Diarrhea

Diarrhea

Diarrhea is an increase in the wateriness volume or frequency of bowel movements. Although uncomfortable most diarrhea is not serious and will go away in a few days without treatment. See a health care provider however if the feces contains blood if the diarrhea is particularly severe or if the diarrhea lasts more than a few days.

Signs and Symptoms

Diarrhea is a symptom of another ailment. Symptoms you might experience with diarrhea include the following.

Frequent need to defecate
Fever chills general sick feeling
Abdominal pain cramping
Weight loss

What Causes It?

Most diarrhea is caused by an infection (viral bacterial or parasitic) or intestinal disorders such as inflammatory bowel disease. Other common causes include viruses and food poisoning. Eating local food and drinking local water during foreign travel can result in "traveler's diarrhea." Exposure to people who have diarrhea can also result in diarrhea.

What to Expect at Your Provider's Office

Your health care provider will question you about your symptoms. Your provider will also check if you are dehydrated and may feel your abdomen to see if it is tender listen to your abdomen with a stethoscope and give you a rectal exam.

Treatment Options

Treatment Plan

Because some medications can make the diarrhea last longer it is important to know what is causing your diarrhea before treating it. There are various drugs to treat the symptoms. Many times diarrhea will go away by itself. Severe diarrhea can be life threatening. You may need to be hospitalized if you become too dehydrated.

Drug Therapies

Prescription

Opioid derivatives—such as Lomotil and Imodium

Over the Counter

Adsorbents—bismuth salts (Pepto-Bismol) for traveler's diarrhea; pectin (Kaopectate)
Bulk-forming medications—psyllium (Metamucil Konsyl)
Opioid derivatives—such as Lomotil and Imodium; also available over the counter

Complementary and Alternative Therapies

Work with your provider to find remedies that are right for you.

Nutrition

Avoid coffee chocolate dairy products strong spices and solid foods. Introduce clear soup crackers white bread rice potatoes applesauce and bananas as diarrhea gets better.
Rice or barley water fresh vegetable juices (especially carrot and celery) miso broth or other clear broths help restore proper fluid and electrolyte balance. Make rice and barley water using 1 cup of raw grain to 1 quart of boiling water. Let steep for 20 minutes. Strain and drink throughout the day.
Lactobacillus taken as powder or in capsules helps normalize bowel flora and may help cure your diarrhea. Take as directed.
Vitamin C (1 000 mg three to four times per day) and vitamin A (10 000 to 20 000 IU per day) help your immune system function well. However high doses of vitamin C may cause diarrhea. High doses of vitamin A should not be taken for a long time without health care provider supervision.
Glutamine (3 000 mg three times per day) is helpful in treating diarrhea that is caused by irritation of the intestinal lining rather than infection.

Herbs

Do not use herbs to treat diarrhea without talking to your health care provider first. If your diarrhea is caused by certain types of infections herbal treatments could make it worse. The most common herbal remedies for diarrhea are described below. They are best used as teas unless otherwise noted. Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

Swelling reducers:

Quercetin (250 to 500 mg two to four times per day)
Chamomile (Matricaria recutita)
Marshmallow root (Althea officinalis) as cold-water tea. Soak 2 tbsp. root in 1 quart of water overnight. Strain; drink throughout the day.

Infection fighters:

Barberry (Berberis vulgaris) 250 to 500 mg three times per day
Goldenseal (Hydrastis canadensis) 250 to 500 mg three times per day
Licorice root (Glycyrrhiza glabra). Do not take if you have high blood pressure.

Antidiarrheal herbs:

Blackberry leaf (Rubus fruticosus) or raspberry leaf (Rubus idaeus) 1 heaping tsp. per cup. Drink 1/2 cup per hour.
Carob powder; use 4 tsp. per 4 oz. of water or mix in applesauce. Take 1/2 to 1 tsp. every 30 to 60 minutes.
Slippery elm powder (Ulmus rubra) or marshmallow root powder (Althea officinalis); use 1 oz. powder to 1 quart of water. Make a paste with the powder and a small amount of water. Gradually add in the rest of the water and then simmer down to 1 pint. Take 1 tsp. every 30 to 60 minutes.

Homeopathy

Some of the most common remedies used for diarrhea are listed below. Usually the dose is 12X to 30C every one to four hours.

Arsenicum album: weak chilly anxious and restless with diarrhea.
Podophyllum: yellow explosive painless diarrhea
Chamomilla: greenish frothy stool with severe colicky pains
Mercurius vivus: strong urging with offensive bloody diarrhea.
Aloe: colicky cramping pains before and during stool
Veratrum album: diarrhea and vomiting; collapsed states

Following Up

If your diarrhea does not stop in three to five days contact your health care provider.

Special Considerations

If you are pregnant tell your doctor. Dehydration can cause you to go into labor early. Also the spasms that diarrhea causes may cause you to have contractions. Do not take goldenseal (Hydrastic canadensis) barberry (Berberis vulgaris) or high doses of vitamin A if you are pregnant.

Diarrhea can be serious even fatal for infants and elderly people because of dehydration and the loss of electrolytes.

Supporting Research

Andreoli TE Bennett JC Carpenter CCJ. Cecil Essentials of Medicine. 3rd ed. Philadelphia Pa: WB Saunders; 1993:271–277.

Barker LR Burton JR Zieve PD eds. Principles of Ambulatory Medicine. 4th ed. Baltimore Md: Williams & Wilkins; 1995:481–491.

Bartram T. Encyclopedia of Herbal Medicine. Dorset England: Grace Publishers; 1995:147.

Bensky D Gamble A. Chinese Herbal Medicine. Seattle Wash: Eastland Press; 1986:47–49.

Blumenthal M ed. The Complete German Commission E Monographs. Boston Mass: Integrative Medicine Communications; 1998:425 464.

Berkow R. The Merck Manual of Medical Information. Whitehouse Station NJ: Merck Research Laboratories; 1997:523–525.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany Calif: Hahnemann Clinic Publishing; 1993:15 42 116 246 305.

Murray MT. Encyclopedia of Nutritional Supplements. Rocklin Calif: Prima Publishing; 1996:431–439.

Dambro MR. Griffith's 5-Minute Clinical Consult–1999. Baltimore Md: Lippincott Williams & Wilkins; 1999: 316–319.

Gruenwald J Brendler T Jaenicke C et al eds. PDR for Herbal Medicines. Montvale NJ: Medical Economics Company; 1998:617–618 621–622 763–766 1047–1050 1061–1063 1078–1079 1103–1104 1201–1202 1226–1227.

Stein JK ed. Internal Medicine. 4th ed. St. Louis Mo: Mosby-Year Book; 1994:436–440.

Stoller JK Ahmad M Longworth DL eds. The Cleveland Clinic Intensive Review of Internal Medicine. Baltimore Md: Williams & Wilkins; 1998:638–643.

Tyler VE. Herbs of Choice. Binghamton NY: Haworth Press; 1994:51–54.

Walker LP Brown EH. The Alternative Pharmacy. Paramus NJ: Prentice Hall Press; 1998:147–150.

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.