Use in Irritable Bowel Syndrome
Diarrhoea resulting from cyclic or diarrhoea-predominant IBS may not be optimally treated with diphenoxylate or difenoxin, and may not respond to a meaningful degree to loperamide; thus, diarrhoea and cramping which does not respond to belladonna derivatives and non-centrally-acting soothing and/or stool-desiccating agents are often treated with conservative doses of codeine, especially where paregoric and/or laudanum are not currently in general use.
Diarrhoea accompanied by significant cramping or intestinal cramping alone may benefit from either adding another smooth-muscle agent to the protocol such as dicycloverine, papaverine, or orphenadrine (which accomplishes several things at once since it is an antihistamine as noted above). Such cases may also benefit from a switch to paregoric, laudanum, powdered or granulated opium, or B&O (i.e. Belladonna & Opium) Suppositories as all of the above include many drugs which work together and have non-narcotic alkaloids like papaverine and other components like oils, waxes, resins &c. which work elsewhere in the body. Pantopon (Opium Alkaloids Hydrochlorides) and similar preparations have much of the advantages of whole opium in injectable form
Read more about this topic: Diphenoxylate
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