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As uncomfortable as diarrhea is, the good news is that it usually goes away quickly, typically lasting from a few hours to a few days. In the United States, on average, adults have it once a year, and children twice a year. Most of the time, diarrhea does not pose a significant health risk. However, there are times you should contact your healthcare provider. In this article, we discuss the difference between acute and chronic diarrhea, how to treat it, when it is dangerous, and what you can do at home.
What is diarrhea?
Diarrhea is loose stools three or more times in a day. Other symptoms include cramping, abdominal pain, and an urgent need to use the bathroom, according to the National Institute of Diabetes and Digestive and Kidney Diseases. “Some common causes of diarrhea include viral infection, bacteria, and parasites due to consuming contaminated water, and antibiotics,” says Dr. Lina Velikova M.D., a medical advisor for Supplements 101. “Furthermore, lactose-intolerant people can experience diarrhea if they consume foods with lactose. Fructose and artificial sweeteners can also cause diarrhea.”
Diarrhea is characterized as acute, persistent, or chronic. Acute is the most common type of diarrhea, and the second most reported illness in the United States (respiratory infections are number one). It usually comes on abruptly and lasts less than two weeks. Persistent diarrhea lasts between two and four weeks; chronic lasts longer than four weeks.
The most common cause of acute diarrhea is a viral infection. In children, it is rotavirus, and in adults, it is norovirus. Traveler’s diarrhea comes from consuming contaminated water or foods and is typically associated with visiting developing countries. Food poisoning from viruses, bacteria, or parasites can also cause diarrhea.
Diarrhea symptoms can include:
- Loose, watery stools
- Loose stools three or more times in one day
- Bloating and cramps
- Strong or uncontrollable need to use the bathroom
- Usually lasts one or two days and then goes away on its own
Some people also experience nausea and vomiting.
When symptoms of diarrhea last between two and four weeks, it is considered persistent; over four weeks is chronic, according to the Centers for Disease Control and Prevention (CDC). As with acute, causes include infections from viruses, bacteria, or parasites. Other causes of persistent and chronic diarrhea include:
- Pancreatic disorders
- Gastrointestinal disorders (Crohn’s disease, irritable bowel syndrome, celiac disease, functional digestive (GI) disorders, small intestinal bacterial overgrowth, ulcerative colitis)
- Medications (antibiotics, cancer drugs, antacids containing magnesium)
- Food intolerances and malabsorption
- Thyroid disorders
- Tumors
- Immune deficiencies
- Autoimmune disorders
- Hereditary disorders
- Cancer treatments
- Abdominal surgery
It is called idiopathic diarrhea when the cause is unknown. Diarrhea is not usually severe; however, acute, persistent, and chronic diarrhea can cause dehydration.
How is diarrhea diagnosed?
Most of the time, diarrhea is self-diagnosed and self-treated. It frequently gets better with dietary changes and over-the-counter medications. But, if you are experiencing any of the following symptoms, you should contact your healthcare provider:
- Symptoms for more than two days as an adult, more than 24 hours for children
- Severe pain in the abdomen or rectum
- Fever of 102 or higher
- Stools containing blood or pus
- Bowel movements that are black or tarry
Diarrhea can be very dangerous in newborns and infants since due to their small size they can become dehydrated very quickly. Severe dehydration can be deadly, so if your baby has diarrhea, you should call your pediatrician immediately.
“Usually diarrhea is not a severe condition, and is often described as an inconvenience,” says Dr. Velikova, “However, it can lead to severe dehydration. That’s why it is important to contact your doctor if it lasts more than two days.”
Signs of dehydration include:
- Thirst
- Urinating less than usual (in babies no wet diapers for three hours or more)
- Fatigue
- Dark-colored urine
- Dry mouth
- When skin is pinched and released, does not flatten back to normal right away
- Sunken eyes or cheeks
- Light-headedness or fainting
- In children, there may not be tears when crying
At first, healthcare professionals often suggest dietary changes, over-the-counter medications, and rest. Typically, providers do not try to find the cause of acute diarrhea, assuming it is an infection. However, if diarrhea does not go away within 48 hours, your doctor might complete a physical exam, including checking for dehydration, taking your temperature, and checking your abdomen for tenderness or pain, according to the NIDDK. Some questions your physician might ask are:
- How long have you had diarrhea?
- How much stool have you passed?
- How often have you had diarrhea?
- What color is your stool?
- What is your stool’s consistency?
- Are you experiencing any other symptoms?
- What foods did you eat before the diarrhea started?
- What medications, including vitamins and supplements, are you taking?
- Have you had recent contact with people who are sick?
- Have you recently traveled? If so, to where?
If your doctor feels it is warranted, they could suggest additional testing, such as:
- Stool test to check for the presence of bacteria or parasites
- A blood test to check for infections, disorders, and diseases
- Hydrogen breath test to check for lactose intolerance
- Fasting studies to determine if the diarrhea is a result of food intolerance or allergy
If, after comprehensive testing, your healthcare provider cannot determine the cause of your diarrhea, they might order an endoscopic procedure such as colonoscopy, flexible sigmoidoscopy, or upper gastrointestinal endoscopy. These tests allow a doctor to look at your intestinal tract to check for rare causes of diarrhea.
Diarrhea treatment options
When symptoms of diarrhea only last a few days, the standard for treating diarrhea includes:
- Taking over-the-counter medications to relieve the symptoms
- Drinking plenty of fluids, including water, fruit juices, sports drinks, and soda without caffeine
- Instituting a liquid diet and as symptoms improve adding bland foods
You should not use over-the-counter medications for young children, or if you have bloody stools or a fever, contact your healthcare provider before taking any drugs, including over-the-counter medications, vitamins, or supplements..
For persistent or chronic diarrhea, you should follow the general dietary suggestions from your doctor. Also, you should have treatment for any underlying medical conditions and speak to medical professionals about whether a change in medication or dosage is warranted.
Diarrhea medications
A few medications for diarrhea are available over-the-counter (OTC). If these are not effective, you may be prescribed stronger medications. Some of the common medications include:
Antidiarrheals
- Pepto BismolKaopectate (bismuth subsalicylate)—available over-the-counter
- Imodium AD (loperamide)—available over-the-counter
- Lomotil (diphenoxylate/atropine)—available by prescription only, used to treat serious diarrhea
- Mytesi (crofelemer)—available by prescription only, used to treat diarrhea associated with HIV/AIDS
Antibiotic/Antibacterial
Antiprotozoals
- Alinia (nitazoxanide)—available by prescription only, used to treat parasite infections
Anticholinergic/opioid combination
- Motofen (difenoxin and atropine sulfate)—available by prescription only, used to treat serious diarrhea
What is the best medication for diarrhea?
There is no “best” diarrhea medication. People react differently to drugs, and what is the best remedy for one person may not be the right one for someone else. Choosing the best medication for each person depends on several factors, including:
- Current health
- Medical history
- Other drugs currently being used and potential interactions
- Other conditions
- Tolerance for drugs and response to treatment
The following is a comparison chart to help you understand the most commonly prescribed medications for diarrhea.
| Best medications for diarrhea | ||||
|---|---|---|---|---|
| Drug Name | Drug Class | Administration Route | Standard Adult Dosage | Common Side Effects |
| Pepto Bismol, Kaopectate (bismuth subsalicylate) | Over-the-counter antidiarrheal | Oral | 525 mg every 30-60 minutes as needed for up to 2 days, not to exceed 8 regular strength doses in 24 hours | Abdominal pain, headache, ringing in the ears, gray/black color on tongue or |
| Imodium AD (loperamide) | Over-the-counter antidiarrheal | Oral | 4 mg after 1st loose stool, then 2 mg after each loose stool, not to exceed 16 mg per day | Abdominal pain, nausea, constipation, dizziness |
| Lomotil (diphenoxylate / atropine) | Rx Antidiarrheal | Oral | 5 mg (2 tablets) 4x per day to start, a maximum of 8 tablets per day | Abdominal pain, dry mouth, constipation, nausea, urinary retention, headache |
| Xifaxan (rifaximin) | Rx Antibiotic/Antibacterial | Oral | 200 mg 3x per day for 3 days | Swelling in arms/legs/abdomen, dizziness, tiredness, nausea, orange-colored urine and other bodily fluids |
| Alinia (nitazoxanide) | Rx Antiprotozoals | Oral | 500 mg every 12 hours for 3 days, taken with food | Headache, nausea, abdominal pain, urine discoloration |
| Motofen (difenoxin and atropine sulfate) | Rx Anticholinergic/opioid combination | Oral | 2 tablets at first loose stool, then 1 tablet after additional stools or every 3-4 hours as needed, maximum of 8 tablets in 24 hours | Drowsiness, dizziness headache, loss of appetite, nausea, vomiting, dry mouth, stomach pain |
What are the common side effects of diarrhea medication?
Side effects for diarrhea depend on the type of drug you are taking. Below are common side effects based on the class of medication.
Side effects of antidiarrheals include abdominal pain, dry mouth, drowsiness, dizziness, constipation, nausea, and vomiting.
Antibiotic and antibacterial side effects include heartburn, nausea, vomiting. Xifaxan can cause urine, saliva, sweat, sputum, and tears to turn an orangish color.
Side effects of antiprotozoals could include heartburn, headache, nausea, and changes in urine.
Anticholinergic/opioid combination side effects can include drowsiness, dizziness, headache, blurred vision, dry mouth, and loss of appetite.
What are the best home remedies for diarrhea?
‘Sometimes, all it takes is changing your diet or giving your bowel some time to rest,” explained Mobola Kukoyi, MD, a board-certified emergency physician at the Carle Foundation Hospital. “Also, taking proper precautions while traveling, such as handwashing and eating hot meals, reduces your risk.” Some suggestions from the Cleveland Clinic are listed below.
You should drink liquids frequently, trying to consume two to three quarts or liters per day or sip liquids throughout the day. Fluids for diarrhea include:
- Pulpless fruit juice
- Chicken broth
- Oral rehydration solution
- Non-caffeinated soda
- Tea with honey
- Sports drinks
As your diarrhea improves, you can eat soft, low-fiber, bland foods, including:
- Potatoes
- Rice or noodles
- Ripe bananas
- Applesauce
- Smooth peanut butter
- White bread
- Chicken or turkey without the skin
- Lean ground beef
- Fish
- Yogurt
- Cottage cheese
Foods you should avoid include:
- Greasy, fatty, or fried foods
- Raw vegetables and fruits (apples, pears, peaches)
- Strong spices
- Whole-grain cereals and bread
- Alcoholic beverages
- Diet drinks containing artificial sweeteners
- Caffeine
Diarrheal illnesses sometimes cause temporary lactose intolerance. If dairy products are worsening symptoms, avoid them.
Frequently asked questions about diarrhea
What is diarrhea a sign of?
Usually, diarrhea isn’t a sign of anything; it is usually the result of a viral, bacterial, or parasitic infection. Persistent or chronic diarrhea can signal an underlying medical condition, such as inflammatory bowel disease, pancreatic disorders, or even colon cancer. So if diarrhea lasts longer than a couple of days for an adult or a day for a child, contact your doctor.
What is the main cause of diarrhea?
Viral infections are the most common cause of diarrhea. Other causes include bacterial infections, parasite infections, certain medical conditions, and some medications.
What can stop diarrhea fast?
“People have success with drugs like Imodium, which decreases the speed at which the bowel moves,” says Dr. Kukoyi. But it is important to remember that everyone reacts differently to medications, so what works well for one person might not work for someone else.
-effectsHow long does diarrhea usually last?
Acute diarrhea usually lasts about two days but can last up to two weeks. Persistent diarrhea lasts for between two and four weeks. Chronic diarrhea lasts for four weeks or longer. If you still have diarrhea after 48 hours, you should contact your healthcare provider.
Is diarrhea serious?
A potentially severe complication of diarrhea is dehydration. Some signs of dehydration include increased thirst, decreased urine output, dry skin, and dizziness. Severe dehydration can be deadly, so if you think you are dehydrated, contact your healthcare provider.
How long should you have diarrhea before going to the doctor?
Most of the time, diarrhea clears up on its own in a few days, and you don’t need to see a doctor. But, if you have diarrhea for more than 48 hours, or if it is accompanied by a fever, bloody or black stools, or severe pain in your abdomen, you should contact your healthcare provider immediately.
There is no “best” medication. Each person reacts differently to drugs. Many people find over-the-counter medications, such as Imodium AD, work quickly, but this works best when it is a viral infection.
Should you let diarrhea run its course?
Acute diarrhea usually lasts anywhere from a few hours to a few days. If you have severe diarrhea, accompanied by a fever or blood in your stool, you should immediately contact your doctor. If it continues after 48 hours, you should speak with your healthcare provider.