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HealthyLife® Self Care Guide Section I – Common Health Problems: Diarrhea

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"My first night in the dorm, I was nervous with an upset stomach. The fact that I had to use a community bathroom made it even more uncomfortable."

Susan S., Rutgers University

Diarrhea is passing body waste from the bowel more often and in a more liquid state than usual.

Signs & Symptoms

• Watery, loose stools
• Frequent bowel movements
• Cramping or pain in the abdomen

Causes

• "Stomach flu," which is a viral infection of the intestines
• Spoiled food, contaminated water, or  infections from bacteria or parasites that affect the digestive tract. One example is traveler's diarrhea.
• Overuse of alcohol or laxatives
• A side effect of some medicines, such as some antibiotics
• Lactose intolerance or a food allergy
• Menstrual cramps
• Stress or a panic attack

Diarrhea is also a symptom of health conditions, such as irritable bowel syndrome ("spastic colon").  It results in irregular bowel habits and abdominal pain that are not due to any other bowel disease.

Prevention

• Wash your hands after going to the toilet and before preparing food. Use disposable paper towels to dry your hands.
• When traveling, find out if it is advisable to drink bottled water, boiled water, and to avoid using ice cubes. You may need to remove the peels from fruits and vegetables before eating.

Treatment

Self-care treats most bouts of diarrhea. If the diarrhea is caused by a medical condition, treating it will help alleviate the diarrhea.

Questions to Ask

With diarrhea, do you have these signs of dehydration? Sunken and dry or tearless eyes Dry mouth, tongue, and lips No urine or a low amount of urine that is dark yellow Lightheadedness, especially when getting up quickly Dry skin that doesn’t spring back after being pinched Dizziness, confusion, weakness Increase in breathing and heart rate Severe thirst (sometimes)
Is there blood in the diarrhea or is its color tarlike or maroon?
Do you have the following signs and symptoms of irritable bowel syndrome? Gas, bloating, cramps, or pain in the abdomen Changes in bowel habits: Constipation, diarrhea, or both Crampy urge, but inability to move your bowels Mucus in your stool
With diarrhea, do you have abdominal or rectal pain?
Do you have any of these problems with diarrhea? Temperature of 101 degrees Fahrenheit or higher The diarrhea has lasted 48 hours or longer. You have a chronic illness and have diarrhea more than 8 times a day. You are taking medicines (regular medicines that the body may not be absorbing due to the diarrhea, and/or prescribed or over-the-counter ones that might be contributing to the diarrhea).
Did diarrhea occur on, during, or after returning from a foreign country?

Self-Care

• If vomiting is also present, treat for vomiting first. (See "Vomiting & Nausea")
• Follow your normal diet if there are no signs of dehydration (see above).
• Avoid having high "simple" sugar drinks, like apple juice, grape juice, gelatin, regular colas, and other soft drinks. These can pull water into the gut and make the diarrhea persist.
• If there are signs of dehydration, stop solid foods. Have around 2 cups of clear fluids per hour (if vomiting isn't present). Fluids of choice are:
  • Sport drinks, such as Gatorade
  • Kool- Aid. This usually has less sugar than soda pop.
• Don't drink clear liquids exclusively for more than 24 hours.
• Start eating normal meals within 12 hours.
• Good food choices are:
  • Starchy foods, such as rice, potatoes, cereals (not sweetened ones), crackers, and toast
  • Vegetables, such as cooked carrots, and non milk-based soups with noodles, rice, and/or vegetables
  • Lean (not fatty) meats
  • Yogurt, especially with live active cultures of lactobacillus acidophilus
• Use over-the-counter lactobacillus acidophilus capsules or tablets. These help restore normal bacteria to the bowel.
• Avoid fatty and fried foods.
• The B.R.A.T. diet: Just having bananas, rice, applesauce, and dry toast is no longer the diet if choice for diarrhea. These foods are still okay to eat, though.
• Exercise moderately until the diarrhea is gone.
• Try an over-the-counter antidiarrheal medicine, such as Imodium A-D, but wait at least 12 hours before you take this to let the diarrhea "run its course" to get rid of what caused it.

For Lactose Intolerance:

• Avoid foods that are not easy for you to digest. Some people with lactose intolerance can tolerate dairy products in small portions.
• Try foods that have had lactose reduced by bacterial cultures. Examples are buttermilk, yogurt, and sweet acidophilus milk. Take over-the-counter lactobacillus acidophilus capsules.
• Take over-the-counter drops or pills that have the enzyme lactase when you have dairy foods.
• If the above measures don't help, avoid products with milk, milk solids, and whey. Products marked "parve" are milk free.

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