What Causes Gastrointestinal Issues While On Medication For Alzheimer's Disease?

Posted on Tue, 4 Jul 2017

Question: Side effect of Alzheimer's drugs
Dear Doctor
My husband is in early stages of Alzheimer's and his neurologist has him on nerve stimulating drugs and these drug cause him intestinal problems including embarrassing accidents. He takes over the counter Imodium and now uses Excelon patches but still has the problem. He is afraid to do enjoyable activities with friends that mean he will not have immediate access to a bathroom. Is there something else we can try. I hate to have stop the medicines as I do think that they help him with his memory. He won't wear diapers. Is there a diet change that could help?

Answered by Dr. Olsi Taka (3 hours later)

Brief Answer:
Please read below

Detailed Answer:
Hi,

I read your question carefully and I understand your situation. Gastrointestinal issues are common with that class of medication. Usually switching to patches and Imodium works, a pity that is not the case.

In terms of diet, a food diary might help to identify food triggers. Fibers are known to cause diarrhea, but they have other benefits so can't be stopped completely, should avoid certain fibers like whole wheat flour, nuts, potatoes, green beans which contain insoluble fiber.

Regarding medication the other class of medication used for Alzheimer is Memantine. It could help with diarrhea as well as it causes constipation. However, it is officially approved only for moderate or severe cases so I wonder whether insurance will pay for it.

I remain at your disposal for other questions.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Olsi Taka (1 hour later)

Thank you for your response. Is there a prescription "Imodium" that would be stronger and have timed release?

Answered by Dr. Olsi Taka (1 hour later)

Brief Answer:
Read below

Detailed Answer:
An alternative to Imodium would be Lomotil (contains diphenoxylate and atropine) or bismuth subsalicylate (OTC). However I am afraid none has a timed release form, have to be taken several times a day. There is not a slow/extended release form of antidiarrheal medications that I know of.

Let me know if I can further assist you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar