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Understanding Diarrhea: What Happens in Your Body

Diarrhea occurs when stool moves through your intestines too quickly, or when your intestines absorb less water than normal. The result is loose, watery bowel movements that happen more frequently than usual. Most adults experience diarrhea about once per year, while children get it more often—typically between 1 and 3 times yearly. Understanding what's happening inside your body can help you respond appropriately and know when home care is sufficient.

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Your digestive system works by moving food through your stomach and intestines using muscle contractions. As food breaks down, your small intestine absorbs nutrients and water. Your colon then absorbs additional water before the remaining waste leaves your body. When something disrupts this process—whether an infection, food, medication, or stress—you get diarrhea. The loose stools happen because either the intestines are moving too fast or aren't absorbing enough water.

Acute diarrhea, the kind that appears suddenly, typically lasts a few days to a week. This is different from chronic diarrhea, which lasts more than four weeks. Most cases of acute diarrhea resolve on their own without treatment. Your immune system works to clear infections, or your digestive system adjusts to whatever triggered the problem. However, while your body heals, you lose fluids and electrolytes—minerals like sodium and potassium your body needs to function.

Common causes include bacterial infections from contaminated food (like salmonella), viral infections (stomach flu), parasites from travel or contaminated water, food intolerances like lactose sensitivity, and certain medications such as antibiotics. Stress and anxiety can also trigger diarrhea in some people. Inflammatory conditions like irritable bowel syndrome (IBS) affect millions of Americans and often cause recurring diarrhea.

Practical takeaway: Recognizing that diarrhea is your body's way of clearing something harmful helps you understand why replacement fluids matter more than stopping the diarrhea immediately.

Staying Hydrated: The Most Important Step

Fluid replacement is the single most important treatment for diarrhea at home. When you have loose stools, your body loses water faster than normal—sometimes losing a liter or more per day depending on severity. Dehydration can develop quickly, particularly in children and older adults. Signs of mild dehydration include thirst, dry mouth, and dark urine. More serious dehydration causes dizziness, extreme fatigue, rapid heartbeat, and confusion. Severe dehydration is a medical emergency.

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Plain water alone isn't the best choice during diarrhea. While water replaces fluids, it doesn't replace electrolytes—sodium and potassium your body needs for nerve signals, muscle function, and fluid balance. Drinking only water can actually dilute your body's electrolyte levels. Oral rehydration solutions (ORS) are specifically formulated with the right balance of water, glucose, sodium, and potassium. Common brands include Pedialyte, Gatorade, and store-brand equivalents. These cost between $3 and $8 per bottle and are widely available at pharmacies and grocery stores.

If commercial rehydration solutions aren't available, you can make a homemade version using ingredients in most kitchens. Mix one liter of clean water with 6 teaspoons of sugar and 1/2 teaspoon of salt. This mixture provides similar electrolyte balance to commercial solutions. The World Health Organization recommends this recipe for diarrhea management globally. Stir until dissolved and drink throughout the day in small, frequent sips rather than large amounts at once.

Drink about 200-500 milliliters (roughly 8-16 ounces) of rehydration solution after each loose stool, adjusted for body size. For children, this might be less. Sip slowly over 5-10 minutes rather than drinking quickly, which can trigger more diarrhea. Other acceptable fluids include broths, coconut water, diluted juice (one part juice to three parts water), and weak tea. Avoid caffeinated beverages, alcohol, and sugary drinks, which can worsen diarrhea.

Practical takeaway: Prepare an oral rehydration solution before you need it, or keep a commercial brand on hand. Small, frequent sips work better than large amounts.

Nutrition During Diarrhea: What and When to Eat

Contrary to old advice, you don't need to fast completely during diarrhea. Eating helps your intestines heal and restores nutrients. However, certain foods work better than others. The BRAT diet—bananas, rice, applesauce, and toast—remains a reasonable starting point. These bland, easily digestible foods are gentle on your intestines while providing calories and some nutrition. Add crackers, plain chicken, or boiled potatoes as you feel better.

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Bananas are particularly helpful during diarrhea because they contain pectin, a type of fiber that absorbs water and thickens stool. One medium banana also provides about 422 milligrams of potassium, helping replace what you've lost. Rice and toast provide carbohydrates and energy without much fat or fiber to stress your digestive system. Applesauce offers similar benefits to fresh apples but is easier to digest since the fiber has been partially broken down.

As your symptoms improve over a few days, gradually introduce other foods. Boiled or grilled chicken, turkey, or fish provide protein without excess fat. Eggs prepared simply—boiled or scrambled—are well-tolerated. Plain yogurt with live cultures may help restore beneficial bacteria in your gut, though this works better for prevention than acute treatment. Saltine crackers, plain bread, and cooked vegetables like carrots and green beans gradually reintroduce more fiber.

Foods to avoid during active diarrhea include high-fat foods (fried foods, butter, creamy sauces), high-fiber foods (beans, whole grains, raw vegetables), dairy products like milk and cheese (unless you normally tolerate them), spicy foods, caffeine, and alcohol. These can stimulate intestinal contractions or draw water into your bowels, worsening symptoms. Sugary foods and drinks also pull water into your intestines. Artificial sweeteners like sorbitol can have the same effect. Even "healthy" foods like beans and brown rice should wait until recovery.

Timing matters too. Eat small amounts every 2-3 hours rather than three large meals. Your digestive system heals better with frequent, gentle input. Continue taking electrolyte solutions regardless of whether you're eating. Within a week, most people with acute diarrhea can return to their normal diet gradually.

Practical takeaway: Start with BRAT foods in small portions, sip electrolyte solutions regularly, and gradually expand your diet as symptoms improve.

Over-the-Counter Treatments and When to Consider Them

Several over-the-counter medications can reduce diarrhea symptoms, though they work differently. Loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol) are among the most common. These are inexpensive—typically $5 to $10 per package—and available at any pharmacy. However, there are situations where these medications aren't appropriate, so understanding when to use them matters.

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Loperamide slows intestinal movement, reducing how often you have bowel movements and making stools firmer. It works relatively quickly—within 1 to 2 hours—and effects typically last 4 to 6 hours. Bismuth subsalicylate reduces intestinal inflammation and also has some antimicrobial properties. It typically works within 30 minutes and can be taken multiple times throughout the day. Both have good safety records when used as directed, though loperamide shouldn't be used if you have high fever or bloody stools, as slowing your intestines could trap harmful bacteria.

The key principle: if your diarrhea is caused by an infection, your body is trying to flush out the harmful organisms. Slowing intestinal movement might keep those organisms inside longer. For this reason, medical guidelines suggest avoiding these medications if you have fever above 101.5°F (38.6°C) or visible blood in your stool. If you have symptoms suggesting