Question

A tourist with a travel history to India presents with complaints of abdominal pain and multiple episodes of watery diarrhea. He reports having food at a local restaurant the previous night. Which of the following antidiarrheal agents is used in this condition?

• A. Octreotide
• B. Loperamide
• C. Rifaximin
• D. Bismuth subsalicylate

Hint:

Loperamide is a first-line treatment for traveler’s diarrhea. However, if the diarrhea is caused by invasive organisms (e.g., shigella, salmonella), antibiotics should be used instead.

Answer 1

The Correct Option is B

Octreotide: This drug is used in conditions like carcinoid tumors and VIPomas, which cause secretory diarrhea. It is not typically used for traveler’s diarrhea, which is usually self-limiting and managed with symptomatic treatment.
Loperamide: This is the correct answer. Loperamide is an antidiarrheal medication that works by slowing down intestinal motility. It is frequently used to treat traveler's diarrhea, especially when caused by non-invasive pathogens. It helps control diarrhea and reduce abdominal discomfort.
Rifaximin: This is an antibiotic that is used to treat traveler's diarrhea caused by non-invasive organisms such as Escherichia coli. While it is used in some cases of traveler’s diarrhea, it is not the first-line treatment when symptoms are mild and can be managed with loperamide.
Bismuth subsalicylate: This can be used for traveler’s diarrhea, but it is more commonly used for symptomatic relief in cases of Helicobacter pylori infection or gastrointestinal upset, rather than as the first-line agent. Thus, the correct answer is Loperamide (2), as it is the most commonly used first-line agent for managing traveler’s diarrhea.