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Diarrhea

• Signs and Symptoms
• What Causes It?
• What to Expect at Your Provider's Office
• Treatment Options
• Following Up
• Special Considerations
• Supporting Research

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 contain blood, if the diarrhea is particularly severe, or if the diarrhea lasts more than a few days. Children and elderly people should see a health care provider sooner because they are at more risk of dehydration.

Signs and Symptoms

Diarrhea is a symptom of another ailment. Symptoms you might experience with diarrhea are as follows:

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

What Causes It?

Most diarrhea is caused by an infection (viral, bacterial, or parasitic), often from food or water. Diarrhea produces watery stools and lasts only a few days. Eating local food and drinking local water during foreign travel can result in "traveler's diarrhea." Diarrhea can also be caused by reactions to medications (including some vitamins, minerals and herbs) and ingestion of milk or dairy products by people who are lactose-intolerant. A different type of diarrhea that results in blood in the stool, accompanied by fever or abdominal pain, could be caused by intestinal disorders such as inflammatory bowel disease or Crohn's disease, and requires a doctor's care.

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

Drug Therapies

In many cases, diarrhea will disappear on its own. However, many drugs can treat symptoms of diarrhea. Your health care provider may suggest the following drugs for your diarrhea:

• Opioid derivatives: diphenoxylate with atropine sulfate, and loperamide
• Adsorbents: Bismuth salt (for traveler's diarrhea) and attapulgite
• Bulk-forming medications: psyllium husk

Over the Counter

Since diarrhea is your body's way of getting rid of toxins, it's best to let it run its course. However, you may use over-the-counter anti-diarrheal remedies for convenience, including loperamide (Imodium), bismuth sub-salicylate (Pepto-Bismol), and attapulgite (Kaopectate). You should not take bismuth sub-salicylate with the herbs meadowsweet ( Spirea ulmaria ), white willow ( Salix alba ), or wintergreen ( Gaultheria procumbens ).

Complementary and Alternative Therapies

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

Nutrition and Supplements

• Drink plenty of liquids, and avoid solid foods, coffee, chocolate, dairy products, and strong spices. 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 acidophilus and/or bifidobacteria taken as powder or in capsules helps normalize bowel flora and may help cure your diarrhea. Take as directed. Active culture yogurt containing these probiotics may help prevent diarrhea.
• A live yeast, Saccharomyces boulardii , is often used in Europe to prevent diarrheas associated with antibiotic use. Take 1 - 3 capsules per day (3 - 9 billion colony forming units). May be taken with other probiotics. Rare but serious cases of infection in seriously ill patients have been reported, so do not take Saccraromyces boulardii without a doctor's supervision.
• Bovine colostrum, the pre-milk fluid secreted by a cow's mammary glands just after giving birth, may help treat some kinds of infectious diarrhea (1,000 - 4,000 mg per day)
• Glutamine (3,000 mg three times per day) is helpful in treating diarrhea that is caused by irritation of the intestinal lining.
• If lactose intolerance is the cause of the diarrhea, use over-the-counter lactase enzyme supplements before consuming dairy products.

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 can be used as teas unless otherwise noted. You should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day.

Astringent herbs:

• Astringent herbs, such as blackberry leaf (Rubus fruticosus) or raspberry leaf (Rubus idaeus), help "dry up" the mucous membranes in the intestine. Make a tea with 1 heaping tsp. per cup. Drink a ½ cup per hour. These teas are safe for children.
• Carob powder ( Ceratonia siliqua ), which is rich in fiber, may be taken at the rate of 1.5 g per 2.2 pounds or 1 kg of body weight.Dissolve powder into a hydrating solution such as Pedialyte.
• Extract of bilberry ( Vaccinum myrtillus ) also has astringent properties (4 g, spread over several doses). Do not take bilberry if you take blood-thinning medication.
• Agrimony (Agrimonia eupatorium) is a traditional remedy for diarrhea. Usual dosage is 3 g (about 1/2 tsp.) per day.

Inflammation reducers:

• Quercetin (250 - 500 mg two to four times per day)
• Chamomile (Matricaria recutita) is usually taken as a tea. Dissolve 3 - 4 g powder (about 3 tsp.) in 1 cup hot water, strain and cool. Drink three times per day.
• Marshmallow root (Althea officinalis) as cold-water tea. Soak 2 tbs. root in 1 quart of water overnight. Strain.Drink throughout the day.
• Slippery elm powder (Ulmus fulva) or marshmallow root powder (Althaea 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 - 60 minutes.

Infection fighters:

• Plants containing berberine can be used for infectious diarrhea. These include barberry (Berberis vulgaris) 250 - 500 mg three times per day; goldenseal (Hydrastis canadensis) 250 - 500 mg three times per day; and Oregon grape ( Berberis aquifolium ), 250 - 500 mg three times per day.

Homeopathy

Some evidence suggests that homeopathic treatment may help diarrhea. In one study, children with acute diarrhea who received an individualized homeopathic treatment for 5 days had diarrhea for significantly less time than children who had placebo. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual. Some of the most effective homeopathic remedies are as follows:

• Arsenicum album -- for foul-smelling diarrhea from food poisoning or traveler's diarrhea with burning sensation in the abdomen and around the anus. This remedy is most appropriate for individuals who feel exhausted yet restless and whose symptoms tend to worsen in the cold and improve with warmth. Vomiting may also occur.; Arsenicum may also be used to prevent diarrhea when traveling.
• Chamomilla -- for greenish, frothy stool that smells like rotten eggs. Used primarily for children, especially those who are irritable, argumentative, and difficult to console. Chamomilla is commonly recommended for colicky or teething infants.
• Calcarea carbonica -- for children who fear being in the dark or alone and who perspire heavily while sleeping. Stools may have a sour odor.
• Mercurius -- for foul-smelling diarrhea that may have streaks of blood accompanied by a sensation of incomplete emptying. This remedy is most appropriate for people who tend to feel exhausted following bowel movements, experience extreme changes in body temperatures, perspire heavily, and have a thirst for cold fluids.
• Podophyllum -- for explosive, gushing, painless diarrhea that becomes worse after eating or drinking. Exhaustion often follows bowel movements and the individual for whom this remedy is appropriate may experience painful cramps in lower extremities.; Podophyllum is often used in infants for diarrhea experienced from teething.
• Sulphur -- for irritable and weepy children. They may have a red ring around the anus and diarrhea with the odor of rotten eggs.
• Veratrum album -- for profuse, watery diarrhea accompanied by stomach cramps, bloated abdomen, vomiting, exhaustion, and chills. The diarrhea is worsened by fruit, and the individual craves cold liquids.

Acupuncture

Although several studies in traditional Chinese medicine journals have reported success in treating childhood diarrhea, acupuncturists in the United States do not generally treat this condition in children. However, acupuncture may be used when conventional treatment has failed. In this case, acupuncturists would examine both the nutritional value and the "energetic" qualities of food that might be affecting digestion.

Acupuncture is also combined with conventional medicine in treating diarrhea in adults.

Acupuncturists treat people with diarrhea based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In the case of diarrhea, a qi deficiency is usually detected in the spleen meridian. As a result, acupuncture treatments often focus on strengthening this meridian. Moxibustion (a technique in which the herb mugwort is burned over specific acupuncture points) is frequently used in the treatment of diarrhea because its effect is thought to reach deeper into the body than needling alone.

Following Up

If your diarrhea does not stop in 3 - 5 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 diarrhea-related spasms may cause you to have contractions. Do not take goldenseal (Hydrastis 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 Co; 1993:271-277.

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: Therapeutic Guide to Herbal Medicines. 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.

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.

Dambro MR. Griffith's 5 Minute Clinical Consult . 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 Co; 1998:617-618, 621-622, 763-766, 1047-1050, 1061-1063, 1078-1079, 1103-1104, 1201-1202, 1226-1227.

Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-2119.

Jacobs J, Jiménez M, Malthouse S, Chapman E, Crothers D, Masuk M, Jonas WB. Homeopathic treatment of acute childhood diarrhea: results from a clinical trial in Nepal. J Altern Complement Med. 2000;6(2):131-139.

Jonas WB, Jacobs J. Healing with Homeopathy: The Doctors' Guide. New York, NY: Warner Books; 1996: 218-220.

Khin-Maung-U, Myo-Khin, Nyunt-Nyunt-Wai, et al. Clinical trial of berberine in acute watery diarrhoea. Br Med J 1985;291:1601-5.

Kollaritsch H, Holst H, Grobara P, Widermann G. Prevention of traveler's diarrhea with Saccharomyces boulardii . Results of a placebo controlled double-blind study. Fortschr Med 1993;111:152-6.

Lin Y, Zhou Z, Shen W et al. Clinical and experimental studies on shallow needling technique for treating childhood diarrhea. J Tradit Chin Med. 1993;13(2):107-114.

Loeb H, Vandenplas Y, Wursch P, Guesry P. Tannin-rich carob pod for the treatment of acute-onset diarrhea. J Pediatr Gastroenterol Nutr. 1989 May;8(4):480-5.

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

Patel AV, Rojas-Vera J, Dacke CG. Therapeutic constiuents and actions of Rubus species. Curr Med Chem . 2004 Jun;11(11):1501-12.

Saavedra J. Probiotics and infectious diarrhea. Am J Gastroenterol . 2000;95:S16-18.

Saaker SA, Casswall TH, Mahalanabis D, et al. Successful treatment of rotavirus diarrhea in children with immunoglobulin from immunized bovine colostrum. Pediatr Infect Dis J 1998;17:1149-54.

Spanier JA, Howden CW, Jones MP. A systematic review of alternative therapies in the irritable bowel syndrome. Arch Intern Med. 2003;163(3):265-74.

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.

Su Z. Acupuncture treatment of infantile diarrhea: a report of 1050 cases. J Tradit Chin Med. 1992;12(2):120-121.

Ullman D. Homeopathic Medicine for Children and Infants. New York, NY: Penguin Putnam; 1992: 75-77.

Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin Putnam; 1995: 243-245.

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

• Review Date: 6/27/2006
• Reviewed By: Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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