Diarrhea: what to eat and what to avoid

To keep diarrhea under control avoiding worsening and extra discomfort, here is the right diet.

The right diet helps to keep diarrhea under control, avoiding worsening and more discomfort. Beware, however, of false myths. Let’s see the advice of nutritionists.

What is diarrhea?

The term “diarrhea” refers to an isolated disorder of defecation characterized by frequent evacuations, at least three times a day, and the production of stools with a liquid or semi-solid consistency.

It is often mistakenly used as a synonym for dysentery, which is instead the most serious form of diarrhea accompanied by the production of mucus and blood, with diarrheal discharges often painful and uncontrollable.

Types of diarrhea

Based on the frequency of the onset of symptoms, we speak of:

Based instead on the mechanism that causes the disorder we can distinguish between:

Multiple causes

It is good to know that, in none of its forms (acute, recurrent or chronic) diarrhea can be considered a real disease, but a symptom of other diseases or disorders, mostly affecting the digestive system. Therefore, to heal it is necessary to research the triggering causes and cure these.

Among the main ones we find:

• bacterial, viral or parasitic infections (such as cholera, salmonella, hepatitis)
• stress, excessive tiredness, irritability
• intestinal motor dysfunction (irritable bowel syndrome)
• intestinal inflammation (ulcerative colitis, Crohn’s disease)
• medications (antibiotics, NSAIDs, laxatives, antacids against reflux) or supplements (magnesium)
• having eaten contaminated food
• food intolerances (e.g. lactose intolerance) or allergies
• malabsorption
• intestinal flu
• endocrine causes (hyperthyroidism, diabetes)
• haemorrhoids
• liver disorders

Among the types of diarrhea caused by a bacterial infection we find the so-called “traveler’s diarrhea”, or an enteritis that can affect adults and children (in equal measure) who generally travel to countries in Southeast Asia, Africa or Central America characterized by poor hygiene standards and high temperatures.

In most cases the bacterium responsible is Escherichia coli, commonly present in the environment and in our microbiome (or bacterial flora), while less frequent are infections with Salmonella, Staphylocchi or Campylobacter.

While Escherichia coli diarrhoea is usually mild, Campylobacter diarrhoea is the most severe form. To these can be added the presence of viruses (rotavirus in particular) or parasites.

After a short incubation period, the first symptoms are:

• abdominal pain (stomach ache)
• abdominal cramps
• fever
• nausea and vomiting
• Meteorism (in some cases)
• diarrhea, characterized by a variable number of discharges devoid of mucus, pus, or blood.

If the symptoms do not tend to improve and the disorder lasts for several days, it is advisable to consult the doctor to arrive at a precise diagnosis and intervene adequately. It is essential to replenish lost fluids and follow the right drug therapy chosen according to the etiological factor, in addition to the use of antidiarrheals and antispasmodics.

The most common forms are usually short-lived, and a proper diet certainly helps to resolve this annoying symptom.

First rule: beware of liquids

The most feared danger resulting from acute diarrhea, especially when it affects young children and the elderly, is that of dehydration.

The excessive loss of fluids that follows persistent episodes of diarrhea (beyond three or four days), can cause serious disorders. So it is always necessary to drink abundantly to ensure proper rehydration.

Being irritating to the intestine, however, the following should be avoided:

• alcohol, in turn dehydrating
• drinks containing caffeine (coffee, tea, cola drinks), fruit juices or liquids rich in fructose or sorbitol (attention also to herbal teas)
• carbonated drinks.

Another trick: drink frequently and in small sips. A glass of water taken in one breath ends up dilating the walls of the intestine, which reacts by expelling what it cannot absorb. On the contrary, small amounts of liquids, even if frequent, leave time to absorb them to the intestinal mucosa.

Finally, after an episode of diarrhea you can easily experience a deficiency of mineral salts. To overcome this problem you can take multivitamin and multimineral supplements.

The foods to bring to the table, those to avoid

Fortunately, the foods that can be eaten without particular problems are many, so as to allow a varied and tasty diet. Here they are:

• toasted white bread, white bread without crumbs, rusks
• white flour pasta 00, rice, semolina
• lean meat (beef, poultry, veal)
• boiled or grilled fish
• fresh, unfermented cheeses (crescenza, mozzarella, robiola)
• poached or hard-boiled eggs
• bresaola, defatted ham (cooked or raw)
• carrots, lettuce, potatoes, spinach (better cooked vegetables)
• apricots, pineapple, banana, lemon, apples, peaches, grapefruit.

As for condiments, it is best to use extra virgin olive oil added raw and in moderation.

On the other hand, all foods rich in crude vegetable fiber and waste are generally not recommended, as they accelerate the transit and emptying of the intestine. So it is good to avoid:

• wholemeal bread, white bread crumbs
• foods based on whole wheat flours
• raw vegetables and vegetables: broccoli, artichokes, cabbage, chickpeas, turnip greens, onion, beans, broad beans, lentils, peas, radishes, celery.

For different reasons, even foods that are too fatty or too fermented, fried foods, creams, aromas that are too irritating are to be avoided:

• fermented cheeses
• spicy cured meats and sausages
• lard, bacon, lard
• fried eggs and fried eggs in general
• foods based on spicy sauces, mustard, mustard, spices.
• avocado, persimmons, coconut, dates, strawberries, figs, dried fruit, raspberries, almonds, blackberries, hazelnuts, walnuts, pine nuts, pears, plums, currants, grapes
• too elaborate sweets based on creams, and chocolate.

Some truths and false myths

Eating “white”

If by white diet you mean chicken broth, butter pasta, and maybe a nice glass of milk, you can certainly not think of improving diarrhea.

If, on the other hand, you eat boiled white rice very cooked (and not too drained) so you release the starch that has astringent functions, white meats (veal, chicken or turkey) steamed, boiled carrots and season everything with a little raw oil, a pinch of salt and plenty of lemon juice, the diet will be a sure help against diarrhea.

Lemon tea

What about the famous “nice cup of hot tea with lemon”? As for tea, it is better to let it go: as we have seen, it can irritate the intestinal walls; As for the “hot” heat would be added to the intestinal inflammation already present.

The only thing that can be saved is lemon juice, which can actually have regulatory activities of intestinal functions.

Probiotics

Another controversial issue concerns some milk derivatives based on probiotics, therefore containing bacteria and lactic acid bacteria beneficial for intestinal functions and immune defenses or fresh yogurts containing live bacteria.

There are those who claim they are a panacea and those who, instead, say the opposite. To avoid mistakes, at least in the acute phases of diarrhea, milk, fresh dairy products, including probiotics, should be avoided. You can take them again after the intestinal irritation has been resolved.

To treat diarrhea there are several natural remedies. Find out what they are by reading the article Nature that helps stomach and intestines.

Remedies for diarrhea: if and when to resort to medication

Most of the time, diarrhea resolves spontaneously within a few days. It is essential to replenish lost fluids with an abundant intake of water, sweetened tea, fruit juices, herbal teas, lemon juice and possibly preparations rich in mineral salts.

It also contributes to healing by eliminating some foods and preferring others.

In case of acute diarrhea or during prolonged antibiotic treatments, the intake of lactic ferments, or more correctly probiotics, which help to restore a normal intestinal bacterial flora, may be beneficial.

As for pharmacological remedies for diarrhea, the intake of antidiarrheal and antispasmodic drugs should be practiced under medical supervision. A belief to be discredited is in fact that it is good to stop diarrhea as soon as possible by taking antidiarrheals at the first symptom.

Antidiarrheal medications can help reduce diarrhea. However, these drugs do not intervene on the causes of diarrhea, but attenuate the symptom and act by blocking the motility of the intestine, thus also hindering the rapid elimination of bacteria and toxins. Also, unless they are prescribed by the attending physician, they should not be taken if fever is present or if blood or mucus appear in the stool and, in most cases, should not be used in children.

In addition, since it is often an infection, many think to solve everything quickly with an antibiotic. Nothing could be further from the truth. Diarrhea often occurs precisely to eliminate pathogenic microorganisms that have affected the intestine.

And in addition, antibiotics, sweeping away all the microorganisms present in the intestine, upset the physiological balance of the intestinal microenvironment, aggravating the situation.

This does not mean that antibiotics are always poorly indicated: in the case of serious infections, in which the responsible bacterium has been clearly identified, the doctor can certainly decide to prescribe the appropriate drug.

Painkillers don’t cure diarrhea, but they can help relieve the fever and headache that sometimes accompany it.

In some cases, for example if diarrhoea has led to considerable dehydration, hospitalisation may be necessary.

If a specific disease causes diarrhea, it is necessary to act on the triggering cause with targeted therapies.

What to do on the road to avoid diarrhea