Help With Diarrhea

Help With Diarrhea

Digestion is important to your overall health. It is through digestion that your body breaks down and absorbs nutrients necessary for it to function properly.  

Most people have digestive problems at some point in their lives. There are many different symptoms - a common one is diarrhea.

What Is Diarrhea?

In general, diarrhea is defined as having mostly loose or watery bowel movements.  The definition usually includes having 3 or more loose stools per day.

Diarrhea may be described as acute if it lasts less than 14 days or chronic if it lasts more than 4 weeks.

Causes Of Diarrhea

Common causes of chronic diarrhea include irritable bowel syndrome (IBS), functional diarrhea*, celiac disease, inflammatory bowel disease (IBD) - Crohn’s disease and ulcerative colitis, and microscopic colitis

*Note: Functional means there is a problem with the way a system works. In this case, the gastrointestinal (GI) system. 

Acute diarrhea (when diarrhea occurs for a short time) may be caused by infections* due to viruses, bacteria, or parasites, or medicine side effects. It usually goes away without treatment and only lasts for a few days. To help prevent infectious diarrhea always wash your hands before eating.

What Are The Symptoms Of Diarrhea?

The main symptom of diarrhea is loose or watery stools. Depending on the cause, other symptoms may include one or more of the following:

  • Belly (abdominal) pain or cramping

  • Loss of control of bowel movements

  • Nausea or vomiting 

  • An urgent need to have a bowel movement

  • Bloody stool

  • Fever and chills

Chronic Diarrhea

Chronic diarrhea occurs with many conditions. Many of them require specific medical care, often with a GI specialist (gastroenterologist) - for example, ulcerative colitis and celiac disease.

Other conditions with chronic diarrhea, like IBS and functional diarrhea, may have severe symptoms and impact your quality of life. However, they can usually be managed with dietary changes, stress management, supplements, and over-the-counter medicines.

The focus of this information is conditions like IBS and functional diarrhea.

Diet and Nutrition for Chronic Diarrhea

When you have certain foods or drinks you may have realized that they cause your diarrhea to worsen, thus you avoid them. Changing what you eat and drink can help lessen diarrhea. However, it may be difficult to identify which foods/drinks, or groups of foods/drinks, are associated with diarrhea. 

We recommend that you work with a dietitian to help you determine which foods are contributing to your diarrhea and a diet that works for you. Goodpath nutrition coaching can help.

General Suggestions

It may help if you have small, frequent amounts of food throughout the day, instead of three larger meals.

Try to rest after meals. Relaxing after eating helps regulate body processes including peristalsis, the wave-like motion that moves food through the digestive tract. 

Foods That May Help With Diarrhea

Bland Foods

Bland foods are safe for diarrhea. Bland refers to foods that are generally low in fiber, soft, cooked, and not spicy. They are gentle on your digestive system and may help your stool to be better formed. Common examples include:

  • Bananas

  • Applesauce

  • Plain white rice

  • Bread or toast

  • Plain baked potatoes

  • Plain crackers, like saltines

  • Cooked cereals, like oatmeal

  • Plain soup broth

  • Weak, brewed tea

Protein

Protein is necessary to maintain good health. Some proteins may worsen diarrhea (e.g. high-fat meats) - so choose carefully, for example:

  • Plain non-dairy* yogurt (e.g. coconut- or almond-based)

*If dairy products contribute to your diarrhea

  • Eggs

  • Lean meats, such as skinless chicken or turkey, lean cuts of beef or pork

  • Lean fish, such as cod, tuna, or haddock

Fiber

You may think fiber-rich foods worsen diarrhea. Some types of fiber help to normalize or regulate bowel movements - meaning they help lessen diarrhea.

Some foods contain soluble fiber, some insoluble fiber, and some have both. Foods (and supplements) with soluble fiber slow digestion, thus they can help with diarrhea. Some examples include:

  • Fruits: apples, oranges, dried figs

  • Grains: barley, oats, oat bran, oatmeal

  • Legumes: black, navy, pinto beans, peas, lentils

  • Vegetables*: avocado, broccoli, brussel sprouts, cooked carrots, potatoes, turnips 

*Note: vegetables should be cooked, not raw

Replacing Fluids (Rehydration)

It is important to remain hydrated or replace lost fluids with diarrhea. 

  • Drink 8-10 cups of fluid per day, such as water, broth, watered-down juice, or electrolyte replacement drinks.

  • To help replace fluid and minerals (sodium and potassium) try:

    • Broth for sodium

    • Bananas or boiled/mashed potatoes for potassium

    • Sports drinks or rehydration drinks (Pedialyte™ is one brand in the U.S.) for sodium and potassium

Note: It is better to have drinks between meals rather than with meals. Fluids with food may worsen diarrhea. 

Foods You May Need To Avoid

Knowing which foods/groups of foods aggravate your diarrhea can be difficult - that is one reason that you should work with a dietitian.

They can assess your diet history (you may complete a food diary) and digestive symptoms and recommend that you avoid certain types of food. For example, you may need to stay away from some carbohydrates or gluten-containing foods.

Specific Carbohydrates

It is common for some carbohydrates to cause a variety of GI symptoms - diarrhea is one of them.

Some carbohydrates are tough for the body to absorb, like fructose, lactose, or sugar alcohols. You can even find these in surprising places, like lactose in common toppings. The following are carbohydrates that can cause diarrhea:

Other Foods to Avoid

High-fat foods may worsen symptoms of diarrhea. Some common sources include:

  • Whole-milk dairy products

  • Fried food, like chicken or French fries

  • Processed meats, like bacon and sausage

  • Red meat

  • Cakes, cookies, pastry, pie

  • Butter, oils, margarine

You may also need to avoid the following as they may worsen your diarrhea:

  • Caffeine-containing drinks and foods

  • Alcoholic drinks

  • Highly spiced foods

  • Nuts and seeds

Special Diets

It can be very challenging to follow diets that restrict certain foods, such as the two that follow. We strongly recommend that you work with your dietitian.

Low FODMAP diet

The low FODMAP diet may be recommended for those with IBS. FODMAPs are a group of carbohydrates (sugars) that include fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. FODMAPS aren’t completely digested or absorbed in the GI tract.

The low FODMAP diet is an elimination diet. It requires that you avoid foods containing FODMAPs. As you start, your diet may change a lot, depending on the amount of FODMAP foods you eat.

Over time, the FODMAP foods are slowly added back into your diet to check for increased symptoms. From there, your dietitian determines which type/s of carbohydrates you should avoid.

Specific Carbohydrate Diet

The specific carbohydrate diet (SCD) excludes certain complex carbohydrates (e.g. grains and starches) that are more difficult to digest and absorb, but it includes simple carbohydrates or monosaccharides (e.g. certain fruits and vegetables). 

Gluten-free Diet

This diet is only recommended for those with celiac disease. Celiac disease is a chronic, autoimmune (immune system attacks body) condition. It is treated with a strict gluten-free diet which eliminates gluten protein found in wheat, barley, and rye. 

Gluten-containing foods may cause diarrhea and other GI symptoms in some people who do not have celiac disease, but instead have gluten sensitivity. Like those with celiac disease, treatment involves avoiding foods with gluten.

Many foods contain gluten. Common ones include:

  • Bread, baked goods, yeast

  • Pasta and noodles

  • Cereal and other breakfast foods (pancakes, waffles, etc.)

  • Snacks, cookies, and crackers

  • Sauces and gravy

  • Beer

Other Parts Of Diarrhea Treatment

Supplements And Over-the-counter (OTC) Medicines

In the U.S. and in some other countries, supplements and over-the-counter medicines (e.g. psyllium, probiotics, guar gum, and loperamide) may be used for diarrhea.

Common Medicines, Nutritional Supplements, Vitamins, and Minerals that May Cause Diarrhea

Many prescription and OTC medicines and certain nutritional supplements, vitamins, and minerals may cause or worsen diarrhea. Artificial sweeteners can also cause diarrhea.

Talk with your doctor or health coach about your medicines, supplements, vitamins, and minerals. Don’t stop taking medicines, etc. without talking with your doctor.

Specific medicines do not cause or worsen diarrhea in everyone. Some medicines may worsen diarrhea, however, they can have the opposite effect. Antidepressants, for example, cause diarrhea in some people and constipation in others.

In the U.S., as well as in some other countries, the following medicines, supplements, vitamins, and minerals can cause or worsen diarrhea:

Stress

Stress has a significant effect on digestion. It is related to the brain-gut connection -  the body’s bidirectional communication system. In this 2-way system, emotions and stress affect the GI system and the GI system affects emotions. 

Relaxation techniques help to lessen stress and improve mood, thus they can help with GI problems.  

There are many ways to relax including meditation, yoga, and journaling. Deep, slow breathing, a simple relaxation technique, can help lessen stress and improve digestion. You can use deep breathing any time - after meals might be a good time to try it.

Sleep

Getting enough sleep helps to promote digestive health and to lessen stress. Poor sleep can affect the quality of gut bacteria which further contributes to poor GI health. And since the brain and gut work closely together, the quality of gut bacteria also affects emotions and mood. 

Other Treatment

Some people may require other treatments including intravenous (IV) rehydration (to replace fluid lost through diarrhea) and other over-the-counter or prescription medicines.

Complications Of Diarrhea

Chronic or severe diarrhea may cause complications including dehydration and malnutrition

Symptoms of dehydration in adults include weakness, lightheadedness, dark-colored urine, extreme thirst, and dry mouth and skin. 

When To See Your Doctor

If your diarrhea continues even with dietary and lifestyle changes, supplements, and over-the-counter medicines, you should contact your doctor.  You should also contact your doctor if you have diarrhea with any of the following:

  • Dehydration

  • Bloody or black stool

  • Fever 

  • Abdominal or rectal pain

For More Information

American College of Gastroenterology (2012).Diarrheal Disease - Acute and Chronic. Retrieved 10-29-2022 from https://gi.org/topics/diarrhea-acute-and-chronic/.

National Institute of Diabetes and Digestive and Kidney Diseases (2016). Diarrhea. Retrieved 10-29-2022 from https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea/symptoms-causes.

U.S. National Library of Medicine (2016). Diarrhea. Retrieved 10-29-2022 from https://medlineplus.gov/diarrhea.html.