Most cases of diarrhea resolve on their own within a few days, and the single most important thing you can do is replace the fluid you’re losing. Beyond hydration, a few straightforward steps, from adjusting what you eat to knowing when over-the-counter medication helps, can shorten your discomfort and prevent complications.
Start Replacing Fluids Immediately
Dehydration is the real danger with diarrhea, not the diarrhea itself. Every loose stool pulls water and essential salts out of your body, and if you don’t replace them, you can progress from mild dehydration (about 5% of body weight lost as fluid) to moderate or severe levels surprisingly fast, especially in hot weather or if you’re also vomiting.
Water alone isn’t ideal because it doesn’t replace the sodium and potassium you’re losing. The World Health Organization’s oral rehydration solution is simple to make at home: dissolve half a teaspoon of salt and two tablespoons of sugar into roughly one liter of water. The sugar helps your intestines absorb the salt and water more efficiently. Sip it steadily rather than gulping large amounts at once, which can trigger nausea.
If you don’t want to mix your own, clear broths, diluted fruit juices, and electrolyte drinks all work. The goal is to keep your urine a pale yellow. Dark urine, dry mouth, dizziness when standing, and skin that stays “tented” when you pinch it instead of snapping back quickly are all signs you’re falling behind on fluids.
What to Eat (and What to Skip)
You may have heard of the BRAT diet (bananas, rice, applesauce, toast), but most experts no longer recommend a heavily restricted diet for acute diarrhea. The National Institute of Diabetes and Digestive and Kidney Diseases advises returning to your normal diet as soon as you feel ready to eat. Restricting yourself to a handful of bland foods for days can actually slow recovery by depriving your gut of the nutrients it needs to heal.
That said, certain foods and drinks reliably make diarrhea worse and are worth avoiding until things settle down:
- Caffeine speeds up your digestive system, which is already moving too fast.
- Dairy products can be hard to digest during and even for a month after a bout of diarrhea, because the infection temporarily reduces your ability to break down lactose.
- Fried and high-fat foods pass through to the colon undigested, where fatty acids trigger the colon to secrete more fluid.
- Sugary drinks, candy, and fruit juices high in fructose pull extra water into the gut. Consuming more than 40 to 80 grams of fructose per day can cause diarrhea even in healthy people.
- Sugar-free gum and candy contain sugar alcohols like sorbitol, mannitol, and xylitol, which are poorly digested and ferment in the gut, worsening loose stools.
- Alcohol irritates the gut lining and increases fluid loss.
- Spicy foods often contain hidden fat, and capsaicin can cause burning on the way out.
Stick with whatever plain, familiar foods appeal to you: rice, potatoes, chicken, eggs, oatmeal, crackers. Eat small amounts frequently rather than large meals.
Over-the-Counter Medications
Loperamide (sold as Imodium) works by slowing the muscular contractions of your intestines, giving your body more time to absorb water from stool. The standard adult dose is two caplets after the first loose bowel movement, then one caplet after each subsequent episode, up to a maximum of four tablets in 24 hours for the over-the-counter version. It’s effective for reducing the frequency and urgency of trips to the bathroom, but it doesn’t treat whatever is causing the diarrhea.
Bismuth subsalicylate (Pepto-Bismol) takes a different approach: it reduces inflammation and the amount of fluid your intestines secrete. It can also help with nausea and cramping. Don’t be alarmed if it turns your tongue or stool black; that’s a harmless chemical reaction.
One important caution: avoid these medications if you have a high fever or bloody stools. In those cases, your body may be fighting off a bacterial infection, and slowing your gut down can trap the pathogen inside longer.
Do Probiotics Help?
There’s reasonable evidence that probiotics can shorten a bout of diarrhea, though they work better as prevention than as treatment once symptoms have started. A large meta-analysis published in The Lancet Infectious Diseases found that probiotics reduced the risk of antibiotic-associated diarrhea by 52% and acute diarrhea from various causes by 34%. The benefit was stronger in children (57% risk reduction) than in adults (26%).
Multiple strains appear to be effective, and no single strain has proven clearly superior. If you want to try probiotics during or after a diarrheal illness, yogurt with live cultures or a supplement from a reputable brand are both reasonable options. They’re unlikely to make things worse, even if the benefit for an individual episode turns out to be modest.
Preventing Spread at Home
Many causes of acute diarrhea are contagious, especially viral gastroenteritis. Wash your hands with soap and warm water for at least 20 seconds after every trip to the bathroom and before touching food. Alcohol-based hand sanitizers are less effective against some of the viruses that cause diarrhea (notably norovirus), so soap and water is the better choice here.
Clean and disinfect bathroom surfaces, toilet handles, and faucets at least daily and immediately after any visible contamination. If you’re caring for a child with diarrhea, sanitize changing areas after each use. Keep towels separate and wash soiled laundry promptly on a hot cycle.
Warning Signs That Need Medical Attention
Most diarrhea clears up within two to three days. Certain symptoms signal something more serious is happening:
- Duration beyond two days in adults or beyond 24 hours in young children
- Fever of 102°F (38.9°C) or higher
- Blood or pus in the stool
- Black, tarry stools (which can indicate bleeding higher in the digestive tract)
- Severe abdominal or rectal pain
- Signs of significant dehydration: no urination for several hours, sunken eyes, rapid heartbeat, confusion, or skin that stays tented when pinched
Children, older adults, and people with weakened immune systems are at higher risk for dangerous dehydration and should be monitored more closely. If an infant has fewer wet diapers than usual or seems unusually lethargic, that warrants prompt evaluation.