The single best thing for diarrhea is staying hydrated, because the real danger isn’t the diarrhea itself but the fluid and electrolytes you lose with it. Beyond that, the right combination of fluids, food choices, and over-the-counter options depends on what’s causing your symptoms and how severe they are.
Fluids and Electrolytes Come First
Every loose stool pulls water, sodium, and potassium out of your body. Replacing those losses is more important than stopping the diarrhea. Water alone isn’t ideal because it doesn’t contain electrolytes. Oral rehydration solutions (sold as Pedialyte or store-brand equivalents) provide the right balance of salt, sugar, and water to maximize absorption. For adults with mild symptoms, broth, diluted juice, or sports drinks can also work, though they’re less precise.
You can gauge your hydration by watching your urine. If you’re producing very little, or it’s dark yellow, you need more fluid. Other signs of worsening dehydration include dry lips, no tears when crying (in children), and skin that stays “tented” when you pinch it rather than snapping back. Skin that’s slow to return to normal suggests moderate to severe fluid loss, which may need medical attention.
Eat Normally, Just Choose Carefully
You may have heard of the BRAT diet: bananas, rice, applesauce, and toast. It’s been a go-to recommendation for decades, but no clinical trials have ever tested whether it actually works. In fact, nutrition experts now consider the old “rest your gut” approach outdated. Randomized trials show that eating a normal diet soon after rehydration leads to lower stool output, shorter illness, and better nutritional recovery compared to gradually reintroducing food.
That doesn’t mean you should eat anything. The goal is to avoid foods that are likely to make things worse while still getting enough calories and nutrients. Skip greasy, high-fat meals, very sugary foods, caffeine, alcohol, and dairy if you notice it worsens your symptoms. Sticking to a restrictive diet like BRAT for more than a day or two can actually impair recovery and, in children especially, contribute to malnutrition. Plain rice, lean proteins, cooked vegetables, and bread are all fine, but so is most of what you’d normally eat.
Over-the-Counter Options That Help
Two main types of medication are available without a prescription, and they work in different ways.
Loperamide (sold as Imodium) slows your intestines down and helps them reabsorb fluid that would otherwise end up in your stool. It works through receptors in the gut wall, essentially telling your intestines to hold on to water and move contents more slowly. It’s effective for run-of-the-mill diarrhea from food triggers, stress, or mild stomach bugs. Don’t use it if you have a high fever or bloody stools, because in those cases your body may be trying to flush out a harmful infection.
Bismuth subsalicylate (the active ingredient in Pepto-Bismol) reduces inflammation in the gut lining and has mild antimicrobial effects. It’s particularly useful for nausea that accompanies diarrhea. However, it contains a compound closely related to aspirin, so it should not be given to children under 12. Children and teenagers recovering from the flu or chickenpox should avoid it entirely due to the risk of Reye’s syndrome, a rare but serious condition. Older adults and anyone already taking aspirin or similar medications should be cautious about stacking salicylate products.
Probiotics Can Shorten Recovery
Certain probiotic strains help your gut flora fight back against whatever’s disrupting it. The most studied strain for diarrhea is Lactobacillus rhamnosus GG, which reduced the average duration of acute diarrhea by about 19 hours in a head-to-head clinical trial. Another commonly recommended strain, Saccharomyces boulardii (a beneficial yeast), is widely used but showed a less significant reduction in that same trial.
Probiotics aren’t a quick fix. They work best when started early in the course of illness, and their benefit is modest: roughly shaving a day off your symptoms rather than stopping them immediately. Look for products that name specific strains on the label rather than vague “probiotic blend” claims.
When Diarrhea Needs an Antibiotic
Most diarrhea is caused by viruses and clears up on its own within a few days. Antibiotics do nothing for viral infections. They’re reserved for bacterial causes, particularly traveler’s diarrhea or cases with fever and bloody stools.
The CDC matches antibiotic use to severity. Mild diarrhea that doesn’t interfere with your day doesn’t warrant antibiotics at all. Moderate cases, where symptoms are disruptive, may benefit from treatment. Severe diarrhea that leaves you unable to function, or any episode with bloody stools, is where antibiotics are most clearly recommended. Azithromycin is the preferred choice for severe or dysenteric cases, especially in regions like Southeast Asia where other common antibiotics face resistance. These are prescription medications, so they require a healthcare provider’s involvement.
Zinc for Children
For children with diarrhea, zinc supplementation is an evidence-based intervention recommended by the World Health Organization. The standard recommendation is 20 mg per day for 10 to 14 days, or 10 mg per day for infants under six months. Zinc helps restore the intestinal lining and supports immune function during the illness. This is primarily relevant in settings where zinc deficiency is common, but it’s a safe and inexpensive addition to oral rehydration for any child with acute diarrhea.
Signs That Need Medical Attention
Most bouts of diarrhea resolve within two to three days. Certain warning signs suggest something more serious is happening. Blood or mucus in your stool, a fever above 102°F (39°C), symptoms lasting more than three days without improvement, or signs of significant dehydration (very little urine, dizziness when standing, rapid heartbeat, skin that stays pinched) all warrant a call to your doctor. In infants and young children, dehydration can progress quickly, so a child who seems unusually sleepy, has a dry mouth, or produces fewer wet diapers than normal should be evaluated promptly.