Racecadotril is preferred over loperamide as an adjunctive antidiarrhoeal in children with acute watery diarrhoea because of which distinguishing feature?

• A It accelerates intestinal transit, shortening the duration of infection
• B It is an antisecretory agent that does not produce rebound constipation or paralytic ileus ✓
• C It directly kills enterotoxigenic bacteria within the gut lumen
• D It enhances active sodium-glucose cotransport across enterocytes

Explanation

Racecadotril inhibits enkephalinase on the enterocyte brush border, protecting endogenous enkephalins that act on delta-opioid receptors to reduce cyclic AMP mediated chloride and water secretion into the lumen. Because it is purely antisecretory and leaves motility untouched, there is no risk of ileus or post-treatment constipation, unlike loperamide, which slows peristalsis through mu-opioid agonism. Oral rehydration solution remains the mainstay alongside either drug.

Reference: WHO Model Formulary / Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.