Adverse reaction to Loperamide and long term effect

Dear Sir,

I had gallbladder removed about 2.5years ago. Had a normal life until 10 months ago. I started with some food poisoning and since diarrhea persisted I took Imodium (immodium). The Imodium (immodium) gave me terrible spasm like a gallbladder attack (I would assume it wasSOD, Biliary tract colic). Blood work right with the pain confirmed elevated liver enzymes.
The spasms came at night usually and lasted for about 3 days. I have not had them anymore since then however I have now developed chronic diarrhea or very very soft stools. Continued blood works then showed normal liver enzymes, pancreatic enzymes, MRCP and CT and both were normall, all blood work normal including panel for celiac disease, colonoscopy and endoscopy also normal. Everything is normal, but i have a permanent diarrhea. I have been put under cholestyramine and it helps a lot but I am completely dependent on it. My indirect billirubin is always a bit high but Dr says it is probably gilberts syndrome as all the rest is always ok and images have come clean. Question: Could my reaction against loperamide have triggered this chronic diarrhea? The fact that I had a short term reaction against loperamide means I have an underlying condition like SOD dysfunction? Thanks for the help.

[Enoch Choi, MD]

The typical effects of Imodium (immodium) are of slowing of intestinal motility (movement) to allow for more fluid to be reabsorbed.  http://www.medhelp.org/drugs/imodium-a-d/show/5451 shows that there are possible side effects of worsening diarrhea.  It's uncommon to have this be permament, though.  The comprehensive workup is reassuring.  It's more likely that an underlying condition is the cause of a chronic diarrhea, rather than side effects of imodium (immodium).