Clinical role of diosmectite in the management of diarrhea

BACKGROUND: Diosmectite (DS), an antidiarrheal absorbent natural clay, was proposed for treatment of acute gastroenteritis and more recently considered for diarrhea within the functional bowel disorder syndrome. Objective: To review pharmacology efficacy, mechanisms of action and safety of DS. METHODS: We consulted PubMed/Medline using the keywords of smectite and diarrhea or gastroenteritis, and reviewed most recent recommendations by scientific societies. CONCLUSIONS: Solid data show that DS is effective in infectious diarrhea, mainly as an ion antisecretory agent and in preventing intestinal damage. Despite clinical data being consistent and convincing, DS is not considered as first-line treatment because of the presence of alternative therapeutic options. However, it definitely may play a role in infectious colitis, where treatment options are less convincing. Some available evidences demonstrate a role of DS in functional diarrhea.