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Any attack of frequent, watery stools is called diarrhea. It can be triggered by many different conditions.

Acute diarrhea is often caused by an infection and may require medical management. The primary role of nutrition in acute diarrhea is to prevent depletion of fluid, sodium, potassium, and calories. Replenishment of all four has been achieved with “rehydration solutions” and with a variety of foods, from salted carrot soup to peeled scraped apple to rice gruel. However, the need for rehydration requires direct medical supervision. Therefore, nutritional approaches to overcoming depletion of fluid, sodium, potassium, and calories are not discussed here, but rather should be discussed with a doctor. Diarrhea-induced low blood sugar, dehydration, or electrolyte imbalance can be serious or even life-threatening, particularly if prolonged in children.

A healthcare provider should be consulted if diarrhea continues for more than a few days, as it may indicate a more serious health condition. Diarrhea alternating with constipation may be a sign of irritable bowel syndrome (IBS).

What are the symptoms of diarrhea? Normal bowel habits vary considerably from person to person depending on age, diet, cultural factors, and individual physiology. However, loose watery stools occurring three or more times in one day is generally considered abnormal. In some instances, diarrhea may be accompanied by cramping abdominal pain, nausea, vomiting, fever, loss of appetite, and bloody or foul-smelling stools.

Conventional treatment options: Rest and fluid replacement (sometimes with the use of oral rehydration solutions) are often recommended. Severe diarrhea, especially in children and the elderly, may require hospitalization for urgent fluid and electrolyte replacement to correct dehydration. Medicines to stop diarrhea may be prescribed in some cases.

Dietary changes that may be helpful: Some foods contain sugars that are absorbed slowly, such as fructose in fruit juice or sorbitol in dietetic confectionery. Through a process called osmosis, these unabsorbed sugars hold onto water in the intestines, sometimes leading to diarrhea. By reading labels, people with chronic non-infectious diarrhea can easily avoid fruit juice, fructose, and sorbitol to see if this eliminates the problem.

People who are lactose intolerant-meaning they lack the enzyme needed to digest milk sugar-often develop diarrhea after consuming milk or ice cream. People whose lactose intolerance is the cause of diarrhea will rid themselves of the problem by avoiding milk and ice cream or in many cases by taking lactase, the enzyme needed to digest lactose. Lactase is available in a variety of forms in pharmacies (and in grocery stores in the form of lactase-treated milk).

Large amounts of vitamin C or magnesium found in supplements can also cause diarrhea, although the amount varies considerably from person to person. Unlike infectious diarrhea, diarrhea caused by high amounts of vitamin C or magnesium is not generally accompanied by other signs of illness. The same is true when the problem comes from sorbitol or fructose. In these cases, avoiding the offending supplement or food brings rapid relief.

Drinking several cups of coffee per day causes diarrhea in some people. People with chronic diarrhea who drink coffee should avoid all coffee for a few days to evaluate whether coffee is the culprit.

Allergies and food sensitivities are common triggers for diarrhea. For example, some infants suffer diarrhea when fed cow’s milk-based formula but improve when switched to soy-based formula. People with chronic diarrhea not attributable to other causes should discuss the possibility of food sensitivity with a doctor.

Some doctors recommend a diet called the BRAT diet for acute bouts of diarrhea. BRAT stands for bananas, rice, apples and toast. These foods are mild, well-tolerated and good sources of fiber, potassium and other nutrients that may be helpful in diarrhea. The efficacy of this diet has not been evaluated in clinical trials.

The information presented is for informational purposes only. The results reported may not necessarily occur in all individuals. Consult your doctor or health care practitioner for any health problem and before using any supplements