Common Everyday Diarrhea

This causes only one symptom—loose, watery, way-too-frequent stools. Usually, you have no idea what causes it: “Must have been something I ate…” Sometimes that’s right, or at least, part of the answer. The combination of foods, drugs, and stress are often to blame—too much pepperoni pizza and coffee the night before final exams.

But more likely, it’s something you drank. Recent research suggests that a great deal of “runs-of-the-mill” diarrhea is caused by germs in the water supply—a mild version of infectious or traveler’s diarrhea (see below). Recently, scientists at Harvard and the Environmental Protection Agency (EPA) correlated levels of germs and other contaminants (turbidity) in Philadelphia’s water during the early 1990′s, and emergency room visits for diarrhea. Although the water never exceeded EPA turbidity limits, even slight increases in contamination caused jumps in ER visits for diarrhea. Since this study, the EPA has tightened up on turbidity limits. But many U.S. water systems still exceed federal contamination limits from time to time, and you may pay the price in urgent trips to the bathroom.

Turbidity may also explain why you’re prone to diarrhea when you travel around the U.S. “You adjust to the mix of micro-organisms in the water where you live, and they stop bothering you,” Dr. Simons explains, “but when you travel, you encounter a different mix, which may cause problems for a few days until you adjust to the new water.”

Infectious Diarrhea

This is the bane of daycare centers. It’s caused by a large number of viruses and bacteria, Dr. Simons explains, including: Shigella, E. coli, and Salmonella, a frequent cause of food poisoning. The germs spread on little hands that touch contaminated fecal material, then touch food, or other children’s hands, which wind up in their mouths. It’s hard to control because young kids don’t win any awards for personal hygiene. Infectious diarrhea is also quite common in nonindustrialized nations, where it is a major cause of childhood death.

Traveler’s Diarrhea

This is turista, the notorious health hazard of trips to Mexican villages and other places where turbidity standards are much lower than they are in the U.S. Turista can cause several days of sprint-for-the-bathroom urgency, liquid stools, cramps, fatigue, loss of appetite, and abdominal distress that may linger for a week or so after the worst of it has cleared up.

You can develop something similar here in the U.S. if you drink from streams without boiling the water first. Even pristine-looking wilderness streams miles from the nearest paved road can be contaminated with diarrhea-causing germs, notably the protozoans Giardia lamblia Entamoeba histolytica.

Food-intolerance Diarrhea

If your system can’t handle dairy products, or wheat, or other foods, you can develop chronic diarrhea—see Lactose Intolerance, Gluten Intolerance, and Food Intolerances. Or perhaps you react badly to sorbitol, an artificial sweetener found in many sugar-free or low-sugar foods and candies. It’s also an ingredient in some drugs.

Supplement-induced Diarrhea

Do you take high doses of vitamin C when you have a cold? It helps, but it may also cause diarrhea, says Alan Brauer, M.D., director of TotalCare Medical Center in Palo Alto, California, one of the nation’s first clinics to combine mainstream and complementary medicine: “Different people have different vitamin C limits.”

Fruit Juice Diarrhea

Apple juice, anyone? Many parents of infants and toddlers give juices by the gallon, and then spend their days changing diapers. Several studies by Dutch researchers have shown that in childhood diarrhea, the culprit is often a diet high in fruit juices. Many adults also notice bowel looseness after eating lots of fruit.

“Leaky Gut” Diarrhea

If you’re small intestine is healthy, only nutrients your body needs pass into the bloodstream. But if your small intestine gets damaged—by infections, drugs (including alcohol and cigarettes), or food intolerances—other potentially harmful substances pass into the bloodstream: incompletely digested fats, proteins, and carbohydrates, and potentially harmful substances that ought to be eliminated in solid waste.

Leaky gut syndrome has been implicated in chronic diarrhea, inflammatory bowel disease, and chronic fatigue syndrome. Until recently, only naturopaths focused on it. But now mainstream doctors are taking it seriously, notably New York City internist Leo Galland, M.D., who specializes in medical mysteries, and contends that leaky gut syndrome contributes to many of them.

Drug- and Illness-induced Diarrhea

Beyond not making it to the bathroom in time, your major risk from diarrhea is water loss (dehydration). Your body may look solid, but it’s more than 75 percent water, explains Ann Arbor, Michigan, health consultant Robert Cooper, Ph.D. Your colon’s main job is to reabsorb two to four quarts of water a day from solid wastes. Diarrhea disrupts this internal water-reclamation project, which depletes your body of sodium and potassium (electrolytes).

If diarrhea lasts more than a few days, it can affect every system in your body, which is, after all, mostly water. Dehydration is a particular hazard for infants, children, the elderly, and people with chronic illnesses, which is why infectious diarrhea is a major public health problem around the world.

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Home Remedies for Diarrhea

• Drink Fluids When You Have Diarrhea When you’re running like a hose, you might feel tempted to stop drinking. Don’t! says naturopath Joseph Pizzorno, N.D., president of Bastyr University, the naturopathic medical school near Seattle. Instead, drink more for as long as your diarrhea lasts.

Water is a start, but it doesn’t replace lost electrolytes. Dr. Simons suggests bouillon, Gatorade, or other rehydration fluids that contain sodium and potassium (or for infants and children, less concentrated electrolyte-rich fluids: Pedialyte, Infalyte, and Lytren). Dr. Pizzorno suggests dilute vegetable juices, which also contain electrolytes, particularly this old naturopathic remedy—equal parts of tomato and sauerkraut juices. “It’s high in electrolytes,” he explains, “and some naturopathic studies suggest that sauerkraut juice helps heal intestinal problems.”

• Coffee and Diarrhea. The one fluid you should not drink for diarrhea is coffee, says Melvyn Werbach, M.D., an assistant clinical professor at the UCLA School of Medicine. It has a laxative effect. Many people use coffee to treat minor constipation. In addition, there is some evidence that caffeine increases secretion of fluids into the intestine, Dr. Werbach says, something you don’t want when you have diarrhea.

• What to Eat When You Have Diarrhea. It’s known as BRATT— an acronym for bananas, rice, applesauce, tea, and toast, all of which are binding foods. Bananas are also rich in potassium, so they help replenish electrolytes. Some people say tea also helps. But stay away from coffee, milk, fruit juices, and spicy, fried, and junk foods, which usually aggravate the problem, and alcohol, which is dehydrating. As symptoms begin to improve, gradually reintroduce other foods: crackers, soups, cooked vegetables, skinless chicken, fish, etc., but stay away from high-fat items— pizza, burgers, ice cream, and french fries—until you’re back to normal again.

• Fiber and Diarrhea. Soluble fibers add bulk to stool, which helps relieve diarrhea. “Apple pulp is rich in the soluble fiber, pectin,” explains Maryland botanist/herbalist James Duke, Ph.D., author of The Green Pharmacy. “That’s why apples and applesauce are hallowed folk remedies for diarrhea.” Fiber also helps heal a leaky gut.

• Bring Back Your Bacteria. In addition to depleting electrolytes, diarrhea wreaks havoc with the helpful (“probiotic”) bacteria that normally live in your intestine and aid digestion. For years, naturopaths including Dr. Pizzorno have recommended restoring these beneficial bugs by eating yogurt with live Lactobacillus acidophilus or L. bulgaricus culture.

Recently, mainstream M.D.’s have climbed on the yogurt bandwagon. Jose Saavedra, M.D., director of pediatric nutrition at Johns Hopkins Children’s Center in Baltimore, studied 55 hospitalized infants. They received either regular formula, or formula supplemented with Streptococcus thermophilus, another bacterium used to make yogurt. After 12 weeks, 31 percent of the infants who received only formula experienced diarrhea, but in the formula-bacteria group, the figure was just 7 percent.

If you or your kids are prone to diarrhea, Dr. Saavedra suggests a daily four-ounce yogurt snack. Just make sure the label says “live bacterial culture.” Or you can buy powders containing these bacteria at most health food stores and supplements shops, and some pharmacies. Dr. Pizzorno recommends 1/2 teaspoon three times a day.

• Honey for Diarrhea. In one study, honey helped treat infectious diarrhea in children. Researchers gave 159 children a standard fluid-electrolyte replacement beverage, containing either added glucose (blood sugar) or honey. The kids in the honey group recovered significantly more quickly.

• The Diarrhea Carrot Cure for Infants. For infant diarrhea, an old folk remedy is cooked, mashed carrots. “I like it,” Dr. Duke says. “Cooked carrots seem to soothe the digestive tract and they help replace lost electrolytes.”

• Read Food Labels. Read food labels carefully. Try eliminating sorbitol, Dr. Simons suggests.

• Breast Milk and Diarrhea. If you’re a new mother, breastfeeding your baby helps prevent infant diarrhea. In a recent survey of 1,743 new moms, researchers with the Centers for Disease Control and Prevention in Atlanta discovered that the more they breast-fed, the less likely their babies were to suffer diarrhea. Compared with infants who ate only formula, the diarrhea risk of those who were exclusively breast-fed was 80 percent lower. Breast-feeding spurs the growth of beneficial intestinal bacteria, which help prevent diarrhea.

Alt: diarrhoea, diarhea, diareah, diarrhea