Diarrhea

Diarrhea

That aching in your gut and sudden need to get to the nearest toilet is, granted, not one of life’s more elegant moments. But try to appreciate the episode for what it is: an overly protective measure by your body to get rid of something it sees as a threat to you. In simple terms, your digestive system identifies a problem—a food ingredient it can’t digest or is allergic to, a spice or flavoring that irritates it, an invading bacterium bent on real harm—and moves to expel the offending pest.

Fortunately, most diarrheal episodes don’t persist indefinitely. “Most cases of diarrhea are self-limited and resolve within 7 to 14 days,” says Jorge Herrera, M.D., professor of medicine in the division of gastroenterology at the University of South Alabama College of Medicine in Mobile. See your doctor if it persists longer than that or if you have any of the other warning signs in “When to See a Doctor” on page 156. Diarrhea can be very harmful to you. But you can minimize its effects. Here’s how.

Try This First

’Lyte up the town. You’ve heard that you should drink more water when you have diarrhea, but you might be better off drinking a sports beverage instead. During a diarrhea attack, you rapidly lose important body fluids and minerals called electrolytes. Electrolytes include glucose, sodium, potassium, chloride, magnesium, and phosphorous, all things your body needs to function properly, says Roger L. Gebhard, M.D., gastroenterologist at the Veterans Affairs Medical Center and professor of medicine in the division of gastroenterology at the University of Minnesota, both in Minneapolis. Just drinking water, he says, dilutes the remaining electrolytes in your body.

Instead, Dr. Gebhard suggests quaffing sports drinks such as Gatorade or an electrolyte solution such as Pedialyte. Try to replace the approximate volume lost in diarrhea by drinking about eight ounces after every visit to the bathroom, plus two to four cups per day. If the volume is clearly larger, compensate by drinking even more. If that isn’t handy, help yourself to some fruit juice or flavored drinks to help restore the balance.

Other Wise Ways

Keep it plain. What you eat during a bout of diarrhea is just as important as what you drink. This is not the time to eat any new and unusual foods that you’ve wanted to try, says Shobita Rajagopalan, M.D., assistant professor of medicine in the department of internal medicine at the Charles R. Drew University of Medicine and Science in Los Angeles.

Instead, Dr. Rajagopalan recommends a bland carbohydrate diet with foods such as rice, bread, or mashed potatoes. Foods that are sweet, sour, or spicy may stimulate peristalsis, the rhythmic, wavelike intestinal contractions that aid digestion and hasten diarrhea.

Mix it up. Dr. Gebhard offers a simple way to remember what to eat: Try the BRAT—bananas, rice, applesauce, and toast—diet, he notes, amending the formula to include a second T, which stands for tea.

K.O. with Kaopectate. Have some Kao pectate, says Dr. Gebhard. The remedy works simply by absorbing and binding irritating material in the gut, he adds. Follow the dosage instructions on the label.

Be antiantacid. Dr. Rajagopalan warns against antacids such as Maalox or Mylanta to treat diarrhea. “People often mistake bloating and gas with diarrhea symptoms,” she explains, “so they take antacids. Unfortunately, these compounds contain magnesium, which can cause bowel movements.”

Take a powder. For diarrhea, “a good natural remedy is carob powder, available at health food stores,” says Andrew T. Weil, M.D., director of the program in integrative medicine and clinical professor of internal medicine at the University of Arizona College of Medicine in Tuscon. He recommends mixing one tablespoon of powder with applesauce and honey to make it palatable. Use this remedy no more than three times a day for no more than three days, until the symptoms subside, says Dr. Weil. Take it on an empty stomach with acidophilus, dried or liquid bacteria cultures that are considered friendly to the intestinal tract. When taking acidophilus, follow the instructions on the label. You’ll find these ingredients in health food stores.

Know your body. Certain underlying medical conditions make some individuals more prone to diarrhea throughout their lives, say experts. If you have, for instance, food allergies, irritable bowel syndrome, lactose intolerance (LI), diabetes, or ulcers, you simply have to watch your diet more closely than other people do.

One of these conditions, LI, affects some 30 million Americans. People with LI lack an enzyme that digests lactose (a sugar found in dairy products). If they eat or drink dairy, they are likely to feel bloated, gassy, or diarrheal.

Dr. Gebhard notes that you can ask your doctor to administer a painless breath test to check for lactose intolerance. A confirmation of the condition could save you needless episodes of diarrhea.

Travel cautiously. Diarrhea sometimes is brought on when you take a trip outside the United States, especially to underdeveloped nations. This condition, known as traveler’s diarrhea, is caused by bacteria that secrete toxins into the intestine. The microbes find their way into your system by way of food and water. Since you’re just visiting, you haven’t had time to build up the proper bacterial immunity.

Dr. Rajagopalan recommends several potential defenses against traveler’s diarrhea.

• Drink bottled water.

• Peel all fruit that you intend to eat (the skin may have been washed with tainted water).

• Avoid raw and uncooked food.

Stick with the bottle. That country stream you noticed on your nature walk may look inviting, but don’t drink from it. Dr. Herrera points out that many natural waterways can contain intestinal parasites that cause diarrhea. Carry bottled water with you and sip from that instead. If you’re camping overnight and can’t take along enough water, visit a camping-goods store to find out about water purifiers and water-purifying tablets.