Dietary Tips for Diarrhea: What to Eat and What to Avoid

Diarrhea is a common gastrointestinal problem. According to the American College of Gastroenterology (ACG), acute diarrhea is the second most common illness in the United States, behind respiratory infections. Given the prevalence of diarrhea, it's important to know how to manage symptoms. Read on to learn more about what causes diarrhea, the best foods for diarrhea management, strategies for hydration, and other helpful tips for children and adults.

Understanding diarrhea and digestive health

Diarrhea is defined as passing loose, watery stools three or more times per day, particularly if this is more than your usual number of stools. Having an occasional loose bowel movement can be normal, but experiencing several per day when that's not your usual pattern is not. The consistency of the stool is also important to consider, as passing formed stools multiple times per day is not considered diarrhea.

Diarrhea can be acute, lasting for a short period of up to one week, or chronic, lasting longer than four weeks.

Acute causes of diarrhea

Per the National Institute of Diabetes and Digestive and Kidney Diseases, common causes of acute diarrhea include:

• Viral illnesses that cause diarrhea, including norovirus, rotavirus, and adenovirus
• Food poisoning from either food or drinks
• Traveler's diarrhea, which is caused by eating food, water, and other drinks contaminated with bacteria on a trip
• Side effects from certain medications, especially antibiotics, chemotherapy, or liquid medications with added sugar alcohols

Chronic causes of diarrhea

Chronic diarrhea has many potential causes, according to the ACG, including:

• Celiac disease
• Inflammatory bowel disease, or IBD, which includes Crohn's disease and ulcerative colitis
• Irritable bowel syndrome, or IBS, though symptoms of IBS are sometimes a combination of constipation and diarrhea
• Small intestinal bacterial overgrowth, often referred to as SIBO
• Radiation therapy for cancer
• Parasites
• Chronic pancreatitis, which affects your body's absorption of fats
• Carbohydrate malabsorption
• Lactose intolerance

Foods that help manage diarrhea

While health experts typically recommend high-fiber foods as an essential part of a healthy diet, the opposite is often recommended when acute diarrhea occurs.

Low-fiber foods and a bland diet may help ease diarrhea symptoms, especially for acute diarrhea. The BRAT diet is commonly recommended for the first day or two of a diarrheal illness. There hasn't been extensive clinical research to support using the BRAT diet, but it's reasonable to consume bland, low-fiber foods during a diarrheal illness to avoid further irritation, and some of the starches in these foods could make your stools firmer.

The BRAT diet is an acronym for the foods included in the diet:

• Bananas
• White rice
• Applesauce
• Toast made from white bread

If you're successfully tolerating the BRAT diet, add other bland foods, such as plain crackers, baked chicken breast or turkey, baked potatoes, boiled potatoes, clear soups, cream of wheat, and chicken noodle soup. Advance your diet to include cooked fruits and vegetables as tolerated.

The BRAT or a bland foods diet should only be used for a few days, and you should resume your regular diet as soon as tolerated after becoming ill. Though it might help you feel better when suffering from occasional diarrhea, the BRAT diet is low in calories, protein, fiber, and fat and quite limited in micronutrients due to the narrow range of foods consumed.

Which foods to avoid when you have diarrhea

Beyond high-fiber foods, other foods you should avoid when you have diarrhea include:

Staying hydrated with diarrhea

It's vital to replenish lost fluids when you have diarrhea to prevent severe dehydration.

When losing fluids due to diarrhea, an oral rehydration solution (ORS) or oral rehydration therapy is a potential hydration choice. These drinks contain sugar, salts, and sometimes other electrolytes such as zinc. They are widely available at pharmacies, grocery stores, or other big retailers. ORS is typically sold in ready-made liquid containers or as individual serving packets that you can mix in a glass of water or water bottle. They're available in various flavors for palatability.

Drinking water is also recommended, but shouldn't be your only beverage, especially if you're unable to eat much. Sips of sodium-containing liquids, including clear broths and soups, can help maintain hydration. Sports drinks may also be an option, as they contain salt and sugar.

Notably, you should avoid caffeinated beverages, as caffeine may worsen diarrhea. Caffeine can have a laxative effect and also acts as a mild diuretic, which can increase urination and fluid loss.

Diarrhea diet tips for kids

Diarrhea is dangerous for infants and small children. Worldwide, diarrhea is one of the leading causes of death in children under 5 years of age, so it should be taken seriously. Use extra caution, and always reach out to a healthcare provider if your child has the following symptoms:

• Diarrhea for more than one day
• Goes more than six hours without a wet diaper or going to the bathroom
• Blood or mucous in stools
• No tears when crying
• Sunken eyes
• Dry or sticky mouth
• Fever that isn't resolving
• Severe abdominal pain

If your child doesn't have the above symptoms, which require immediate medical care, there are strategies to try at home to manage diarrhea symptoms and maintain hydration. In my work with children as a registered dietitian, we frequently recommend the following tips to families when children have acute diarrhea:

• If your child doesn't have the above symptoms, which require immediate medical care, there are strategies to try at home to manage diarrhea symptoms and maintain hydration. In my work with children as a registered dietitian, we frequently recommend the following tips to families when children have acute diarrhea:
• If you're breastfeeding, continue during your child's diarrheal illness. According to the World Health Organization, breastfeeding may help reduce the severity of diarrhea, and infants who drink formula should continue to receive infant formula.
• Provide a regular diet focusing on easily digestible and bland foods. Introduce more foods and advance to their usual diet fully as soon as tolerated.
• If your child is over one year of age, try creative sources of fluids, like broth, diluted fruit juice, popsicles, gelatin, or some sports drinks.
• Limit sugary drinks and undiluted fruit juices to small amounts, even if 100% freshly squeezed juices, as the sugars may worsen diarrhea.

When to see a doctor for diarrhea

If you're an adult, contact your medical provider if you have diarrhea for more than two days or if you experience these problems:

• Dehydration that you're unable to resolve with sips of oral rehydration solution or other liquids
• A high fever
• Severe rectal or stomach pain
• Bloody stools
• Stools that are black or tarry
• Stools that contain mucous or pus

Dehydration means losing more fluids than you're taking in and can be dangerous at any age. Signs of dehydration include:

Additional ways to manage diarrhea

In addition to eating a blander diet and ensuring adequate hydration, eating small, frequent meals is sometimes helpful for people with diarrhea. Instead of having three larger meals, aim for several small meals of foods that are easier to tolerate.

Another strategy is supplementing with probiotics, especially for antibiotic-associated diarrhea. Per the Office of Dietary Supplements, taking either Lactobacillus rhamnosus GG or Saccharomyces boulardii within two days of starting antibiotics may potentially help reduce the risk of diarrhea in children and adults up to age 64.

Over-the-counter medications may help manage symptoms of diarrhea. Speak to a healthcare provider or pharmacist if you're considering taking over-the-counter or anti-diarrheal medications.

Summary

Diarrhea should be taken seriously, but a bland, low-fiber diet and adequate hydration may help manage diarrhea symptoms at home. Seek medical care for diarrhea if it lasts more than one to two days or if there are other concerning symptoms, especially in infants or young children.