The best approach for most cases of diarrhea is replacing lost fluids with the right balance of water, salt, and a small amount of sugar, while letting the illness run its short course. For faster relief, an over-the-counter antimotility medication like loperamide (Imodium) reduces stool frequency more effectively than other options. But the type of diarrhea matters: some cases call for different treatments, and others require you to avoid certain remedies entirely.
Fluid Replacement Comes First
Dehydration is the real danger with diarrhea, not the diarrhea itself. Your body loses water and essential minerals (sodium, potassium, chloride) with every loose stool, and replacing them is the single most important thing you can do. An oral rehydration solution, available at any pharmacy, contains a precise ratio of glucose and sodium that helps your intestines absorb water efficiently.
If you don’t have a rehydration solution on hand, you can sip clear broths, diluted sports drinks, or water with a pinch of salt. What you drink matters just as much as how much you drink, because some common beverages actually make diarrhea worse. Your intestinal lining works like a filter: when a drink has far more sugar than your body can absorb at once, water gets pulled into the gut to dilute it, increasing the volume and frequency of loose stools. Prune juice is the worst offender, with an osmolarity (a measure of dissolved particles) of roughly 1,265, about five times higher than what your intestines handle well. Apple juice comes in around 680, and regular colas range from 550 to 700. All of these can worsen symptoms. Stick with low-sugar, lightly salted fluids until you’re feeling better.
Over-the-Counter Medications
Two widely available medications target diarrhea in different ways. Loperamide (sold as Imodium) slows the muscle contractions in your intestines, giving your body more time to absorb water from stool. Bismuth subsalicylate (Pepto-Bismol) has a milder effect, coating the gut lining and reducing inflammation. In a head-to-head comparison at standard doses, loperamide significantly reduced the number of unformed bowel movements compared to bismuth subsalicylate. If your goal is to get relief quickly, loperamide is the stronger option.
There is one critical caveat: loperamide should not be used when diarrhea comes with blood in the stool or a high fever. These signs suggest an invasive bacterial infection (from organisms like Salmonella, Shigella, or Campylobacter), and slowing your gut in that situation can trap the pathogen inside, potentially leading to dangerous complications like toxic megacolon. Loperamide is also not recommended for children under two years old. If you see blood or have a fever above 102°F (39°C), skip the Imodium and focus on fluids while seeking medical advice.
What to Eat During Diarrhea
You don’t need to stop eating. In fact, continuing to eat helps your intestinal lining recover faster. The old “BRAT diet” (bananas, rice, applesauce, toast) is no longer officially recommended as a strict protocol because it’s too nutritionally limited, but the principle behind it still holds: bland, low-fiber, easy-to-digest foods are gentler on an irritated gut. White rice, plain crackers, boiled potatoes, lean chicken, and bananas are all good choices.
Avoid dairy products if you notice they make things worse. During a bout of diarrhea, the cells lining your small intestine can temporarily lose their ability to break down lactose, the sugar in milk. Fatty and heavily spiced foods can also speed up gut contractions and worsen symptoms. Reintroduce your normal diet gradually over two to three days as stools firm up.
Probiotics That Actually Help
Not all probiotics are useful for diarrhea, but one strain has solid evidence behind it. Lactobacillus rhamnosus GG reduced the average duration of acute diarrhea by nearly 19 hours in a clinical trial comparing it to standard treatment alone. That’s close to cutting a full day off the illness. Saccharomyces boulardii, another widely marketed probiotic, did not show a statistically significant reduction in the same study. If you’re going to try a probiotic, look specifically for products containing L. rhamnosus GG.
Traveler’s Diarrhea
Diarrhea that strikes during international travel is usually caused by bacteria picked up from contaminated food or water. For mild cases that don’t interfere with your plans, antibiotics aren’t recommended. For moderate cases that disrupt your day, or severe cases that leave you incapacitated, the CDC considers antibiotics appropriate. Azithromycin is the preferred first-line option, particularly in Southeast Asia where resistance to other antibiotics is common. It’s also the go-to choice if you develop dysentery (bloody diarrhea with fever).
If you’re planning travel to a high-risk region, ask your doctor about carrying a standby antibiotic before you leave. A single dose can resolve many cases within 24 hours, though treatment may continue for up to three days if symptoms persist.
Diarrhea in Children
Children dehydrate faster than adults, so fluid replacement is even more urgent. Pedialyte or a similar pediatric oral rehydration solution is the best choice. The World Health Organization recommends zinc supplementation for children with acute diarrhea: 20 mg per day for 10 to 14 days, or 10 mg per day for infants under six months. Zinc shortens the duration of the episode and reduces the likelihood of recurrence over the following two to three months.
Watch for warning signs that a child needs medical attention: no wet diaper for three or more hours, a sunken appearance around the eyes or cheeks, skin that stays “tented” when you pinch and release it, unusual drowsiness or irritability, fever above 102°F, or blood in the stool. In children, diarrhea that doesn’t improve within 24 hours also warrants a call to the pediatrician.
Signs of a More Serious Problem
Most diarrhea in adults resolves on its own within two to three days. If yours lasts longer than two days with no improvement, something beyond a routine stomach bug may be going on. Other red flags for adults include signs of dehydration (excessive thirst, dark urine, dizziness, dry mouth), severe abdominal or rectal pain, bloody or black stools, a fever over 102°F, or more than 10 bowel movements in a single day. Any of these warrant medical evaluation rather than continued home treatment.