Diarrhea is an abnormal increase in the liquid content or frequency of a bowel movement. What is “normal” will vary among the population. Diarrhea constitutes greater than 3 bowel movements per day. Symptoms may include weakness, flatulence, abdominal cramping/pain, fever > 102.2°F, nausea, and vomiting. Diarrhea can be acute, chronic or persistent. Mild to moderate diarrhea (≤ 5 loose stools per day) can be treated with non-prescription and non-drug remedies. Severe diarrhea (6-9 loose stools per day) must be treated by seeking medical attention. However, most diarrheas are self-limiting and will subside in 2 to 3 days.
There are a myriad of reasons that people get diarrhea. Viruses, bacteria, medications, and food can all be potential sources. Many people find that the prevalence of diarrhea is greatest when traveling, known commonly as Traveler’s diarrhea. Traveler’s diarrhea often has an acute onset and is bacterial in origin. Some people find that dairy products cause intestinal discomfort. Lactose intolerance commonly causes diarrhea and there are available therapies for this as well.
Is it safe to self-treat or should I seek medical advice?
Most diarrheas are self limiting and should resolve within a couple of days. However, symptomatic treatment may be necessary. There are a number of reasons that people should seek medical treatment and these may include:
- Diabetes or other chronic medical conditions
- Receiving chemotherapy
- Severe vomiting and/or dehydration (rapid pulse, low blood pressure)
- < 6 months old
- Fever ≥101.3°F
- Blood, mucous, or pus in stool
- Passage of ≥ 6 unformed stools in 24 hours
- Diarrhea lasting ≥ 48 hours
What over-the-counter (OTC) treatment options are available?
Initially, management of diarrhea in children and adults should focus on staying hydrated. Symptomatic relief can be achieved by using anti-diarrheal agents in some patients.
Dehydration commonly accompanies diarrhea, due to fluid losses through the stool. It can manifest as tiredness, muscle aches, passing little urine, dry mouth, and irritability. Fluid and electrolyte replacement is the cornerstone of therapy for dehydration. Other treatment modalities may include diet alternation and symptomatic relief with the use of non-prescription anti-diarrheal medications.
• The bowel does NOT need to be “rested” by avoiding foods
• Eat a normal, bland diet
• Avoid potential trigger foods
• Preferred treatment for mild to moderate diarrhea
o Enfalyte Solution®
o CeraLyte Products®
o Avoid colas, ginger ale, apple juice, chicken broth, tea
Over-The-Counter Drug Options
• Imodium® (loperamide)
o Indicated for acute and non-specific diarrhea
• Bismuth Subsalicylate (Pepto-Bismol®)
o Indicated for acute diarrhea, such as Traveler’s diarrhea
Lactose Intolerance Agents
• Lactaid®, Lactase®, or Dairy Ease®
o Indicated for diarrhea due to inability to digest dairy products
What is all the buzz about complementary therapies?
There has been much marketing surrounding products like Culturelle® for a healthy colon. There is little evidence to substantiate safety and efficacy of products like this, other than those containing Lactobacillus. Products like Culturelle®, Lactinex®, Bacid® are intended to replace gastrointestinal flora, much like yogurt does. The Food and Drug Administration (FDA) only recognizes these products as dietary supplements. Therefore, they should not be used in place of more appropriate treatment for diarrhea.
If you have any additional questions or need help deciding to self-treat or with products, be sure to ask you local Foster’s pharmacist or contact us at (740) 392-0911.