Dietary considerations for diarrhoea

Diarrhoea is the passing of looser or more frequent stools than is normal for you. If it continues for a long period of time or occurs frequently it can be distressing, isolating and affect your mental and physical health.

What causes diarrhoea?

Diarrhoea can be caused by a number of different things such as a viral or bacterial infection in the bowel, emotional distress, irritable bowel syndrome (IBS), bowel surgery or as a side effect of some illnesses or treatments. Cancer treatments particularly such as chemotherapy or radiotherapy can affect the healthy cells that line the digestive tract which can result in diarrhoea.

What to do if you have diarrhoea?

In most cases diarrhoea will clear up without treatment. However if it continues diarrhoea can lead to dehydration so it’s very important to try to replace lost fluids. Some changes to your diet can also help to control your symptoms.

Fluids

Sip small amounts of fluids throughout the day.

Aim for around 2 litres (8-10 cups) of fluid per day, such as water, herbal teas or squash.

Avoid caffeine and alcohol

Caffeinated drinks such as tea, coffee and cola may worsen diarrhoea so should be avoided.

Alcohol can also make diarrhoea worse, so it is best to avoid it.

If you are suffering from severe diarrhoea then oral rehydration solutions, such as Diarolyte can help prevent dehydration as they replace both the loss of fluids and salts.

Fibre intake

It can be useful to reduce your fibre intake, particularly insoluble fibre. Insoluble fibre is the rough, stringy indigestible part of foods such as pith and pips and it helps to speed up the transition of the stool through the gut. During a bout of diarrhoea it is an idea to limit insoluble fibre to attempt to slow down gut transit.

Fibrous foods to avoid:

• Brown, wholemeal or granary bread. Wholemeal pasta, noodles or rice
• Raw vegetables: All skins, seeds, stalks and peel. Salad, beans, peas, pulses and lentils
• Raw fruit, especially those with skin, pith and seeds such as berries and oranges

What to eat instead:

• White bread, pasta or rice
• Vegetables peeled and well cooked
• Fruit with skin removed such as peeled apples – cooked or stewed fruit with pips sieved out
• Tinned fruit without skins
• Smooth fruit juice

Avoid high fat foods

High fat foods don’t cause diarrhoea but they can exacerbate it so it can help to limit your fat intake whilst you have diarrhoea.

It is important to only try this for a few days as avoiding fat long term can cause weight loss.

• Avoiding fried foods
• Limit high fat dairy products
• Use less butter, margarine or oil

Avoid sweeteners

Avoid diet foods and drinks with sweetener such as those listed in the ingredients ending in ‘tol’ e.g. mannitol, sorbitol or xylitol.

Lactose

Some people can become temporarily lactose intolerant due to medications, treatment or sometimes prolonged diarrhoea. Lactose is a sugar found in milk and milk products.

If you are lactose intolerant it means that you are not producing enough of the enzyme (lactase) needed to break down the lactose. This can cause diarrhoea if too much dairy is eaten.

Most people can tolerate a small amount of dairy and so limiting dairy products or switching to a lactose free milk is usually sufficient to control symptoms. Yoghurt and hard cheeses such as cheddar are low in lactose, due to the fermentation process, so can often be tolerated.

Probiotics

Probiotics are live bacteria and yeasts that are found in certain food products or in supplements and are sometimes referred to as ‘good’ or ‘friendly’ bacteria. In some cases, it is said that probiotics can restore the natural balance of ‘good’ bacteria in the gut that may have been disrupted by illness or treatments.

There is some evidence that certain probiotics can be helpful in relieving diarrhoea. They are safe to take for most people however, they can cause problems in people who have a compromised immune system so speak to your doctor to ensure they are safe before trying them.

Stress or anxiety

There is a well-known link between stress and anxiety and diarrhoea. Studies have shown that stressful situations can cause the release of certain hormones that increase movement in the bowel which can lead to diarrhoea.

Being unwell can cause a lot of stress and anxiety so it is important to consider introducing ways to relax and help manage stress.