How is diarrhea treated?

Lawrence S. Friedman, MD
Most people with acute diarrhea will recover on their own; it generally runs its course in a few days. In particularly severe or prolonged episodes, replacement of lost fluids and electrolytes (such as sodium and potassium) is essential to combat dehydration. Clear liquids are the first choice. For mild cases of dehydration, juices, soft drinks, clear broth, and safe water are recommended. Apple juice and sodas are good. Citrus juices are not. Neither are alcoholic beverages.

For more severe cases, sports drinks like Gatorade can replace sugars and electrolytes, but too much may cause further diarrhea. Rehydration solutions such as Pedialyte are probably best, particularly for children with diarrhea.

Products such as kaolin and pectin (Kaopectate) give the stool a firmer consistency. Medications that work to slow the bowel include paregoric, opiates, and diphenoxylate with atropine (Lomotil), all of which are available by prescription only, as well as loperamide (Imodium), which is available over the counter. These provide quick but temporary relief by reducing muscle spasms in the gastrointestinal (GI) tract. They should be used only for a few days, however. Bismuth subsalicylate (Pepto-Bismol) also seems to work pretty well; it may turn the stool and tongue black, so don't be alarmed if that happens.

Be aware, however, that using these remedies for symptomatic relief is controversial, particularly for some types of bacterial gastroenteritis. While they may make you more comfortable, they suppress the diarrhea that helps cast the offending bacteria out of your system. If you slow down the process, the bugs stay in your system longer.

After the first 24 hours, a little food is probably okay. But it may be best to try to go without food as long as possible. If you are really hungry, try going on a BRAT diet: bananas, rice, applesauce, and white toast. The bananas bind the stool, slowing the movement a little. The rice, applesauce, and dry (white bread) toast are low in fiber and easily digested.

A wide range of probiotic and prebiotic products have been proposed as treatment for diarrhea. (Probiotics are live microorganisms used to benefit health. Prebiotics are non-living substances intended to promote the growth of beneficial organisms.) The most commonly tested probiotic ingredient for diarrhea is Lactobacillus rhamnosus GG. Some trials have shown it may shorten the duration of diarrhea.
Diarrhea can last a few hours or a few days. It usually goes away on its own. Until then, do the following:
  • Keep eating. Choose foods like bananas, yogurt, crackers, soup, rice, and noodles.
  • Stay away from milk and cheese, fatty foods, and high-fiber or spicy foods. When your diarrhea is gone, you can eat normally.
  • Drink 8 to 10 glasses of water, clear soda, or juice each day. For babies with diarrhea, give drinks like Pedialyte or Ricelyte. You can buy these in a store. Babies can also keep breastfeeding. If your child won't drink, give her Popsicles to suck on.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.