I'm prescribed 8 a day by my doctor. If I folowed my diet to a T, that would be enough. 
But I don't, so for the cookout I'm attending this afternoon, I took 2 this morning as I woke up, and I'll likely take 4 as a preventative before I even go. Then it'll be 2 at a time when I eat anything suspicious. If I have to go urgently, depending on the shape, runniness and color of the BM, and other factors like how much heat, sweat, gas and pain are involved, I will take 3 to slow everything down, eliminate some more, then take another 4 to stop going to the bathroom.
It's a balancing act, like sugar and insulin to a diabetic. Maybe you need to cut down, focus more on eliminating bad foods, or drink more water when you're taking Immodium... Everybody's different. Maybe it's because you have too much food in your system and you need to evacuate before taking Immodium to stop the attack. Only you will know, through lots of practice and trial and error.
Or you might try an anti-spasmodic like Donnatal. Could these be spasms (sometimes they present as a stitch in your side so sharp it makes you grimace ).
Anyway, don't let anyone tell you which is the only way for you to take them. Everyone Is Different. It's only through many years of trial and error I know what my body can take as far as food and medicine. 
Best of luck to you, and don't give up on Immodium! I know it saved my life, more than anything else I've tried! 
~nelly~
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