Diarrhea

It’s best to have a positive mental attitude when struggling with a bout of simple diarrhea. It may be comforting, while you’re sitting there, to realize how none of the Beautiful People has ever been spared the experience. Believe me, the likes of Oprah, Julia Roberts, Brad Pitt, and Tom Cruise have all been there, just like you. Be philosophical and accept your body is doing its job. Your intestines are simply struggling to deal with the water you were told not to drink, the leftovers that tasted a little funny while you were eating them, or the virus which recently arrived in your neighborhood. Of course, any episode lasting more than a week, or accompanied by fever, severe cramps, or bleeding needs medical attention. As do episodes of recurrent diarrhea.

But for one of those vacation spoilers, our WholeHealth Chicago strategies just might help you along.

What is Diarrhea?

Diarrhea is the passage of frequent, loose, or watery stools. As food passes through the digestive tract, the liquid in the foods is reabsorbed through the walls of the large intestine, so that fecal matter solidifies as it travels through the digestive tract. If something speeds up or interferes with this process, these fluids are expelled from the body along with the fecal matter, causing it to become loose or watery. Diarrhea is not a disease in itself, but rather a symptom of some other underlying disorder, most of which are completely benign. In healthy adults, diarrhea is unpleasant but seldom serious, and usually subsides without treatment in a day or two. For children and the elderly, however, diarrhea is potentially serious, because it’s more likely to cause dehydration–the excessive loss of body fluids and salts that are needed for metabolism to occur.

Key Symptoms

• A change in bowel habits, such as frequent, loose, or watery stools
• Abdominal cramping and pain
• Bloating
• Possible nausea, fever, or thirst

What Causes Diarrhea?

It’s important to distinguish between two basic types of diarrhea. Non-inflammatory diarrhea is characterized by unformed, watery, and frequent bowel movements, often accompanied by abdominal cramps, gas, and nausea. This type of diarrhea is common and has many causes. Most frequently, it is due to eating food or drinking water contaminated with certain viruses or bacteria. An acute bout of mild to moderate non-inflammatory diarrhea is often simply unpleasant and inconvenient (although for children and the elderly it can be more serious because of the dehydration risk).

Inflammatory diarrhea is another matter; it involves small stools, blood and/or pus in the stool, fever, and abdominal pain. These symptoms are indicative of a more serious bowel ailment, such as Crohn’s disease or ulcerative colitis, and should not be self-treated. Anyone with these symptoms needs to be diagnosed by a physician before beginning treatment.

• Persistent or recurrent diarrhea can be caused by other specific circumstances. These include:
• A reaction to antibiotics and to certain other medications, including over-the-counter antacids.
• Excessive consumption of milk or milk products in people who are lactose-intolerant (that is, they have trouble digesting milk products).
• A reaction to certain foods, such as citrus fruits, beans, wheat or dairy products.
• Large amounts of artificial sweeteners, such as sorbitol or aspartame
  Large doses of vitamin C or magnesium
• Excessive use of laxatives, which can bring on chronic diarrhea that lasts for weeks
• Infectious diseases, such as traveler’s diarrhea, typhoid fever, amoebic dysentery, and bacillary dysentery
• Stress and anxiety

Treatment and Prevention

Simple non-inflammatory diarrhea is usually what doctors call self-limiting, meaning it just gets better in a day or two without specific treatment. Although over-the-counter antidiarrheal medications may be necessary (especially when you’re traveling or have important obligations), it’s usually best to avoid them if possible–except for Pepto-Bismol. Diarrhea is the body’s tool for purging harmful toxins from its system, and these medications do just the opposite–they force the body to retain toxins by discouraging bowel movements. However, Pepto-Bismol acts by blocking the effect of toxins, and it’s fine to do that.

As a general rule, wait at least a few hours after the onset of diarrhea before using an antidiarrheal medication. And if you suspect food poisoning, you are probably better off letting the diarrhea run its course.

It’s also important to drink plenty of water or other liquids to replace the water and other essential body fluids that you’ve lost. Older people and young children are especially at risk of dehydration and may benefit from an oral rehydration (see “Self-Care Remedies,” below). In addition, you should avoid alcohol, caffeine, milk and dairy products, and any products containing artificial sweeteners, all of which can aggravate diarrhea.

Once you’ve given your system a chance to purge whatever is causing the problem, you may get some relief with an over-the-counter medication. (Don’t use such a medication, however, if you suspect the diarrhea is caused by antibiotics; call your doctor.) Bismuth subsalicylate (Pepto-Bismol and numerous other brands) is probably the best to start with. Move to loperamide (Imodium A-D) if the Pepto isn’t working adequately.

As an alternative, a variety of supplements can be used to provide natural relief for the symptoms of diarrhea. You might want to try these before using an over-the-counter product.

Just a reminder: If you have a serious medical condition, it’s always a good idea to check with your doctor before beginning a supplement regimen.

How Supplements Can Help

Three types of tea: agrimony, blackberry leaf, and raspberry leaf, contain chemicals known as tannins that have a binding effect on the mucous membranes in the intestines. They not only help the body absorb fluids, but also help it replenish lost fluids. Each of these is a real favorite among naturopathic physicians and herbalists because they’re safe and effective diarrhea treatments that children even enjoy using. (Read the labels carefully, however, because many products contain blackberry-flavored black tea rather than true blackberry leaf.)

If none of these teas help, try using psyllium husks. Although most people commonly associate psyllium with its laxative properties, in actual fact, this natural soluble fiber absorbs excess fluid in the intestine and adds bulk to the stool.

Acidophilus, a form of “beneficial bacteria,” inhabits the digestive tract and fortifies the body against digestive disorders by restoring a normal balance of bacteria to the intestines. Supplements containing acidophilus are especially important to take after a round of antibiotics. Make sure the product contains “live cultures” or “active cultures;” that it’s cultured to be dairy-free; that its expiration date has not passed; and that it’s refrigerated until you finish it. DDS-1 strain of acidophilus is often referred to as a “superstrain” because of its far greater potency and survival in the large intestine. Some acidophilus products contain fructo-oligosaccharides (FOS). This is a nonabsorbed sugar that feeds the healthy bacteria already in your colon.

Activated charcoal, either as capsules or powder, can be taken after every loose stool. If you use the powder, put two or three tablespoonfuls into the bottom of a large glass. Add some cool water and stir carefully with a long-handled spoon (to keep the charcoal from scattering) and drink through a straw (to keep the charcoal off your teeth). If this doesn’t sound appetizing, rest assured the charcoal is tasteless. This substance absorbs the toxins without inhibiting bowel movements and is one of the most effective remedies for diarrhea available.

Self-Care Remedies

Drink plenty of fluids. To prevent dehydration, you need to drink plenty of water and clear liquids (fruit juices, clear broths, and noncarbonated soft drinks), at least eight ounces every hour.

Have an oral rehydration solution. You can do this by mixing one teaspoon of salt and four teaspoons of sugar in one quart of water. Measure carefully because too much salt will worsen dehydration. Drink eight ounces of the solution every hour until the diarrhea subsides. An alternative would be to buy one of the nutrient-rich rehydration products usually available in health-food stores (often sold as sports drinks). They contain important electrolyte replacement minerals, including magnesium, manganese, and potassium. One convenient form is an electrolyte powder that can be easily stored, and then reconstituted as needed, without refrigeration.

Keep eating. But stick with light, bland, easy-to-digest foods, such as bananas, white rice, applesauce, and toast.

Avoid irritating or triggering foods. It would probably be a good idea to forgo milk, citrus fruits, alcohol, and high-fiber foods for a day or two.

Use care when traveling. If you’re visiting a place where the food or water is suspect, eat only thoroughly cooked foods. Peel all fruit yourself, and drink only bottled water, even for brushing your teeth. Always avoid ice cubes. And as a precaution, try bringing along dairy-free acidophilus; take 1 capsule every eight hours at the earliest signs of gastrointestinal distress, namely increased gas, bloating, loose stools, or abdominal cramping.

Take precautions to reduce the risk of food poisoning: Don’t eat any food if you suspect it may be spoiled. Defrost foods only in the refrigerator or microwave. Marinate meats only in the refrigerator. Wash your hands with warm water and soap before preparing foods and after handling raw meats. Wash any plates and utensils that have touched raw meat or poultry. Refrigerate leftovers promptly. Avoid dairy products or mayonnaise that has been left out at room temperature or warmer for more than two hours.

When to Call a Doctor

• If diarrhea persists longer than two days in an adult or child, or longer than one day in a child under the age of two.
• If diarrhea is accompanied by any of the following symptoms: dizziness or lightheadedness; severe abdominal cramps; blood in the stool or black, tarry stool; fever above 101°F; or no urination.
• If you’ve developed diarrhea recently after starting a course of antibiotics and it’s not responding to simple measures such as acidophilus or Pepto-Bismol.
• If there are signs of dehydration: persistent thirst, dry lips, or sunken eyes.
• If you get frequent bouts of diarrhea, or alternating bouts of diarrhea and constipation.

Supplement Recommendations

From David Edelberg, M.D. at WholeHealth Chicago: The family doctor’s favorite remedy for treating diarrhea is Pepto-Bismol, now sold under a slew of different names. Just follow the instructions on the package and expect your bowel movement to turn a discomfiting shade of black. Don’t worry–that’s supposed to happen.
If you dislike the bubble-gummy taste of Pepto-Bismol, use the charcoal or the blackberry tea suggested here. They all work on the intestines in a similar way.

Note: If you know or suspect that your diarrhea is from food poisoning, ride it out for a day; you want the intestines to clear the toxins from your body.

How to Take the Supplements

Herbal teas work nicely for diarrhea, and you can easily substitute them for over-the-counter remedies. Agrimony, blackberry leaf, and raspberry leaf are available at most health-food stores; the tannins in these teas help bind the mucous membranes in the intestine. (By the way, blackberry brandy was a favorite antidiarrheal in the 1800s.)

If neither Pepto-Bismol nor herbal teas work for you, try psyllium fiber. Although most people use it for constipation, the fiber also soaks up excess fluid in the intestines and adds bulk to the stool.

Activated charcoal is another old but effective remedy. You can take capsules or you can mix a tablespoon of charcoal powder into a glass of cold water. Use a tall glass and a long-handled spoon to blend (so the powder doesn’t fly back in your face), and sip through a straw to avoid coloring your lips and teeth. On the plus side, charcoal is completely tasteless. And if your tongue and teeth are blackened, the color disappears with a quick brushing and rinse.

If your diarrhea is due to antibiotic use, then immediately start taking acidophilus, which will help rectify the bacterial imbalances caused by the antibiotic. In fact, if you are prone to antibiotic diarrhea, it’s probably a good idea to start both at the same time. Acidophilus has been shown to reverse this form of diarrhea. Continue using acidophilus until your bowel movement is back to normal. Be sure to contact your doctor if your diarrhea doesn’t clear up after a couple of days off the antibiotics.

Important:

We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.

Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.

For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.

Be well,
David Edelberg, MD