WHAT ARE THE TREATMENT Options FOR DIARRHEA?

* Be aware that the best treatment for diarrhea is to find the cause and treat it; however, in the event that is not possible, then it may be necessary to treat the symptoms without knowing the cause. This website was last update on 11/1/2024. The best treatment option MIGHT have changed since that time.

1. When the exact cause is known from a stool test some of the following antibiotics will be used:
B. Azithromycin 
C. Ciprofloxacin
D. Levofloxacin
E. Bactrim
F. Refaximin 
G. Vancomycin
H. Metronidazole (Flagyl)

2. When there is high suspicion of bacteria infection from recent travel:
A. Ciprofloxacin 500 mg 1 x / day for 3 days*
B. Azithromycin 500 mg 1 x / d for 3 days *
F. Refaximin 200 mg 3 x / day for 3 days *

3. When the cause is NOT KNOWN the Symptoms may be treated.
A. Peptobismol (has the potential to now only absorb toxins but also medications)
B. Loperidine (Imodium) 2 - 4 mg up to 4 times a day: There is some beliefs that slowing diarrhea down with Medication MIGHT increase the toxins in the body.  At this time, there is no proof of this.

CAUTION

1. In some cases, it MIGHT be better to allow the body to have some diarrhea for a short period of time (maximum 2 days) to try to flush out possible bacteria and toxins. However, too much diarrhea will cause dehydration and loss of potassium. Therefore, diarrhea for more than two days without an effort to slow it down, is not recommended.
2. All medication, including anti-diarrhea medicaions and antibiotics, have a risk of side effects. 3. Mild side effects are constipation, nausea, vomiting, diarrhea, itching, and light skin rash.
4. Possible Severe side effects are a severe skin rash, an anaphylactic allergic reaction (leading to the inability to breathe and subsequent death if not treated rapidly), and Clostridioides difficile infection (C. Diff.) of the colon.
5. Medications such as creams, lotions, and gels should be tested in small dosages in areas of the body that are not easily seen.

Consult “Epocrates.com” for each Specific Medication’s possible “Adverse Reactions.” Side effects are also referred to as “Adverse Reactions.” Epocrates.com will tell you both “common reactions” and “serious reactions.” You will have to create an account, but it is simple, fast, and free.

WHAT ARE THE SYMPTOMS OF DIARRHEA?

The symptoms of diarrhea are an increase in the volume, wateriness, and frequency of bowel movements. Diarrhea does not need to be all water. Diarrhea can refer to any stool that is unable to sustain its form. Another words, any stool that is soft enough to take the shape of the toilet bowl, rather than maintain its own form can also be considered diarrhea.

WHAT CAUSES DIARRHEA?

Diarrhea can be caused by both infectious and non-infectious causes. Brief periods of Non-infectious causes are illnesses such as lactose intolerance, food allergies, a high fiber diet, and side effects from medications.

Other non-infectious causes that often last a long time, more than 4 weeks, can be due to Irritable Bowel Syndrome (IBS), Chrohn’s Disease, and Inflammatory Bowel Disease (IBD).

Infectious causes are due to viruses, bacteria, and parasite. Some specific viral causes are norovirus and rotavirus. Some specific bacteria are Salmonella, Campylobacter, Shigela, Staphylococci, Bacillus Cereus, Clostridium Perfringens, Escherichia Coli, and Clostridioides Difficile. And some parasitic infections are Giardia, Entamoeba, Histolytica, and Cryptosporidia.

HOW IS DIARRHEA DIAGNOSED?

The diagnosis of diarrhea that started just recently can be made from careful history. Diarrhea that last more than 3 days usually requires the testing of the person’s stool. The test will look for specific causes of the Diarrhea such as the following: Campylobacter, Yersinia, Amebas, Giardia, Shigells, Cryptosporidium, Shigela, Giardia, and Clostridioides Difficile (C. Diff.). However, while it is best to get a stool test, it is not always used because it takes time to get the results, and for people who don’t have insurance its expensive.  Commonly ordered stools tests are: fecal leukocytes (WBCs) or fecal lactoferrin (WBCs), calprotectin (test for inflammation), stool cuture (which test for many bacteria), ova and parasites (which looks for parasitic infections) and a c diff test (especially if a person has taking antibiotics in the last 3 months, which looks for a c diff infection.)