loperamide / Generic mfg. - LARVOL DELTA

Five-Year Safety Outcomes of Teduglutide in Adults With Short Bowel Syndrome-Associated Intestinal Failure: A Propensity Score-Matched Analysis (ACG 2026) - "One-to-one PSM was performed on demographics (age, sex, race), SBS etiology (Crohn's disease, mesenteric ischemia, volvulus, GI malignancy), comorbidity burden, medications (proton pump inhibitors, loperamide, octreotide, opioids), procedures, and baseline laboratory values (albumin, creatinine, eGFR, ALT, AST, total bilirubin). Before matching, 739 teduglutide-treated and 23,184 control patients were identified. After 1:1 PSM, 706 well-balanced patients remained per cohort (all SMDs < 0.10). Mean follow-up was 1,047 vs."

Clinical • Acute Kidney Injury • Biliary Cancer • Cardiovascular • Crohn's disease • Gastroenterology • Gastrointestinal Cancer • Gastrointestinal Disorder • Hepatology • Immunology • Infectious Disease • Inflammatory Bowel Disease • Nephrology • Orthopedics • Pancreatitis • Renal Disease • Short Bowel Syndrome • Venous Thromboembolism

Clinical Characteristics and Outcome of Gastrointestinal Immune-Related Adverse Events in Patients Receiving Immune Checkpoint Inhibitors: A Single-Center Cohort Study (ACG 2026) - "Diarrhea was managed with loperamide (49%) , supportive treatment (30%) and Steroids (19%)... Mean age was 66 years, with 55% male and lung cancer most common (50%). Majority received PD-1 inhibitor (74.4%), followed by PD-L1 Inhibitor (21.3%) & combination PD-1 and CTLA-4 (4.3%). GI irAEs included diarrhea 53 (19.1%), colitis 9 (3.2%) and hepatotoxicity 5 (1.8%) and no pancreatitis."

Adverse events • Checkpoint inhibition • Clinical • Breast Cancer • Chronic Kidney Disease • Gastroenterology • Gastrointestinal Disorder • Head and Neck Cancer • Immunology • Lung Cancer • Oncology • Pancreatitis • Solid Tumor • CTLA4

Association Between Opioid Exposure and Adverse Disease-Related Outcomes in Inflammatory Bowel Disease (ACG 2026) - "Patients receiving loperamide or eluxadoline were excluded. After propensity score matching, cohorts included 255,291 patients per group at 30 days, 244,959 patients per group at 90 days, and 254,925 patients per group at 1 year. Opioid exposure was associated with increased adverse disease-related outcomes across all time points. At 1 year, patients with opioid exposure had increased risk of IBD-related surgery compared with patients without opioid exposure (HR 3.24, 95% CI 2.83â3.71, p< 0.001)."

Addiction (Opioid and Alcohol) • CNS Disorders • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Immunology • Inflammation • Inflammatory Bowel Disease • Mental Retardation • Obesity • Substance Abuse • Ulcerative Colitis

More Than Skin Deep: Colitis as a Manifestation of Lamotrigine-Induced DRESS (ACG 2026) - "Lamotrigine was discontinued and prednisone initiated at 1 mg/kg. Symptoms improved, however, the patient continued to experience 6-10 episodes of diarrhea daily refractory to loperamide...Clinicians should maintain a high index of suspicion for GI involvement in patients with DRESS, as early endoscopic evaluation and treatment can prevent significant morbidity. Figure: Sigmoid colon with diffuse mucosal friability, granularity, loss of vascularity, and shallow ulcerations Figure: Sigmoid colon with diffuse mucosal friability, granularity, loss of vascularity, and shallow ulcerations"

CNS Disorders • Dermatitis • Eosinophilia • Epilepsy • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Nephrology

Severe Nirogacestat-Induced Colitis Responsive to Budesonide After Failure of Standard Therapies (ACG 2026) - "Despite treatment with cholestyramine, loperamide, dicyclomine, tincture of opium, octreotide, and high-dose hydrocortisone, diarrhea persisted at 3-5 L/day. Budesonide's potent local anti-inflammatory activity and limited systemic absorption may make it a valuable treatment option for inflammatory chemotherapy-related colitis, particularly when associated with targeted therapies. Further studies are needed to evaluate its efficacy in similar cases."

Desmoid Tumors • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Immunology • Sarcoma • Solid Tumor • CRP

The Hazy Brush Border: A Case of Intestinal Spirochetosis in a Patient With HIV (ACG 2026) - "He had received clindamycin for folliculitis but states his diarrhea preceded this. Loperamide was ineffective...He was treated with ciprofloxacin and azithromycin for E. Coli but his symptoms recurred following completion of each antibiotic...This case shows the importance of considering intestinal spirochetosis in the evaluation of chronic diarrhea, especially when other etiologies have been ruled out. Figure: Figure 1: Colonoscopy Biopsy Results Hematoxylin and Eosin Stain (A) and Warthin Starry silver stain (B) showing the "false brush border" characteristic of intestinal spirochetosis"

Clinical • Colonic Polyps • Diabetes • Gastroenterology • Gastrointestinal Disorder • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders • Type 2 Diabetes Mellitus • ELANE

Heartache for Gastroenterologists: A Case of De Novo Crohnâs in a Heart Transplant Recipient (ACG 2026) - "Symptoms were initially attributed to functional diarrhea and infection, and managed with dietary modification, loperamide, and acid suppression with modest benefit...In this patient, vedolizumab was chosen for its gut-selective mechanism and favorable safety profile in the setting of heart failure. Figure: Figure 1: Colonoscopy images showing distorted ileocecal valve (1A) and cecal stenosis (1B) with several ulcers and surrounding erythema (1A, 1B). Figure: Figure 2: Hematoxylin and eosin (H&E)âstained section of colonic mucosa demonstrating crypt microabscesses, focal Paneth cell metaplasia, and focal surface erosion."

Clinical • Cardiomyopathy • Cardiovascular • Cognitive Disorders • Congestive Heart Failure • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Heart Failure • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Muscular Dystrophy • Solid Organ Transplantation • Transplantation

When Colon Biopsies Mislead: Refractory Diarrhea as a Manifestation of GI ATTRv Amyloidosis After Heart and Liver Transplantation (ACG 2026) - "Case Description/ A 71-year-old male with hereditary ATTR cardiac amyloidosis, status post liver and heart transplant (2016), on vutrisiran, presented with chronic refractory diarrhea...He failed loperamide, diphenoxylate, tincture of opium, codeine, antibiotics, cholestyramine, and fiber...Third, diarrhea in GI amyloidosis is multifactorial-including SIBO, malabsorption, protein-losing enteropathy, rapid transit, and autonomic neuropathy-and remains difficult to manage even after surgery. Figure: Figure 1 and 2 Figure: Figure 3"

Biopsy • Amyloidosis • Cardiac Amyloidosis • Cardiovascular • CNS Disorders • Gastroenterology • Gastrointestinal Disorder • Immunology • Transplantation

A Marked Response to GLP-1 Receptor Agonist Therapy in Refractory High-Output Jejunostomy (ACG 2026) - "Despite loperamide, PPIs, octreotide, and PN, stoma output remained uncontrolled...Unlike teduglutide, often limited by cost and availability, liraglutide may represent a useful adjunctive strategy targeting dysmotility and hypersecretion...This case highlights potential utility of GLP-1 receptor agonists in chemoradiotherapy-related adhesive enteropathy complicated by severe high-output jejunostomy. Figure: Erect abdominal radiograph demonstrating dilated proximal small bowel loops consistent with high-grade obstruction Figure: Intraoperative view showing densely matted small bowel loops and extensive post-treatment adhesions"

Gastrointestinal Disorder • Short Bowel Syndrome

Silent Progression to Catastrophe: Mesenteric Ischemia From Mesenteric Vessel Invasion in Duodenal Adenocarcinoma (ACG 2026) - "She was initiated on FOLFIRINOX, after which she developed progressive diarrhea refractory to loperamide and diphenoxylate-atropine...(A, B) A long-segment duodenal malignancy involving the third portion of the duodenum, causing mild luminal narrowing. Despite this, the endoscope traversed the affected segment without resistance, indicating preserved luminal patency."

Anorexia • Cardiovascular • Gastrointestinal Cancer • Gastrointestinal Disorder • Hepatocellular Cancer • Oncology • Small Intestinal Carcinoma • Solid Tumor • Thrombosis

Intestinal Failure-Associated Liver Disease in a Child With Short Bowel Syndrome: Management Issues (ACG 2026) - "Stool cultures grew multidrug-resistant E. coli , treated with IV colistin and amikacin. Despite targeted antibiotics, diarrhea persisted, requiring amino acid-based formula, racecadotril, loperamide, and pantoprazole...Management included UDCA (bile salt inhibition, hepatoprotection), pantoprazole (short-term, for hypergastrinemia-driven losses), rifaximin (empirical SIBO treatment), and DHA (promotes adaptation, reduces cholestasis)...Figure: Table 1: Serial investigations of the patient. Note: PTBD: Percutaneous transhepatic biliary drainage, CRP: C-reactive protein, SGOT: Serum glutamate oxaloacetate transferase, SGPT: Serum glutamate pyruvate transferase, ALP: Alkaline phosphatase, GGT: Gamma glutamyl transferase."

Clinical • Cholestasis • Gastrointestinal Disorder • Hepatology • Hypoglycemia • Infectious Disease • Short Bowel Syndrome • CRP

Delayed Diagnosis of Crohnâs Disease Following Ileal Pouch-Anal Anastomosis: A Diagnostic Challenge (ACG 2026) - "Colonoscopy confirmed severe colitis, and he was started on 6-mercaptopurine with good response. In 2016, elevated liver enzymes and worsening psoriasis prompted transition to adalimumab, which was discontinued after suspected drug-induced lupus...With infliximab and methotrexate initiation, he achieved clinical and endoscopic quiescence...Post-operative diarrhea and bowel urgency were unresponsive to ciprofloxacin, loperamide, cholestyramine, and dicyclomine...He remains on vedolizumab for luminal disease and risankizumab for psoriasis with sustained remission...In our case, delayed recognition contributed to a complicated clinical course, including bacterial infection, pouch-related complications, and poorer quality of life. Hence, this case highlights the importance of maintaining diagnostic flexibility at the onset of suspected IBD and the need for prudent treatment reassessment in refractory or atypical disease courses."

Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Inflammatory Arthritis • Inflammatory Bowel Disease • Lupus • Psoriasis • Ulcerative Colitis

Ketamine-Assisted Psychotherapy as a Novel Treatment for Refractory Irritable Bowel Syndrome: A Case Series (ACG 2026) - "He had previously failed treatment with as-needed loperamide, psyllium fiber, amitriptyline, alprazolam, and cognitive behavioral therapy...She had previously attempted a low-FODMAP and gluten-free diet, and had failed trials of an antispasmodic, psyllium fiber, and desipramine...By modulating central sensitization and the gut-brain axis, KAP may address both the visceral hypersensitivity and psychological comorbidities inherent to IBS. This case series represents the first report highlighting KAP as a potential therapy for refractory IBS, while more trials are currently underway."

Clinical • Cardiovascular • CNS Disorders • Depression • Diabetes • Gastrointestinal Disorder • Hypertension • Immunology • Metabolic Disorders • Mood Disorders • Post-traumatic Stress Disorder • Type 2 Diabetes Mellitus

Fecal Management System as a Novel Rectal Drug Delivery Platform for Refractory Collagenous Colitis in a PEG-Dependent Patient With Fecal Incontinence (ACG 2026) - "She developed an acute CC flare with more than ten watery bowel movements daily, refractory to loperamide, banana flakes, and cholestyramine. Figure: Figure 2. Components of the indwelling stool management system used for rectal hydrocortisone delivery."

Clinical • Cerebral Palsy • CNS Disorders • Epilepsy • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Pneumonia • Respiratory Diseases

Cholestyramine-Induced Acute Pancreatitis Following Initiation for Low Anterior Resection Syndrome: A Case Report and Review of the Literature (ACG 2026) - "His postoperative course was complicated by recurrent small bowel obstruction and persistent LAR syndrome refractory to loperamide. Naranjo Adverse Drug Reaction Probability Scale. A score of 6 (Probable) supports cholestyramine as the causative agent in this case of drug-induced acute pancreatitis."

Case report • Clinical • Review • Colorectal Cancer • Dyslipidemia • Endocrine Disorders • Gastroenterology • Hypertriglyceridemia • Metabolic Disorders • Pancreatitis • Rectal Cancer • Solid Tumor

Characterization and management of gastrointestinal (GI) adverse events (AEs) with zanidatamab + chemotherapy (CT) ± tislelizumab in first-line (1L) HER2-positive (HER2+) locally advanced or metastatic gastroesophageal adenocarcinoma (mGEA): Analysis from HERIZON-GEA-01. (ASCO 2026) - P3 | "Funded by Jazz Pharmaceuticals, BeOne Medicines, Zymeworks Biopharmaceuticals Clinical Trial Registration Number: NCT05152147 Background: In HERIZON-GEA-01, replacing 1L trastuzumab (tras) + CT with zanidatamab + CT ± tislelizumab significantly improved progression-free survival and, with tislelizumab, yielded a statistically significant overall survival benefit in HER2+ mGEA... Eligible patients (pts) with previously untreated HER2+ mGEA were randomized 1:1:1 to zanidatamab (1800 mg [<70 kg]/2400 mg [≥70 kg] IV Q3W) + tislelizumab (200 mg IV Q3W) + capecitabine/oxaliplatin (CAPOX) or 5-FU/cisplatin (FP); zanidatamab + CAPOX or FP; or tras + CAPOX or FP... In zanidatamab-treated pts, most diarrhea events were grade 1/2, and first-onset events tended to occur in cycle 1 and resolved in <3 wk. Diarrhea rarely led to zanidatamab discontinuation. The safety of zanidatamab-containing regimens appears favorable given the survival benefits; diarrhea should be..."

Adverse events • Clinical • Metastases • Gastroenterology • Gastroesophageal Junction Adenocarcinoma • Gastrointestinal Disorder • Immunology • Oncology • Solid Tumor • HER-2

Characterization of Volatile Oil Constituents from Aurantii Fructus Immaturus (Zhishi) Based on Geographical Origin, Extraction Method, and Processing Differences and Its Mechanism of Ameliorating Slow Transit Constipation via Regulation of the PERK/CHOP-Autophagy Axis. (PubMed, J Ethnopharmacol) - "Origin, processing, and extraction method influence Zhishi volatile oil composition. Bran-frying enhanced antioxidant activity and therapeutic effects against STC, potentially through attenuation of PERK/CHOP-mediated ER stress, modulation of LC3B-associated autophagy-related processes and oxidative stress, protection of interstitial cells of Cajal, and modulation of 5-HT4R signaling."

Journal • Constipation • Gastroenterology • Gastrointestinal Disorder • HSPA5 • KIT

FITE Study: Faecal Microbiota Transplantation Optimised Immune Checkpoint Inhibitor Therapy in Advanced Cutaneous Squamous Cell Carcinoma (ANZCTR) - P2 | N=30 | Not yet recruiting | Sponsor: St Vincent's Hospital, Melbourne

Checkpoint inhibition • New P2 trial • Non-melanoma Skin Cancer • Oncology • Solid Tumor • Squamous Cell Carcinoma • Squamous Cell Skin Cancer • Transplantation

Tucatinib (TUC) combined with trastuzumab and pertuzumab (HP) as first-line (1L) maintenance therapy for HER2+ metastatic breast cancer (MBC): An in-depth safety analysis of HER2CLIMB-05. (ASCO 2026) - P3 | "Among the patients with a TEAE of diarrhea, 57.7% and 29.9%, respectively, in the TUC and PBO arms used antidiarrheals; the most used medication was loperamide. TUC addition to 1L HP maintenance therapy may be an effective option for HER2+ MBC with a clinically manageable safety profile. *As of data cutoff, Sep 5, 2025."

Clinical • Metastases • Breast Cancer • HER2 Breast Cancer • HER2 Positive Breast Cancer • Oncology • Solid Tumor • HER-2

Neratinib + fulvestrant + trastuzumab for HR-positive, HER2-negative, HER2-mutant metastatic breast cancer: outcomes and biomarker analysis from the SUMMIT trial. (PubMed, Ann Oncol) - "The benefit of N+F+T for HR+ HER2-mutant MBC after progression on CDK4/6 inhibitors is clinically meaningful and, based on this study, N+F+T has been included in National Comprehensive Cancer Network treatment guidelines. SUMMIT has improved our understanding of the translational implications of targeting HER2 mutations with neratinib-based therapy."

Biomarker • Journal • Metastases • Breast Cancer • HER2 Breast Cancer • HER2 Negative Breast Cancer • Hormone Receptor Breast Cancer • Hormone Receptor Positive Breast Cancer • Oncology • Solid Tumor • ERBB3 • HER-2 • PIK3CA

Acteoside alleviates slow transit constipation with attenuation of NLRP3 inflammasome activation and preservation of enteric neurons. (PubMed, Front Pharmacol) - "The effects of ACT were investigated in a loperamide (LOP)-induced STC-like mouse model...Nlrp3 deficiency partially reproduced ACT-mediated protection against STC-like phenotypes, inflammasome activation, and ENS injury, whereas ACT retained additional protective effects in Nlrp3-KO mice, suggesting that NLRP3-independent mechanisms may also contribute. ACT alleviates LOP-induced STC-like injury, and this protection is associated with attenuation of NLRP3 inflammasome activation and preservation of ENS integrity, while additional NLRP3-independent mechanisms may also contribute."

Journal • Constipation • Gastroenterology • Gastrointestinal Disorder • Inflammation • Oncology • IL1B • IL6 • NLRP3 • TNFA

Developing expertise in laparoscopic management of total colonic aganglionosis cases: Duhamel vs. Swenson procedures. (PubMed, Front Surg) - "Three patients required loperamide and six cases used dietary fiber modification. Laparoscopic management of TCA is safe and feasible. Both Swenson-type and Duhamel approaches yield acceptable continence and growth outcomes, with the choice tailored to rectal anatomy and continence risk."

Journal • Pediatrics

LOPERAMIDE TOXICITY INDUCED REFRACTORY VENTRICULAR TACHYCARDIA REQUIRING VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION (CHEST 2026) - No abstract available

Cardiovascular • Ventricular Tachycardia

Donor outcome in living-donor intestinal transplantation (TTS 2026) - "Two donors had vomiting on post-operative day (POD) 1 and 2, and all 4 donors experienced transient diarrhoea from POD4 which responded to loperamide... With appropriate donor selection, apart from early transient diarrhoea and vomiting, the risk of surgical complication and long-term sequalae from isolated SB donation is low, making LD-ITx a viable and effective treatment option for irreversible IF where deceased organ donation is limited."

Cardiovascular • Dyslipidemia • Gastrointestinal Disorder • Hypertension • Short Bowel Syndrome • Transplantation • HLA-B • HLA-C

Dissolution Enhancement by Binding Agents: A Potential Shortcut to Improving Bioavailability? (PubMed, AAPS J) - "Loperamide hydrochloride, fenofibrate, compound c0 (a drug candidate) and carvedilol were chosen for this study as poorly water-soluble model compounds. Although solubilities and dissolution profiles of the model compounds were mostly improved by the binders, correlation between solubility in buffers and dissolution from the tablets in biorelevant FaSSIF-V1 was poor, indicating that dissolution experiments may be a better screening tool than solubility experiments. An important conclusion of these studies is that it is possible to increase the rate, and in some cases, the extent of dissolution of four poorly soluble drugs using wet granulation with polymeric binders, followed by tablet compression - a simple and cost-effective approach to improving drug performance."

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