Most cases of upset stomach and diarrhea resolve on their own within a few days, but the right combination of fluids, food choices, and over-the-counter options can shorten your misery and prevent complications like dehydration. Acute diarrhea typically lasts less than a week. What you do in those first 24 to 48 hours matters most.
Fluids Come First
Diarrhea pulls water and electrolytes out of your body fast. Replacing them is the single most important thing you can do. Plain water helps, but it doesn’t replace the sodium and potassium you’re losing. Oral rehydration solutions, available at any pharmacy, contain a balanced mix of glucose, sodium, and other electrolytes designed to be absorbed quickly even when your gut is inflamed. These are the same formulations the World Health Organization recommends for treating dehydration worldwide.
If you don’t have a commercial rehydration solution on hand, clear broths and diluted fruit juices can fill the gap. Avoid sugary sodas and energy drinks. High concentrations of simple sugars like fructose can actually pull more water into the intestine and make diarrhea worse. Sports drinks are better than soda but contain more sugar and less sodium than a true rehydration solution. Sip small amounts frequently rather than gulping large volumes, especially if nausea is part of the picture.
What to Eat (and What to Skip)
You’ve probably heard of the BRAT diet: bananas, rice, applesauce, and toast. It’s a reasonable starting point for the first day or two because those foods are soft, bland, and low in fiber, which puts less demand on an irritated digestive tract. But the BRAT diet is no longer the go-to recommendation it once was. It lacks protein, calcium, vitamin B12, and fiber, and following it for more than a day or two can actually slow recovery, particularly in children. The American Academy of Pediatrics considers it too restrictive for kids.
A better approach: eat as tolerated, choosing soft, bland foods and expanding your diet as symptoms improve. Cooked vegetables, lean chicken, eggs, oatmeal, and plain crackers are all reasonable options. The goal is to give your gut easy-to-digest fuel without starving it of the nutrients it needs to repair itself.
Certain foods and ingredients reliably make things worse during a bout of diarrhea. The National Institute of Diabetes and Digestive and Kidney Diseases specifically flags these:
- Lactose. Milk and dairy products can be hard to digest even if you’re not normally lactose intolerant. Some people have trouble with lactose for a month or more after an acute episode.
- Fructose. Found in sweetened beverages, fruit juices, candy, and packaged desserts.
- Sugar alcohols. Sorbitol and other sugar alcohols hide in sugar-free gum, candies, and “diet” snacks. They’re poorly absorbed and draw water into the intestine.
- Greasy or spicy foods. Both can stimulate intestinal contractions and worsen cramping.
- Caffeine and alcohol. Both increase gut motility and can worsen dehydration.
Over-the-Counter Medications
Two widely available medications target diarrhea directly. Loperamide (the active ingredient in Imodide) slows intestinal contractions, giving your gut more time to absorb water. The standard adult dose is two capsules (4 mg) after the first loose stool, then one capsule (2 mg) after each subsequent loose stool, up to a maximum of eight capsules in 24 hours. It should not be used in children under two years old.
Bismuth subsalicylate (the active ingredient in Pepto-Bismol) works differently. It has mild anti-inflammatory and antimicrobial properties and can help with both nausea and diarrhea. It’s a reasonable first choice when your stomach feels sour and crampy on top of loose stools. One thing to know: it can temporarily turn your tongue and stool black, which is harmless but startling if you’re not expecting it.
Neither medication should be used if you have a high fever or bloody stools, which can signal a bacterial infection that needs different treatment.
Peppermint Oil for Cramping
If stomach cramping is a major part of your discomfort, enteric-coated peppermint oil capsules are worth considering. In a controlled trial of 110 patients, 79% of those taking peppermint oil capsules experienced reduced abdominal pain, and 83% had less bloating and lower stool frequency, compared to roughly 30 to 40% improvement with placebo. The enteric coating is important: it protects the capsule from dissolving in the stomach, which can cause heartburn, and delivers the oil to the intestine where it relaxes smooth muscle. Take capsules 15 to 30 minutes before meals.
Ginger for Nausea
Ginger has a long reputation as a nausea remedy, and there’s some physiological basis for it. Research shows ginger speeds up gastric emptying and increases contractions in the lower stomach, which can help when food feels like it’s sitting in your gut like a brick. It may also interact with serotonin receptors involved in the nausea reflex. That said, the evidence is stronger for motion sickness and pregnancy-related nausea than for stomach-bug nausea. Ginger tea, ginger chews, or capsules containing around 1 gram of ginger are common doses. It’s unlikely to hurt and may take the edge off.
Probiotics Can Shorten Recovery
Certain probiotic strains can reduce the duration of acute diarrhea by about a day. A large meta-analysis of randomized trials found that Saccharomyces boulardii shortened diarrhea by roughly 1.25 days compared to no treatment, while Lactobacillus reuteri reduced it by about 0.84 days. Combination products containing Lactobacillus, Bifidobacterium, and Saccharomyces species also showed benefit, cutting duration by just over a day. Look for products that list specific strain names on the label, not just genus and species, since effectiveness varies by strain.
Probiotics are most helpful when started early in the course of diarrhea. They work by competing with harmful bacteria for space in the gut and by supporting the intestinal lining’s barrier function. They won’t stop diarrhea in its tracks, but they can meaningfully speed up the tail end of recovery.
Signs That Need Medical Attention
Most upset stomachs and diarrhea episodes are self-limiting, but certain signs indicate something more serious. Seek care if you notice blood or pus in your stool, a fever above 102°F (39°C), signs of significant dehydration (dark urine, dizziness when standing, dry mouth, or skin that stays tented when pinched), or if symptoms persist beyond two weeks. In young children, watch for lethargy, inability to drink fluids, or no wet diapers for several hours.
Diarrhea lasting two to four weeks is classified as persistent, and anything beyond four weeks is chronic. Persistent or chronic diarrhea often points to an underlying condition like food intolerance, celiac disease, or irritable bowel syndrome, and warrants investigation beyond home remedies.