Diarrhoea means loose or watery stools at least three times a day, or much more often than is normal for a particular person. It can start suddenly and pass within a few days, but frequent or long-lasting diarrhoea can also be a sign of an infection, a side effect of medication or a digestive disease.
The main risk during diarrhoea is the loss of fluid and electrolytes. So the most important thing is not to stop the bowel movements as quickly as possible, but to prevent dehydration and to notice in time the symptoms that need a doctor’s help.
What most often causes diarrhoea?
Acute diarrhoea is most often caused by a viral or bacterial infection. It may be linked to contaminated food, water or contact with someone who is ill. At the same time there may be nausea, vomiting, abdominal pain, weakness and a raised temperature.
Other possible causes of diarrhoea include:
- taking antibiotics or other medicines;
- food intolerance;
- too much alcohol or caffeine;
- artificial sweeteners, such as sorbitol;
- stress and emotional tension;
- irritable bowel syndrome;
- coeliac disease;
- Crohn’s disease or ulcerative colitis;
- pancreatic diseases;
- an overactive thyroid;
- a bowel infection after travelling.
If diarrhoea regularly starts after a particular food or meal, it helps to write down what you ate and how quickly the symptoms appeared. However, you should not cut several food groups out of your diet on your own for a long time before the cause of your symptoms has been found.
What to do if you have diarrhoea?
The first task is to replace the lost fluid and electrolytes. The best option is an oral rehydration solution from the pharmacy, which contains water, salts and glucose in the right proportions.
Drink fluids often and in small amounts. If you also feel sick or are vomiting, it is better to take a few sips every few minutes than to drink a large amount at once.
During diarrhoea you can drink:
- oral rehydration solution;
- water;
- light broth;
- unsweetened tea;
- other drinks without alcohol or a lot of sugar.
Very sweet drinks, juices and soft drinks can make diarrhoea worse. Coffee, energy drinks and alcohol can also stimulate the bowel and increase fluid loss.
If you have heart or kidney disease and have been told to limit your fluid intake, ask your doctor how much fluid is right for you.
What to eat when you have diarrhoea?
There is no need to fast for a long time when you have diarrhoea. As soon as you have an appetite and can keep food down without vomiting, you can start eating small, easily digestible meals again.
Usually better tolerated are:
- rice and pasta;
- boiled potatoes without skin;
- white bread or toast;
- oat or rice porridge;
- bananas;
- cooked carrots;
- lean chicken or fish;
- eggs;
- light broth;
- dry biscuits without much fat or sugar.
There is no single compulsory diet that suits everyone with diarrhoea. If a food makes your symptoms worse, you can avoid it for a while. As you feel better, gradually return to your usual, balanced diet.
What is better not to eat during diarrhoea?
While stools are frequent or watery, it is best to limit:
- fatty and fried foods;
- very spicy foods;
- alcohol;
- coffee and energy drinks;
- very sweet drinks and sweets;
- products with sorbitol and other sugar alcohols;
- large amounts of bran, pulses, nuts and raw vegetables.
After an acute bowel infection, the ability to break down lactose is sometimes temporarily reduced. If milk makes bloating and diarrhoea worse, you can limit it for a few days. This does not mean that dairy products have to be cut out of your diet completely.
What helps with diarrhoea?
The most important remedy for diarrhoea is the right intake of fluid and electrolytes. Medicines can ease the symptoms, but they are not suitable in every situation, because treatment depends on the cause of the diarrhoea, how long it has lasted, the patient’s age and any other symptoms.
Recovery is helped by:
- drinking fluids regularly;
- oral rehydration solution;
- small, easily digestible meals;
- limiting alcohol and caffeine;
- washing your hands with soap;
- rest;
- seeing a doctor in good time if the symptoms do not go away.
If the diarrhoea is caused by an infection, careful hand washing after using the toilet and before preparing food helps protect other family members.
Medicines for diarrhoea in adults
There is no single “best medicine for diarrhoea” that suits everyone. In adults, loperamide, which slows down the bowel, is sometimes used to ease short-term diarrhoea. Before taking it, read the patient leaflet carefully and stick to the stated dose.
Loperamide should not be used if:
- the diarrhoea contains blood;
- you have a high temperature;
- you have severe pain or a very bloated abdomen;
- the diarrhoea started during or after a course of antibiotics;
- you have a flare-up of inflammatory bowel disease;
- the cause of the diarrhoea is unclear;
- the symptoms last longer than 48 hours.
Loperamide and other medicines that slow the bowel may only be given to children on a doctor’s advice.
Antibiotics are not a universal cure for diarrhoea. Most acute bowel infections do not need them, while incorrect use of antibiotics can cause side effects and contribute to bacterial resistance. Whether antibiotics are needed is for the doctor to decide.
Does activated charcoal help with diarrhoea?
Activated charcoal is often used as a remedy for diarrhoea, but it is not the main treatment. Activated charcoal does not replace fluid and electrolyte intake and does not protect against dehydration.
It can reduce the absorption of other medicines taken at the same time. So people who regularly take prescription medicines should ask a doctor or pharmacist before using activated charcoal.
Activated charcoal can also turn stools black. This must be distinguished from black, tar-like stools, which may indicate bleeding in the digestive system and need urgent medical assessment.
Do home remedies help with diarrhoea?
Unsweetened tea, rice, light broth or other simple foods can help you take in fluid and gradually start eating again. However, home remedies for diarrhoea do not replace an oral rehydration solution, especially for children, older people and anyone with severe vomiting or watery diarrhoea.
It is not advisable to make a very concentrated salt solution yourself or to use inaccurate amounts of salt and sugar. A wrongly prepared solution may be ineffective or even harmful. It is safer to use a rehydration product from the pharmacy and prepare it according to the instructions.
Does tea help with diarrhoea?
Light, unsweetened tea can add to your fluid intake, but on its own it does not treat the cause of diarrhoea. Very strong black or green tea contains caffeine, which can stimulate the bowel in some people.
So tea can be used as an extra drink, but during severe diarrhoea an oral rehydration solution should be preferred.
Does coffee help with diarrhoea?
Coffee is not a remedy for diarrhoea. Caffeine stimulates the bowel and can make stools more frequent. During acute diarrhoea it is better to limit coffee, energy drinks and other caffeinated drinks.
Watery diarrhoea
Watery diarrhoea can cause a rapid loss of fluid and electrolytes, especially if bowel movements are very frequent or there is also vomiting.
Possible signs of dehydration:
- severe thirst;
- dry mouth and tongue;
- dark urine;
- passing urine less often than usual;
- dizziness when standing up;
- marked tiredness or weakness;
- a fast heartbeat;
- confusion or marked drowsiness.
If a person cannot take in or keep down fluids, urgent medical help is needed. In severe dehydration, fluids may need to be given into a vein.
Diarrhoea and vomiting
Diarrhoea and vomiting are most often caused by an acute bowel infection or food poisoning. In this situation, drink fluids in very small portions — a few sips every few minutes.
Seek help urgently if:
- vomiting makes it impossible to keep fluids down;
- vomiting is repeated or prolonged;
- there is blood in the vomit;
- there is severe abdominal pain;
- signs of dehydration appear;
- the person becomes listless, confused or very drowsy.
Diarrhoea and fever
A slight rise in temperature can be linked to a bowel infection. A high temperature together with frequent diarrhoea, blood in the stool, severe pain or feeling very unwell may indicate a more serious infection.
In this situation you should not take medicines that stop the bowel on your own. You need to see a doctor.
Green diarrhoea
Green stools do not always mean a dangerous illness. They can occur when the bowel contents move so fast that bile pigments do not have time to change fully. The colour can also be affected by green vegetables, food colourings, iron supplements and other dietary or medication factors.
More important than the colour is how the person feels and what other symptoms there are. If green diarrhoea continues, is very frequent or is accompanied by fever, vomiting, pain, blood or signs of dehydration, see a doctor.
Diarrhoea after antibiotics
Antibiotics can change the balance of microorganisms in the gut and cause loose stools. Mild diarrhoea sometimes passes on its own, but during or after a course of antibiotics a Clostridioides difficile (C. difficile) infection can also develop.
Contact a doctor if after taking antibiotics you have:
- frequent or watery diarrhoea;
- a raised temperature;
- pain or tenderness in the abdomen;
- nausea and loss of appetite;
- blood in the stool;
- marked weakness;
- signs of dehydration.
Do not stop or change antibiotics on your own. Agree on what to do next with the doctor who prescribed them.
Diarrhoea in a child – what to do?
Dehydration can develop faster in a child with diarrhoea than in an adult. The most important thing is to regularly offer oral rehydration solution in small portions.
Do not stop breastfeeding. A baby should continue to get breast milk or their usual formula. An older child can be offered age-appropriate food in small portions as soon as they want to eat.
Contact a pediatrician if:
- the diarrhoea is in a baby;
- the child refuses to drink;
- the child vomits repeatedly;
- nappies stay dry for a long time;
- the child passes urine much less often;
- the child has a dry mouth or no tears when crying;
- the child is unusually drowsy or listless;
- there is a raised temperature;
- there is blood in the stool;
- there is severe abdominal pain;
- the child’s condition gets worse.
A child should not be given anti-diarrhoea medicines or antibiotics without a doctor’s advice. If needed, book a pediatrician consultation.
Long-lasting and frequent diarrhoea
Acute diarrhoea usually starts suddenly and passes within a few days. If diarrhoea lasts longer than two weeks, it is considered persistent, and symptoms lasting at least four weeks or recurring regularly may indicate chronic diarrhoea.
Long-lasting or frequent diarrhoea can be caused by:
- irritable bowel syndrome;
- coeliac disease;
- lactose or other food intolerance;
- Crohn’s disease;
- ulcerative colitis;
- a prolonged bowel infection;
- side effects of medicines;
- pancreatic disorders;
- thyroid disease;
- other absorption disorders.
A doctor’s consultation is especially necessary if long-lasting diarrhoea is accompanied by weight loss, anaemia, symptoms at night, fever, blood in the stool or constant abdominal pain.
Diarrhoea with blood
Blood in the stool is not a usual symptom of diarrhoea. It may indicate a bowel infection, inflammatory bowel disease, bleeding or another health problem.
Seek medical help urgently if you have:
- diarrhoea with visible blood;
- black, tar-like stools;
- sudden or very severe abdominal pain;
- a very high temperature;
- inability to keep fluids down;
- impaired consciousness or fainting;
- marked signs of dehydration.
In these cases, do not take medicines that slow the bowel without a doctor’s advice.
When to book a gastroenterologist?
A gastroenterologist consultation is recommended if:
- the diarrhoea continues and does not improve;
- the symptoms keep coming back for several weeks;
- diarrhoea regularly starts after eating or in the mornings;
- diarrhoea alternates with constipation;
- you have long-lasting pain or bloating;
- you are losing weight;
- tests have shown anaemia or a nutrient deficiency;
- there is coeliac disease, inflammatory bowel disease or bowel cancer in the family;
- previous test results need to be assessed.
To find the cause of diarrhoea, a gastroenterologist may recommend blood tests, stool tests, coeliac disease testing, a colonoscopy or other examinations. The scope of tests needed is decided individually.
Frequently asked questions
How to stop diarrhoea quickly?
First, take in fluid and electrolytes. Medicines that slow the bowel are not suitable in every case, especially if there is fever, blood in the stool or the diarrhoea started after antibiotics.
What is the best medicine for diarrhoea?
There is no medicine that suits everyone. The choice depends on the cause of the diarrhoea, how long it has lasted, the person’s age and any other symptoms. The safest first step is to replace fluid and electrolytes.
Can I eat during diarrhoea?
Yes. Long fasting is not necessary. As soon as you have an appetite, you can eat small, easily digestible meals and gradually return to your usual diet.
What can I eat with a stomach bug?
If diarrhoea is one of the symptoms of a stomach bug, the dietary principles are the same as for diarrhoea: rice, boiled potatoes, bananas, lean chicken and broth are easy to digest and do not irritate the gut. Avoid fatty and spicy food, dairy products and sugary drinks until the symptoms have eased. If the illness is accompanied by a high fever, repeated vomiting or signs of dehydration, see a doctor.
What to drink during diarrhoea?
The best choice is an oral rehydration solution from the pharmacy. You can also drink water, light broth and unsweetened tea. Avoid alcohol and very sweet drinks.
How long can acute diarrhoea last?
In many cases you feel better within a few days. If the diarrhoea does not go away, gets worse or is accompanied by blood in the stool, severe pain, a high temperature or dehydration, you need to see a doctor.
Gastroenterologist consultation in central Riga
If your diarrhoea is long-lasting, keeps coming back or its cause is unclear, book a gastroenterologist consultation at Republikas laukuma klīnika.
Dr. Denis Jevdokimov
Gastroenterologist
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