What is diarrhoea?

Diarrhoea is defined at having loose, liquid stools and increased daily bowel movements. It is usually a symptom of a reaction by the body and often goes hand-in-hand with a gut infection (fecal contamination from viruses, bacteria and parasites), IBS, a reaction to a medication or an imbalance of bacteria in the digestive tract[1]. It can also be associated to specific food reactivities such as gluten.In the case of diarrhoea, there are water and electrolyte losses and there is limited time for reuptake of these that normally happens in the large intestine during more normal transit time.

There are various forms of diarrhoea including both acute and chronic. Acute diarrhoea is often infectious and generally caught by fecal-oral contamination through food and water and is a common ailment for travelers in hot countries[2]. In these instances, viruses, bacteria and parasites make their way into your digestive tract and disturb the balance of beneficial and commensal microbial colonies there. Acute diarrhoea is the response by the body to try and flush out these microorganisms and restore the natural balance.

Chronic diarrhoea is typically diagnosed if it lasts for 4 weeks or more and is usually investigated by a gastroenterologist at this stage. Chronic diarrhoea can be associated with a number of different health conditions affecting the gastrointestinal tract, endocrine system and immune system. The side effects of some medications, such as antibiotics, need to be investigated too[3]. Diarrhoea is the most common symptom in IBS-D, and this is an example of chronic diarrhoea[4].

Dietary considerations for diarrhoea

Hydration is important with diarrhoea, as is restoring the electrolyte balance which is commonly lost during acute episodes of diarrhoea. Sip water slowly, avoiding big gulps and try adding a small pinch of Himalayan salt to your water or alternatively drink some coconut water to help restore electrolytes. These electolytes are essential for cellular hydration as varying degrees of dehydration is common both during and after bouts of diarrhoea.

For acute diarrhoea, be mindful of high fibre foods which will make stools travel faster through the digestive tract such as lots of fruit and vegetables. Stimulants will also have the same effect, so avoid things like caffeine, sugar, spicy foods, additives and alcohol. Prebiotic foods such as onions, and garlic may also irritate your stomach as these foods feed gut bacteria. Foods such as dairy and fatty foods are difficult to digest and therefore are best avoided during a flare up too. It may be beneficial to avoid eating too much on the first or worst day of diarrhoea during an acute flare and keep foods simple but most importantly stay hydrated. A small fast (12 hours) allows the digestive system to relax and focus on healing. Bananas and rice may help with bulking stools and chicken and bone broths help the gut lining to recover from inflammation. Probiotic foods like yogurt with live cultures may be soothing for the large intestine and help with reducing pathogenic bacteria there[5].

Supplement suggestions for diarrhoea

A probiotic called Saccharomyces Boulardii, which is actually a beneficial yeast, is particularly helpful for both acute and chronic diarrhoea. It is also commonly taken alongside antibiotics to prevent the associated diarrhoea[6]. Various companies offer different formulations and strength of this probiotic but the Viridian one is a nice blend with a few other supportive probiotic strains.They also offer a similar Travel Biotic form of these probiotic designed for preventative use when travelling.

Viridian also offer a product called KiwiZyme which contains a specific enzyme from the kiwi fruit which may be beneficial to reduce transit time and it comes in soothing base of aloe vera.

Mesima Mushroom may also be a useful supplement as this is traditional used to treat anti-inflammatory effects on the GI tract and can help to reduce diarrhoea as a symptom of bacterial infections.

As electrolyte replacement is so important, the Sports Electrolyte Fix by Viridian is electrolyte rich natural water from the salt lakes of the US and is a simple addition to a glass or bottle of water to support electrolyte replacement.Although designed for use in sports, this can also be useful at times of acute diarrhoea.

Last but not least is Molkosan from A Vogel which is rich in prebiotic compounds which may help to soothe and support microbial restoration following acute diarrhoea.

Testing options for diarrhoea

If you are experiencing chronic diarrhoea then it may be worth booking a consultation with our Nutritional Therapy team to provide professional guidance dietary interventions and potential for functional testing. We offer complete Microbiome Analysis which may be useful to ascertain if pathogenic flora are influential in symptoms and also then to look at specific antimicrobials that may be a useful part of the protocol. Gluten sensitivity or food sensitivity testing may also a useful insight to understand whether there are any specific foods that are creating an immune response resulting in the symptoms experienced. However, it should be noted that testing is only recommended where is has potential to alter the protocol. Dietary and lifestyle modifications alone using our knowledge and experience are often enough to address symptoms and provide guidance for optimising long term health.