why do some meds give you diarrhea?

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Why do some meds cause GI upset only when you first start taking them? What is the mechanism, and why does your body eventually get used to it and the GI upset ends?

Contrast with meds that are hard on your stomach and need to be taken with food forever – your body never acclimates, but on the other hand you can avoid all unpleasantness by taking it with food.

Bonus question: why do some people always get diarrhea and some people always get constipated in this situation?

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