What drug is used to decrease intestinal motility? A Guide to Antidiarrheal Medications

October 12, 2025 •

2 min read

Approximately 179 million cases of acute diarrhea occur annually in the United States, prompting the need for treatments that address a key symptom: increased intestinal motility. When considering what drug is used to decrease intestinal motility, options range from common over-the-counter remedies like loperamide to prescription medications for chronic conditions.

Quick Summary

Several medications can decrease intestinal motility, including over-the-counter loperamide and prescription drugs like diphenoxylate and eluxadoline. These antidiarrheal agents slow the movement of the digestive tract to manage symptoms of diarrhea and associated conditions.

Key Points

Loperamide (Imodium): An over-the-counter opioid receptor agonist that slows intestinal contractions and increases fluid absorption to treat diarrhea, with minimal central nervous system effects.
Diphenoxylate with Atropine (Lomotil): A prescription opioid-related drug combined with atropine to treat diarrhea.
Eluxadoline (Viberzi): A prescription medication specifically for adults with diarrhea-predominant IBS (IBS-D) that acts on opioid receptors to slow motility and reduce pain.
Drug Selection Varies by Condition: The choice of antimotility drug depends on whether the diarrhea is acute or chronic and the underlying cause.
Non-Pharmacological Measures: Dietary changes, proper hydration, and avoiding trigger foods are essential strategies for managing intestinal motility.
Consult a Professional: It is crucial to consult a doctor before taking antimotility drugs.
Safety Precautions: Specific warnings exist for certain drugs, such as pancreatitis with eluxadoline, especially in patients without a gallbladder.

Understanding Intestinal Motility

Intestinal motility involves the muscle contractions that move contents through the GI tract. Hypermotility, common in diarrhea, means rapid movement that reduces water absorption, leading to loose stools. Medications to decrease motility target gut nerves and muscles to slow this process and aid water absorption.

Opioid-Related Antidiarrheals

Opioid receptor agonists are often used to reduce intestinal movement by acting locally in the gut.

Loperamide

Loperamide (Imodium) is a common over-the-counter option. It works on mu-opioid receptors in the gut to slow contractions. It usually doesn't cause central nervous system effects because it doesn't cross the blood-brain barrier easily at typical doses. Loperamide is used for acute diarrhea and managing chronic diarrhea in conditions like IBD. High doses can be risky for the heart.

Diphenoxylate with Atropine

Diphenoxylate with atropine (Lomotil) is a prescription drug combining an opioid (diphenoxylate) with a small amount of atropine. Diphenoxylate slows gut movement. Unlike loperamide, it can affect the CNS and is a controlled substance. It's typically for those 13 and older and requires caution due to potential dependence and overdose risks.

Prescription Agents for Chronic Conditions

Chronic issues like IBS-D may require specific prescription treatments.

Eluxadoline

Eluxadoline (Viberzi) treats IBS-D in adults. It acts on mu and delta-opioid receptors, reducing contractions and pain while limiting constipation. There's a risk of pancreatitis, especially in patients without a gallbladder, making it unsuitable for those with a history of biliary issues, pancreatitis, or alcohol abuse.

Other Antidiarrheal Options

Bismuth Subsalicylate

Bismuth subsalicylate (Pepto-Bismol) is an over-the-counter drug with anti-secretory and antibacterial actions. It helps with mild and traveler's diarrhea.

Comparison of Key Antimotility Drugs

For a detailed comparison of Loperamide, Diphenoxylate/Atropine, and Eluxadoline, including availability, mechanism, uses, CNS effects, abuse potential, and side effects, please refer to {Link: Dr.Oracle https://www.droracle.ai/articles/121314/drugs-to-slow-down-bowel-movements-}.

Non-Pharmacological Strategies

Non-pharmacological strategies can support the management of intestinal motility alongside or in place of medication. For information on these methods, including dietary adjustments, hydration, and stress management, consult resources such as {Link: Dr.Oracle https://www.droracle.ai/articles/121314/drugs-to-slow-down-bowel-movements-}. Oral rehydration is vital during diarrhea to replace lost fluids.

Conclusion

The choice of medication to decrease intestinal motility depends on the specific condition. Loperamide is a common OTC option for acute diarrhea, while prescription drugs like diphenoxylate with atropine are used for more persistent cases. Eluxadoline is available for chronic IBS-D but has specific risks and contraindications. It is crucial to consult a healthcare provider for diagnosis and before starting any medication, particularly with fever, bloody stools, or suspected infection. Non-pharmacological methods like diet and hydration are also key to managing gut health. For additional information on motility disorder treatments, consult resources such as the NIH.

Frequently Asked Questions

The primary over-the-counter drug used to decrease intestinal motility is loperamide, commonly sold under the brand name Imodium. It works by slowing the movement of the intestines, which helps to reduce the frequency of diarrhea.

Loperamide works by acting on the mu-opioid receptors in the gut wall, which decreases the activity of the intestinal muscles. This slows down the movement of food and waste, allowing more water to be absorbed and resulting in firmer, less frequent stools.

You should avoid taking antimotility drugs if you have a fever, bloody diarrhea, or suspect a bacterial infection (e.g., E. coli or C. difficile). In these cases, slowing down the gut could prolong the infection and worsen the condition.

Diphenoxylate with atropine (Lomotil) is a prescription medication for diarrhea that combines the opioid diphenoxylate with a small amount of atropine. It is a controlled substance because diphenoxylate has the potential for abuse and dependence.

Eluxadoline carries serious risks, including pancreatitis and spasm of the sphincter of Oddi. These risks are significantly higher in patients who have had their gallbladder removed, and the drug is therefore contraindicated in this population.

Yes, dietary changes are a crucial part of managing intestinal motility. For diarrhea, this can include consuming a diet rich in soluble fiber, eating smaller, more frequent meals, and avoiding triggers like high-fat foods, lactose, caffeine, and alcohol.

Bismuth subsalicylate (Pepto-Bismol) helps manage mild diarrhea by exerting anti-secretory effects, which decrease fluid secretion, and antibacterial effects. It is also effective for preventing traveler's diarrhea but should not be given to children with viral illnesses due to the risk of Reye's syndrome.