DIARRHEA
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Please refer to our health precautions section before proceeding.
DIARRHEA is not really a disease; it's a symptom. Most commonly, diarrhea--loose, watery, unformed, frequent bowel movements--comes on suddenly. You'll feel some cramping and then find, in a case of acute diarrhea, that you have a bowel movement every hour or more frequently. It usually lasts for a day or two and can be stimulated by too much fruit in the diet, tainted food, the flu, or even extraordinary stress. In this type of diarrhea the body is trying to rid itself of toxins, and the best course to take is to let the body do what it wants, namely have frequent bowel movements. Most people immediately reach for a medication, like Pepto-Bismol, Kaopectate, or Imodium A-D. This can help temporarily control the symptoms, but if at all possible you should wait at least twelve hours before taking over-the-counter medications so that your body has a chance to rid itself of the toxins that caused the problem. Make an effort to replace the fluids and nutrients lost through diarrhea. I tell my patients that the best diet for an occasional bout of diarrhea is a clear simple one.
- Drink plenty of fluids, particularly juices (although apple juice sometimes provokes diarrhea in children). Tomato juice or mixed vegetable juices like V-8 can be beneficial because they're rich in sodium and minerals lost through diarrhea.
- Avoid solid foods, even if you feel hungry, for the first day.
- Take clear soups, broths, and bouillon.
- Avoid caffeine; it can irritate the bowel.
- Avoid carbonated drinks because they can affect bowel contractions and worsen diarrhea. Instead, stick with herb teas such as chamomile or mint to help settle your stomach.
- Avoid "diet" foods--candy and gum--that are sweetened with sorbitol or mannitol; these artificial sweeteners can act as laxatives.
- After a day of a clear diet, you'll be ready to start some solid foods. Yogurt with live active cultures (check the label) is a good choice, as it can help restore the bowel flora.
- Bananas help restore minerals; they're an easily digested carbohydrate rich in pectin, which helps bowel function.
- Rice, applesauce, and mashed potatoes are among the foods that are usually easily tolerated by the digestive system and are good foods to try once the worst of the diarrhea has passed.
If your diarrhea wasn't caused by the flu or by an intestinal "bug," there are other causes that you should know about. They include:
ANTACIDS: Antacids are the most common over-the-counter cause of diarrhea. Both Maalox and Mylanta contain magnesium hydroxide, which acts on your bowel like milk of magnesia.
ANTIBIOTICS: Antibiotics kill the good bacteria in your bowel along with the bad bacteria for which you're taking the antibiotic. Eating yogurt with live cultures or taking acidophilus tablets during the course of the medication will help. If diarrhea connected with antibiotics becomes troublesome, you should consult your doctor.
VITAMIN C: Too much vitamin C can cause diarrhea. Most people can tolerate up to 4 g. daily (not that everyone should be taking that much!), but if you're taking more than 1,000 mg., cut out the vitamin C to see if it has an affect on your symptoms.
MEDICATIONS: Various prescription drugs, in addition to antibiotics, can cause diarrhea. They include quinidine, lactulose, and colchicine. If you're taking a drug that seems to be causing diarrhea, discuss it with your doctor.
ARTIFICIAL SWEETENERS: Sorbitol and mannitol, artificial sweeteners found in diet foods, particularly candy and chewing gum, can act as a laxative when they're consumed in large doses. Many diabetics eat foods that contain sorbitol and are unaware that occasional bouts with diarrhea are caused by this ingredient.
If your diarrhea lasts for more than a couple of days or if it is accompanied by other symptoms including pain and/or fever or chills, consult your doctor.
What about "tourista" or traveler's diarrhea? You probably know that the best way to avoid it is to be scrupulous about what you eat when you travel--no unboiled water (including ice cubes), no unpeeled fruit or raw vegetables, no cooked food that has been sitting around. Do not drink milk or eat dairy products that have not been pasteurized. Do not eat food from street vendors. But if despite your best efforts, you still come down with a sudden case, the best thing to do is to use Pepto-Bismol. In more severe cases, Imodium A-D can be very helpful. By the way, Pepto-Bismol is used as a preventive by many savvy travelers, though no one is certain exactly why it works. Be sure that you are careful if you also take aspirin regularly: The salicylate in Pepto-Bismol added to the dose in your aspirin could cause such symptoms as ringing in the ears. Persistent traveler's diarrhea may be caused by an acute parasitic infection, which would need to be diagnosed and treated by a doctor.
If your diarrhea is not acute and is not due to the causes discussed above, you should not continue to take over-the-counter medications. They will only serve to mask the symptoms and can ultimately be dangerous. You need to get at the root of the problem and consult your doctor. The most common chronic conditions are:
LACTOSE INTOLERANCE: Many of my patients have found that when they deal with their lactose intolerance, their diarrhea disappears. See Lactose Intolerance.
INFLAMMATORY BOWEL DISEASE--ulcerative colitis or Crohn's disease.
FOOD ALLERGIES. A number of my patients who have suffered from chronic diarrhea have learned that they in fact have a food allergy. Once the allergy is identified and the offending food eliminated, the diarrhea disappears.
GLUTEN SENSITIVITY (possibly Celiac Disease)
PARASITIC INFECTIONS (possibly Protozoa Disease)
BENIGN OR MALIGNANT TUMORS, which must be identified by a physician.
NATURAL TREATMENTS FOR DIARRHEA:
- If your diarrhea is acute, caused by a flu, tainted food, intestinal infection, and so on--let it run its course and treat with diet (see above) until it subsides, Sometimes the use of over-the-counter medications like Pepto-Bismol, Kaopectate, or Imodium A-D can be helpful only if used to control the most acute symptoms.
- Avoid antibiotics, antacids and other medications, excessive vitamin C, and artificial sweeteners, which can cause diarrhea.
- If your diarrhea is accompanied by pain, bloody stool, fever and chills (unrelated to a flu), jaundice, severe abdominal cramps, or severe weakness, or if it lasts more than a couple of days, you should consult your doctor.
- If your diarrhea is caused by something you ate or drank while traveling, Pepto-Bismol is an effective remedy, and it can even be used as a preventive in the course of your trip. (If you take regular aspirin doses, you should cut down when taking Pepto-Bismol, as they both contain salicylate and an overdose can cause symptoms like ringing in the ears.) Imodium A-D is also useful for more acute cases: if your traveler's diarrhea persists, see your doctor.
- If you regularly suffer from diarrhea and cannot determine the cause, you could be suffering from a chronic condition that needs to be treated; see your physician. The most common chronic Conditions include: Lactose Intolerance, Irritable Bowel, Food Allergy, Celiac Disease, and Protozoa Disease.
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