Recently in the US, there’s been an uptick in conversations about diarrhea. As of late August, over 17,000 cases of cyclosporiasis, a parasitic infection often linked to contaminated fruits and vegetables, have been reported across the country. Yet, millions of diarrhea cases happen annually, stemming from various causes.
Some diarrhea cases can be effectively treated with antibiotics, particularly cyclospora infections. However, most instances resolve on their own, with the main recommendation being to stay hydrated, according to Benjamin Levy, a gastroenterologist at the University of Chicago.
While dealing with diarrhea is certainly unpleasant, it’s typically manageable. Below are some guidelines on when to consult a doctor and how to care for yourself at home.
When do I need to see a doctor?
Levy notes that most diarrhea episodes tend to clear up within three or four days. However, if your diarrhea lasts longer than a week or comes with other troubling symptoms, it’s wise to seek medical attention. These symptoms include a fever of 101°F or higher, blood or mucus in your stool, severe abdominal discomfort, vomiting that persists for more than two to three days, or a feeling of needing to have a bowel movement without being able to.
It’s also crucial to be mindful of dehydration. The classic sign of thirst is one thing, but a significant drop in urine production is a more reliable indicator. If you’re properly hydrating but haven’t produced urine in over six hours, that’s a warning sign. Symptoms can range from feeling faint and confused to noticing dark urine. If that resonates with you, it’s best to see a clinician—bypassing walk-in hydration spas for IV fluids as a dehydration indicator could suggest a more serious underlying issue.
Certain individuals ought to be particularly vigilant. For those aged 65 and older, thirst perception can diminish, so it’s advisable to inform your doctor within a day of any diarrheal symptoms. The same goes for anyone with kidney problems, weakened immune systems, or those who’ve had recent hospital stays or antibiotic treatments.
If you believe you might have a specific condition, like cyclosporiasis, discuss the possibility of specialized testing with your healthcare provider.
What should I eat and drink?
The top priority when dealing with diarrhea is hydration. To replace lost fluids and electrolytes, drink a lot of water, tea, or sports drinks at the onset.
If dehydration starts to set in, consider an oral rehydration solution like Pedialyte, which is formulated for better absorption with a lower concentration of sugar and salt compared to regular sports drinks. That said, you don’t need to strictly adhere to a liquid diet or follow the old Brat diet (bananas, rice, applesauce, toast). Some foods might aggravate your symptoms instead. Levy suggests avoiding fatty, spicy, and high-fiber foods, as well as alcohol, caffeine, and overly sugary beverages or those with artificial sweeteners.
As long as you have an appetite, feel free to eat moderate amounts of whatever sounds appealing, avoiding the foods mentioned. Good options might be broth-based soups with chicken or tofu, starchy items, and eggs.
Keep in mind that diarrhea can cause a temporary lactose intolerance, so it might be wise to steer clear of dairy other than yogurt.
What can I do to relieve my symptoms?
To alleviate symptoms, most adults can safely take bismuth subsalicylate (like Pepto-Bismol) for a couple of days, which can reduce the frequency of bowel movements and cramps. And if your stool turns black, that’s a harmless side effect.
Many can also take loperamide (like Imodium), provided certain conditions are met: no blood in the diarrhea, no fever, and no recent antibiotic usage in the past three months.
For both medications, it’s important to follow package directions and check with your doctor if you have any health concerns.
To minimize irritation after using the bathroom, Levy suggests slightly moistening soft toilet paper and patting rather than rubbing. It’s best to avoid alcohol-based wipes, which can dry and irritate the skin further. Applying zinc oxide, dimethicone, or petroleum-based barriers after cleaning can shield irritated skin, and a sitz bath in warm water might bring some relief.
For severe itching or inflammation, you might find relief with low-dose over-the-counter creams that include either hydrocortisone, a numbing agent like lidocaine, or a combination of both.
One thing you should probably avoid is probiotics. Levy explicitly states they are “not recommended,” despite what some might promote.
How should I protect others?
If a contagious condition is behind your diarrhea, keep in mind that you may continue to be contagious for days or even weeks after your symptoms have subsided. The usual transmission method is through hand-to-mouth contact. Make sure to wash your hands, fingernails, and wrists thoroughly with soap and water, especially after using the restroom and before handling food. It’s advisable to refrain from preparing meals for others while you’re unwell, and, if possible, staying at home until you’re symptom-free is a good idea.
