Diarrhea

Nutrition on the Skids

Your co-workers must think you’re nuts, because here you come again, running down the hall, tearing around the corner and blasting into the bathroom. It’s your third trip this morning. And as you dash past the sinks and screech to a halt in front of the nearest stall, you wonder what on earth has caused such explosive diarrhea. Leftover bacteria from last night’s pork lo mein? Viral invaders from the flu that has hit your office? Alien plankton from a swim at the beach?

You may never know.

“There are a million and one causes of diarrhea,” says Joel B. Mason, M.D., assistant professor of medicine and nutrition at Tufts University in Medford, Massachusetts. But fortunately, most short-term cases of diarrhea—those lasting for a day or two or three—will not deplete your body’s nutritional reserves enough to harm you, which can be a major health effect of diarrhea.

“Acute infectious diarrhea, what people call gastrointestinal flu, is usually related to a viral or bacterial infection,” says Dr. Mason. “It is self-limiting and usually runs its course in several days to a week. The only immediate danger is the loss of fluid and electrolytes, including salt, magnesium, potassium and calcium.”

These are the nutrients that regulate many of the body’s essential processes: blood pressure, heart rate, nerve conduction and muscle movement. Without them, you run the risk of an irregular heart rhythm, low blood pressure and weak or crampy limbs.

Food Factors

Acute diarrhea may last for only a couple of days, but it can make you feel as weak and vulnerable as a kitten. Here are a few tips to get you back on your paws and in roaring good health.

Listen to your body. Diarrhea should begin to slow 24 hours after you start sipping liquids, says William B. Ruderman, M.D., practicing physician at Gastroenterology Associates of Central Florida in Orlando. When it does, start paying attention to what your body is telling you. When your body says . . . well, maybe it's a little hungry, that's the time to reintroduce food.

Go for the bland. The first foods you should reach for are bland complex carbohydrates such as noodles, white bread and applesauce, says Dr. Ruderman. Start with one-fourth of what would be a normal serving for you, then see how it goes down. If your abdomen feels comfortable and diarrhea does not resume, then increase the amount of food at your next meal.

Go easy on yourself. Gradually increase food until you're back to full portions, says Dr. Ruderman. If your abdomen feels uncomfortable at any point or if diarrhea resumes, go back to the previous levels.

Reintroduce your normal diet after you're able to consume normal kinds of foods such as whole grains, says Dr. Ruderman.

When to Seek Help

“It’s not of great concern if you can’t absorb this or that nutrient for a few days,” says Dr. Mason. But there are two prominent exceptions: the very young and the very old. Both groups—preschoolers, for example, and those over age 70—tend to feel the effects of electrolyte and fluid loss very quickly.

“Remember that between 500 and 1,000 children in the United States still die of acute diarrhea every year,” adds Dr. Mason. “And that’s largely because small children, preschool children, are very susceptible to dehydration.”

“Whenever diarrhea lasts more than 6 to 8 hours in the very young or the very old or more than 12 hours in healthy adults, you should add fluids and electrolytes to the diet,” says William B. Ruderman, M.D., practicing physician at Gastroenterology Associates of Central Florida in Orlando. The same goes for anyone who develops signs of dehydration, such as dry mouth, dry skin, decreased urination and skin that tents when pinched.

“When these symptoms occur, you can assume that levels of electrolytes and fluid need to be supplemented,” says Dr. Ruderman.

Fortunately, electrolytes are easily replaced. “Sodium and potassium losses are the most important, so you want to get sodium, potassium, fluids and a simple sugar in first,” says Dr. Ruderman. “The sugar helps your body absorb the fluids and nutrients. The easiest way to get these in our busy lives is to go to the store and buy one of those sports drinks, such as Gatorade.”

“If there’s nausea or vomiting with the diarrhea, wait until it clears,” says Dr. Ruderman. “Then begin rehydration. Start with a small amount: four ounces every hour for as long as the diarrhea lasts.” That should combat the nutritional effects of most short-term cases of diarrhea, he adds.

If diarrhea lasts for more than 12 to 24 hours in an infant or an older person, you should seek medical attention. Signals to see your doctor if you’re an otherwise healthy adult: if the diarrhea lasts for more than three days, if it is accompanied by fever or lethargy, if there is blood or pus in the stool or if any signs of dehydration continue despite efforts to replace fluid.

Prescriptions for Healing

For most people, a bout of diarrhea is not harmful. The exceptions are preschoolers and people over age 70. As a general rule, medical experts say, diarrhea lasting more than 8 hours in the very young or the very old or more than 12 hours in an otherwise healthy adult requires replacement of fluid as well as of essential nutrients known as electrolytes. Here's what these experts recommend.

Nutrient Daily Amount

Potassium and sodium 4-oz. sports drink, taken every hour for as long as diarrhea lasts (the idea is to sip constantly)

MEDICAL ALERT: If diarrhea lasts for more than 12 to 24 hours in an infant or an older person, you should seek medical help.

If you're an otherwise healthy adult, you should see your doctor if diarrhea persists for more than three days, if it is accompanied by fever or lethargy, if there is blood or pus in the stool, or if any signs of dehydration continue despite efforts to replace fluid.

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