous 24hours andillness ofless than72hours toreceive loperamide oraplacebo. Onentryinto thefive daystudypatients tooktwocapsules (oneloperamide capsule=2 mg)andone after each unformed stool up toa maximumofeight perday.Thegroupsdidnotsignificantly differ in pretreatment features orpathogens identified. Meannumberofstools onstudy day1was 2.6inthe loperamide groupand4.0intheplacebo group(p=0.035); onday2itwas 1.3versus3-4(p<0.001). Differences instool frequencies during thefinal three studydays, orproportion ofpatients with cramps,nausea,orvomiting on anystudy day, were notsignificant. Noserious sideeffects occurred ineither group.We conclude thatloperamide, bydecreasing stool frequency during theearly part ofillness, may havearole inthesymptomatic treatment ofthis self-limiting disease.