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Diarrhea: The Ultimate Checklist For Beautiful Bowel Movements

Researched and Written by:
Jenna Swift, APD Dietitian Jenna Swift, APD Dietitian

 

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Table of Contents

  • Effectiveness Rating +++++
  • 1. Bland is Better

    +++++

    Bland foods are easier for your body to digest and allow your gastrointestinal tract to rest.  They are less acidic and promote fewer bowel movements, which is ideal when you are suffering from acute diarrhea. Often these foods come under the umbrella of a “low residue diet” or “BRAT diet” and include bananas, white rice, white crackers, white bread, clear broth and strained fresh fruit juice.

    Tip: Think of the ‘Bland Diet’ as being opposite to a high fibre diet. Since the aim is to reduce bowel movements you need to eliminate foods that irritate the bowel and are unable to be completely digested. This diet is a temporary plan that should be followed for no more than a week before reintroducing fiber back into the diet.

    Rehydration Therapy

    +++++

    Water alone does not replace electrolytes that are lost through diarrhea. Formulated drinks containing these mineral salts are the key to replenishing both fluids and electrolytes. Pedialyte and Hydalyte are examples of commercially available oral rehydration solutions (ORS). Despite being used interchangeably with sports drinks like Gatorade; ORS are more effective at providing relief compared because of higher concentrations of electrolytes and less sugar which can worsen diarrhea. With that being said some glucose is important, as research has shown that glucose sugar stimulates the absorption of sodium and fluid in the small intestine (i.e. equals less loss through diarrhea).

    Tip: Powdered ORS have better compliance with the recommended osmolality compared with pre-mixed products.  Investigations have found that many commercially available pre-mixed versions do not meet the recommended osmolality guidelines.

    Clear Fluids

    ++++

    Following a clear liquid diet is a short term measure that gives your digestive system a rest from  gastrointestinal upset. It includes any liquid that you can see through at room temperature such as water, broths, clear soup, fruit juice without pulp (apple juice, cranberry juice), tea and coffee without milk or cream and icy poles made from clear liquids.

    Tip: Clear fluids are not nutritionally complete. Meaning that while they provide you with fluid, salt, sugar and some nutrients; they lack the nutrients to meet your dietary needs.The clear liquid diet is only intended to be followed for no more than five days. 

    Limit High Fat Foods

    +++++

    It is a good idea to avoid foods that are high in fat; particularly fried foods as they can exacerbate existing diarrhea. 

    Tip: Reduce fat by choosing lean meats, poultry and fish. Try baking, steaming and stir-frying instead of deep-fried foods. 

    Smaller Meals More Frequently

    +++++

    Instead of three large meals, try eating 5-6 small meals. Smaller servings of food are easier to digest, while still delivering important nutrients for your body. 

    Tip: Try swapping to smaller plates and bowls will prevent you from filling your plate. 

    Symptom Diary

    +++

    Keeping a symptom diary can help you identify possible triggers for your diarrhea. This can be crucial in understanding the underlying cause of your diarrhea; particularly for people that suffer from intermittent bouts of diarrhea or episodes lasting longer than 3 days.

    Tip: Record your bowel movements for a minimum of 2-weeks. Some important details to include in your personal diary include; 

    -> The date and time of each bowel movement to assess stool frequency

    -> Use the Bristol Stool chart to describe the consistency of each bowel movement

    -> Note any associated symptoms such as abdominal pain, bloating, gas and incomplete bowel movements. 

    -> You can take it one step further and add in all foods and fluids consumed if you suspect a dietary trigger. 

    Herbal Teas

    ++++

    Herbal teas are more than just a refreshing twist on regular black tea. When consumed as part of a balanced diet, they can enhance your overall health status. This is because they are a rich source of bioactive compounds that render a number of positive effects in the body such as; anti-inflammatory, antibacterial, antiviral, antioxidant and anti-aging effects. The best herbal teas for relieving diarrhea include; 

    • Chamomile Tea:  soothing effect on the digestive tract and reduces excessive bowel motility
    • Ginger Tea:  relieves nausea and abdominal pain
    • Peppermint Tea: reduces severity and frequency of abdominal pain while relaxing digestive muscles
    • Fennel Tea: anti-inflammatory effects help to soothe digestive muscles and reduce cramping. Regular consumption may prevent the onset of diarrhea.

    Tip: Get the maximum benefit from your cuppa by choosing loose leaf tea over tea bags. Not only is it better for the environment, but loose-leaf also is of better quality and comes without the added chemicals coated on teabags.


    Probiotics

    +++

    Probiotics can help shorten the duration of diarrhea and reduce stool frequency. The specific strain will depend on the type of diarrhea. 

     

    Infectious Diarrhea

    • Data supports the use of these probiotics in treatment, however their benefit in preventing infectious diarrhea is modest 

    L. rhamnosus GG (LGG) 

    L. reuteri

    L. casei

    Antibiotic Associated Diarrhea

    • Research supports these strains for prevention, not treatment of AAD

    L. rhamnosus GG (LGG) 

    S. Boulardii


    Stress Relief ++++

    The gut is commonly referred to as the “second brain”. This is because it has its own nervous system called the enteric nervous system made up of millions of nerve cells. 

    Stress can induce a flare up of gastrointestinal symptoms like diarrhea. This is particularly the case for people with irritable bowel syndrome, depression, anxiety and other mental health conditions. It only makes sense that treatment should focus on managing stress and underlying triggers to prevent stress-induced diarrhea. 

    Tip: Calm the mind by including some relaxation techniques into your daily routine;

    -> Deep belly breathing for 5-10 minutes

    -> Practice mindful meditation and the art of learning to be still

    -> Exercise regularly to get those endorphins flowing 

    -> Externalise your thoughts on paper by keeping a journal

    -> Engage an expert in psychology and mental health 


    Drop Dairy ++++

    Diarrhea can reduce the activity of digestive enzymes in your gastrointestinal tract. Lactase for example, is the enzyme needed to digest lactose in dairy foods. Even if you don’t have lactose intolerance (lactase deficiency), you may still experience trouble digesting foods like cheese, cream, ice-cream and milk. When you are unable to break down and absorb lactose it produces an osmotic effect and draws water into the large bowel which will worsen diarrhea.  

    Tip: Fermented dairy in the form of yoghurt and kefir may be easier to tolerate. This is because the natural bacteria present in these foods use up the lactose for energy. Reintroduce dairy back into your diet slowly after 24-48 hours and monitor your symptoms. 


    Over the Counter Medications +++

    Loperamide (brand name: Imodium) is a medication that slows down the movement of food through the gut and reduces diarrhea. It takes effect quickly after approximately 1-hour; but it is only intended for short-term relief. Frequent excessive dosing can increase the risk of life threatening cardiac arrhythmias and respiratory depression. When taken in high doses it produces similar effects to opioids which can lead to dependence. 

    Tip: Anti-diarrhea medication comes in handy for emergency toilet situations; particularly when travelling. Traveler’s diarrhea is more likely to occur when visiting developing countries. Therefore it is recommended to avoid contaminated food and drinking water to lower the risk of coming into contact with diarrhea causing pathogens. Packing anti-diarrhea medication in your suitcase will further give you reassurance.

    Evidence Based

    An evidence hierarchy is followed to ensure conclusions are formed off of the most up-to-date and well-designed studies available. We aim to reference studies conducted within the past five years when possible.

    • Systematic review or meta-analysis of randomized controlled trials
    • Randomized controlled trials
    • Controlled trials without randomization
    • Case-control (retrospective) and cohort (prospective) studies
    • A systematic review of descriptive, qualitative, or mixed-method studies
    • A single descriptive, qualitative, or mixed-method study
    • Studies without controls, case reports, and case series
    • Animal research
    • In vitro research

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    References

    1. Sollanek K, Kenefick R, Cheuvront S. Osmolality of Commercially Available Oral Rehydration Solutions: Impact of Brand, Storage Time, and Temperature. Nutrients. 2019;11(7):1485. doi:10.3390/nu11071485
    2. Rosa K, Delgado-Herrera L, Zeiher B et al. Psychometric assessment of the IBS-D Daily Symptom Diary and Symptom Event Log. Quality of Life Research. 2016;25(12):3197-3208. doi:10.1007/s11136-016-1335-1
    3. Chandrasekara A, Shahidi F. Herbal beverages: Bioactive compounds and their role in disease risk reduction - A review. J Tradit Complement Med. 2018;8(4):451-458. doi:10.1016/j.jtcme.2017.08.006