There are two and only two ways diarrhea knocks on your door. In the first scenario, you are enjoying a peaceful day, casually letting out pleasant smells that little disrupt your schedule and maybe give you a giggle or two. Until at some point, you realize they are not the ordinary kind, but they are courtiers announcing the queen—or the nasty diarrhea. So you use a bathroom to honor her passage. Only, she ignores you. She bursts through like some coffee-machine liquid, leaving you weak and defeated.
And in the second scenario… there are no announcers, dreadfully. You are most likely in a public space, at work or at school, and the queen abruptly demands to exit her kingdom—your rectum. Canons and fireworks—or gases—are already celebrating her coming.
In the latter case, let’s admit it, there is no possible way you can avoid the embarrassment. When this act of greater violence occurs to you, you have to take the hit (or maybe the most appropriate word would be hit with an s.) What you can do though, is try and prevent it.
How to prevent diarrhea
More specifically, if you’re about to head outside for work or a meeting in a few hours or the next morning, you should avoid all of the following:
- Consume a meal full of chili or curry powder, black and red pepper and all the spicy seasonings that Mexicans may worship but your gut won’t. In fact, spices like this affect your stomach flora, causing bloating, gas, burning and diarrhea.
- Drink beverages with artificial sugars. (Because hey, you’ve got to take care of that diet—No.) In fact, alternative sugars such as sorbitol, aspartame, saccharine et cetera, interfere with the healthy bacteria of the lower intestinal tract. Instead of the fat-free versions of your favorite drinks and foods, opt for small portions of the real deal.
- Eat greasy fast food. Fast food contains what is known as saturated fats. They have little nutritional value, so they just pass on through your colon unprocessed. Greasy foods such as pizza, burgers, french fries and fried bacon—those are most likely to cause a leaky gut. To satisfy your fast food cravings, choose meals that have been grilled rather than deep fried in oils.
- Drink coffee. I know, nobody can do without their morning cup of joe, myself included. And if you’re a regular coffee drinker like me, without having any adverse effects, then you’re probably on the safe side. Coffee will affect you though if you’ve also previously consumed guilty foods or if you mix it with artificial sweeteners as we described above. For example, avoid your morning caffeine fix if you ordered pizza with extra cheese the previous night, or after a delicious meal of greasy lasagna. Grease and caffeine don’t mix well together. If grease didn’t win disrupting your digestive system, coffee is sure to stimulate it. Coffee is a cure for constipation, so it goes without saying that for a normal-functioning gut, it would cause the exact opposite effect, diarrhea. If you can’t avoid caffeine at all, try half-caffeinated beverages instead.
- Consume dairy products. This should not have to be said. Most people who are aware of their lactose intolerance have made a sport out of searching for lactose-free products. It’s those who are not aware of it who should be careful. It is possible to gain knowledge of the issue at a later age. Keep track of your digestive system. Did episodes of diarrhea or excess gas or bloating occur right after you consumed milk products? If yes, you’re not far from finding the culprit.
- Eat food that may be spoiled. You have a sudden craving for milk, you remember the carton in your fridge, so you go and check the expiration date, it’s only one or two days past, so you think it’s safe. It is not. You should generally try to stay away from foods that put you in doubt. Raw fish and meat are usually the ones you should suspect most.
- Taste recipes that include one of these foods: garlic, onions, cauliflower, broccoli, corn, sardines, citrus fruits, pineapples, cherries, seeded berries, figs, currants, grapes, raw vegetables and cheese.
Let’s face it though, statistically, there’s a high chance you have or will experience an episode of explosive diarrhea in your life. So as much as there is to do to avoid it, sometimes it is just inevitable. Whether you’re travelling or have been infected with a stomach flu, you’re probably going to get loose stools. In that case, there are always simple steps to take care of yourself.
Steps to ease and cure diarrhea
“You want to eat plain, simple foods, especially in the first 24 hours”, says Peter Higgins, MD, PhD, the director of the inflammatory bowel disease program at the University of Michigan in Ann Arbor. As aforementioned, diarrhea leaves you weakened and defeated, so you don’t want to strain your stomach and intestines with difficult tasks. On the other hand, completely starving yourself of food is not recommended either. Higgins suggests thicker, bland foods like oatmeal, bananas, plain rice, applesauce, boiled potatoes, toast, plain crackers, pretzels and baked chicken without any skin or fat.
Diarrhea causes lots of sodium to be lost through waste. Bananas are rich in potassium and sodium, which makes them easy on the gut flora and useful in keeping your sodium levels balanced.
A popular treatment for diarrhea is probiotics. That is, if you’re not lactose intolerant. A review published in November 2011 in the Journal of Clinical Gastroenterology suggested that foods with probiotics — often called “good” bacteria — may shorten the duration of a bout of diarrhea. According to the American College of Gastroenterology, probiotics work by releasing “chemicals which break down the damaging toxins produced by unhealthy bacteria causing illnesses such as diarrhea.”
Probiotics are found in a number of foods like yogurt, kombucha, kefir, sauerkraut and kimchi.
Also, in cases where diarrhea is induced by a bacterial infection, doctors usually recommend antibiotics. The downside is antibiotics may target healthy bacteria as well. Probiotics can help introduce healthy bacteria back into the digestive system, thus preventing any adverse effects caused by the antibiotics.
Diarrhea is a huge source of dehydration. You may think that consuming lots of liquids may worsen the effects, but that is not true. Being deprived of fluids during diarrhea can lead to serious dehydration, which could put you in a worse situation than before. Liquids you can safely consume are:
- decaffeinated, low-sugar drinks
- diluted fruit juices
- clear broths, like chicken broth or beef broth, with any grease removed
- water or coconut water with vitamins or electrolytes (again, with low or zero sugar levels).
“Look for liquids with sugar and salt — Pedialyte or full-salt soups work well,” Higgins says. “If your urine is not clear, or you are not making much urine, you are not drinking enough.”
As far as over-the-counter treatment is concerned, Higgins says, “if you don’t have an infection and are not seeing blood, you can take over-the-counter loperamide (Imodium, Kaopectate Caplet, or Maalox Anti-Diarrheal) to slow your bowel movements. But this kind of medication should only be taken for a day or two.” Another anti-diarrheal medication is Pepto-Bismol, which can help stop or slow down the diarrhea.
Some myths about diarrhea
As with every health condition, there are many myths about diarrhea spread around the internet. The most popular of them are:
- ‘The BRAT diet’. BRAT stands for “banana, rice, applesauce, toast”. As Higgins suggests, bland foods are your friend in terms of treating diarrhea, but the key word here is ‘only in the first 24 hours’. BRAT foods don’t contain all the nutrients the human body needs, like protein and fat. So after a day or two, you should return to your normal diet.
- ‘Seasonal flu can cause diarrhea’. Symptoms of the seasonal flu – or influenza virus – are fever, body ache, maybe a runny nose or a sore throat, but not diarrhea. Influenza generally inflicts the airways and lungs, not the digestive system. “Stomach flu”, on the other hand, is the one that causes diarrhea. “Stomach flu” is an umbrella term for all the germs that cause viral gastroenteritis, which differ from the influenza bug.
- ‘Fiber is good/not good for diarrhea’. Both assumptions are wrong, the right one being “Not all fiber is good for diarrhea.” There are two types of fiber, the soluble and insoluble type. Soluble fiber – contained in beans, peas, oat bran, peeled fruits and cooked vegetables – absorbs fluids in the intestines and makes stools firmer. But insoluble fiber – mainly contained in the skins of raw fruits and vegetables, whole grains, and wheat bran – can speed up the passage of stools through the colon.
- ‘Eating nothing can help ease the stomach’. Starving yourself is the wrong idea for treating diarrhea, because first, it deprives your body of the necessary nutrients needed to fight the disease and second, it will make you so hungry that once you feel better, you may overeat, which could cause another round of loose stools and bring you back to day one.
- ‘Diarrhea is a side effect caused by a bug that just needs to run its course’. Unlike most symptoms like fever and coughing, diarrhea is not always a response of our immunity system to an infection – it can be the result of a more serious underlying condition. Therefore, you should not just “wait for it to pass” and instead, treat it properly.
In most cases, diarrhea can be treated with home remedies, a healthy diet and over-the-counter treatment. However, sometimes the problem ends up being more serious than we initially thought.
When diarrhea is more serious
“Be evaluated by a physician for diarrhea that lasts more than four weeks; bloody diarrhea; nocturnal diarrhea; or diarrhea associated with abdominal pain, nausea and vomiting, fever, or weight loss,” says Aline Charabaty, MD, director of the Center of Inflammatory Bowel Disease at Georgetown University Hospital in Washington, D.C.
Charabaty lists a few cases of persistent diarrhea:
- Traveler’s diarrhea. If the diarrhea persists after the trip is over, she says, you should have your stools checked for parasites or an underlying condition that has been unmasked by the infection — for example, inflammatory bowel disease. “After an episode of infectious diarrhea, the diarrhea can persist for several months to years because the gut flora and motility has been altered — that’s what we call post-infectious diarrhea or post-infectious IBS.”
- Diarrhea caused by medical conditions like ulcerative colitis, Crohn’s disease and celiac disease. Ulcerative colitis causes ulcers and sores on the internal lining of the colon which can trigger diarrhea, while Crohn’s disease is “a chronic inflammation of the gastrointestinal tract that often manifests with diarrhea as well as abdominal pain, blood in the stool, anemia, and sometimes weight loss and fever.” An allergy to gluten can result in celiac disease. Gluten is a protein found in wheat, rye and barley, and it is toxic to the small bowel, preventing the intake of fluids and nutrients, which leads to diarrhea.
- Diarrhea induced by a surgery in or around the digestive tract. “Resection of part of the small bowel or the large bowel can cause diarrhea because we are removing a portion of the gut responsible for absorbing water,” Charabaty says. “Certain types of surgeries also promote small bowel bacterial overgrowth, which in turn can cause diarrhea. Removal of the gallbladder can also cause diarrhea because of the bile salts irritating the colon and causing leakage of water into the colon lumen.”
- As a symptom of seasonal allergies. Though diarrhea does not usually occur as the sole symptom of seasonal allergies, if it is part of a set of side effects that recur annually, then it is possibly caused by an environmental allergen. In this case, antihistamines may help cure diarrhea, just like the other allergy symptoms.
In any case, if your diarrhea is severe, you should consult a doctor. And if you do happen to experience explosive diarrhea in public, just remember: It has or will happen to everyone at some point in their lives. It is a common disruption of the human digestive system and, a hilarious story to narrate in the years to come.