DIARRHOEA

FOOD POISONING. OVEREATING. Antibiotics, stimulant laxatives and other drugs. Viruses, bacteria and parasites. Megadoses of vitamin C. An attack of nerves. Any one of these things can send you running for the nearest toilet.

 

REASONS TO CALL YOUR DOCTOR

Make an appointment to see your doctor as soon as possible if you develop the following symptoms. If none of these applies to you, you can probably manage your diarrhoea at home.

1. Your diarrhoea lasts longer than a week or becomes recurrent.

2. You have fever, bad abdominal cramps, or blood, mucus or pus in your stools.

3. You think you've become dehydrated as evidenced by dry lips and mouth and a failure to urinate for eight hours.

4. You recently travelled to a foreign country or were in close contact with someone who did.

5. You recently drank water directly from a stream, river or lake.

 

The good news is, many types of diarrhoea go away on their own. Regardless of the cause, the best way to manage diarrhoea is to drink plenty of fluids. If you don't, you'll become dehydrated, which will make you feel much worse.

DRUG TREATMENT

Antibiotics

Erythromycin (Erymax, Erythrocin, Ilosone, others), trimethoprim (Monotrim, Trimopan). Function: eliminate bacteria such as

Campylobacter, Salmonella and Shigella species, Vibrio cholerae (the cholera bacteria) or Escherichia coli. Side effects: mild nausea, vomiting and diarrhoea; vaginal yeast infection, rashes.

 

Other Drugs

Loperamide hydrochloride (Boots Diareze, Diasorb, Diocalm Ultra, Imodium, Normaloe). Function: slow intestinal contractions to halt diarrhoea. Side effects: none common.

Kaolin (KLN). Function: makes loose stools less watery and may also help absorb toxins. Side effects: none common.

Bismuth (Bisma-Rex, Pepto-Bismol, Roter). Function: binds the toxins of some bacteria, stimulates the absorption of fluids from the intestines into the blood, and decreases intestinal inflammation and motility. Side effects: black stools and dark tongue, which cause no harm and cease after the medicine is stopped.

WHAT TO Do WHEN THE RUNS ARE RUNNING

Here's how to care for a mild or brief case of diarrhoea at home.

0. Hold off on solid foods for 12 to 24 hours. If the diarrhoea isn't severe, avoid only whole-grain cereals, raw fruits and vegetables.

1. Drink lots of clear liquids. Diarrhoea can quickly lead to dehydration. Good beverage choices include water, herbal teas, sports drinks, and diluted vegetable and fruit juices. Full-strength fruit juice can aggravate diarrhoea. Milk is also best avoided because you're likely to have trouble digesting it.

2. Eat cooked fruits and vegetables, particularly cooked carrots and apple sauce. Bananas, active-culture yoghurt and low-fibre grains such as white rice and flour are also good choices.

HERBAL REMEDIES

Agrimony (Agrimonia eupatoria)

Agrimony contains astringents, which have a drying action in the bowel. Typical dosage: I to 3 cups of tea per day (steep 1 teaspoon of dried leaves in % litre of hot water for 10 minutes).

Apples (Malus domestica)

Pectin, which apple peels are packed with, is a common antidiarrhoea remedy and a prime ingredient in some over-the-counter medications. Pectin is a soluble fibre that adds bulk to watery stools. Just make apple sauce or bake an apple with the peel on (preferably using organic apples). Stay away from apple juice, however, as it tends to loosen stools further.

 

Blackberry and Raspberry (Rubes spp.)

The roots and leaves of both these berry plants act as astringents to help relieve diarrhoea. Typical dosage: about 3 cups of tea per day (steep 2 teaspoons of dried leaves in '/, litre of hot water for 10 minutes).

Bilberry (Vaccinium myrtillus)

This shrub's fruits contain both tannins and pectin. Typical dosage: 2 or 3 capsules or tablets, standardised to 25 per cent anthocyanosides, per day.

Carob (Ceratonia siliqua)

This chocolate substitute also contains tannins and provides a safe approach to treating diarrhoea for all ages. Simply add carob powder to apple sauce or other foods that are easy on the digestive system and the bowels.

Carrots (Daucus carota)

In cooked form, these veggies are an age-old remedy for diarrhoea. One study found that carrot soup actually prevented bacteria, including E. coil, from sticking to the small intestines of patients with severe diarrhoea. Carrots are also rich in carotenes, an essential ingredient for immune function. All you need to do is steam sliced carrots until soft and then blend them into a soup.

Tea (Camellia sinensis)

No matter where you are, you can usually find a tea bag. Simply pour boiling water over it, wait five minutes and drink.

Oregon Graperoot (Mahonia aquifolium)

This herb and its berberine-containing cousins, goldenseal (Hydrastis canadensis), gold thread (Coptis cbinensis), and barberry (Berberis vulgaris), fight a broad range of microbes. Studies have found berberine effective in diarrhoea caused by bacteria such as Sbigella and Salmonella species, E. coli and V. cbolerae, and by the parasite Giardia species. Typical dosage: 60 drops (about 2 dropperfuls) of tincture three times per day; or up to six 500- to 600-milligram capsules per day. Caution: do not use herbs containing berberine if you are pregnant.

Garlic (Allium sativum)

The so-called stinking rose kills a variety of viruses, bacteria and parasites. Typical dosage: one or two raw, very finely chopped garlic cloves a day; or up to three 500- to 600-milligram capsules per day

(look for a product that delivers 4,000 to 5,000 micrograms of allicin per day).

Catmint (Nepeta cataria) and Peppermint (Mentha x piperita)

Usually thought of as a plant that cats adore, and therefore used to stuff toy mice, catmint (or catnip), like peppermint, has antispasmodic action, a quality you'll appreciate if you have intestinal cramping.

Typical dosage: 3 cups of tea per day (steep 1 to 2 teaspoons of dried leafin 1/4 litre of hot water for 10 minutes). Caution: do not use catmint if pregnant; do not use peppermint if you have heartburn or oesphageal reflux.

Grapefruit Seed Extract

Made from the seed, pulp and inner rind of grapefruit, these products can be helpful in fighting both bacterial and parasitic infections. Studies show they can kill Salmonella and Sbigella species, V. cbolerae and Candida species. They can also inhibit the growth of Giardia species. Some people take grapefruit seed extract as a preventive when they travel to areas where the water is questionable. It comes in liquid or tablet form; follow manufacturer's directions on dosage.

PUTTING `GOOD' BACTERIA TO WORK

Lactobacilli are a type of bacteria normally found in the intestines. Studies show that taking various strains of lactobacilli can help prevent cases of, and improve recovery from, diarrhoea caused by a virus called rotavirus. They work in several ways: by out-competing undesirable bacteria and preventing `bad' bacteria from clinging to the intestinal lining, by strengthening local immune response in the gut, and by stimulating white blood cells.

You can ingest these bacteria when you eat active-culture yogurt or kefir (a yogurt drink). Just make sure the fine print on the label says the product contains live cultures. You can also take a supplement, usually in the form of Lactobacillus acidophilus,