In North America, diarrhea is a common condition that is often a source of discomfort and inconvenience.1 Causes of diarrhea include gastrointestinal infections (such as the stomach flu or food poisoning), indigestion, and certain medications (such as antibiotics).1 Certain chronic conditions may also cause persistent diarrhea if uncontrolled, such as food intolerances or digestive disorders.1 Prolonged or recurring episodes should be discussed with a healthcare practitioner.1
Diet during episodes of diarrhea
Diet plays an important role in the management of diarrhea. Hydrating appropriately is a key component in the treatment of diarrhea to prevent dehydration.2,3 In most cases, it is advised to return to a normal, solid diet as soon as possible.2-6 However, certain foods may exacerbate irritation or be more difficult to digest as the digestive tract recovers.5,6 Examples of such foods include caffeinated or sugary beverages, alcohol, fatty or spicy foods.5,6 The dietary approach to prevent or control diarrhea varies depending on its cause and on personal tolerance.
- The dietary approach for treating diarrhea will vary based on its cause and on personal tolerance.
- While it is generally recommended to return to a normal diet as soon as possible, certain foods such as caffeinated or sugary beverages, alcohol, and fatty or spicy foods may be irritating to the digestive tract.
- Current evidence does not support automatically eliminating dairy during periods of acute diarrhea. Rather, favouring low-fat or fermented products is advised.
- Some research is now suggesting that certain fermented dairy products, such as yogurt, may be helpful in avoiding or alleviating acute episodes of diarrhea.
Acute diarrhea. There is a common belief that dairy products should be eliminated during episodes of diarrhea. However, evidence does not support the need to eliminate dairy completely.4,7 Rather, it is generally advised to consume milk products as tolerated and to favour options that are low-fat or contain probiotics.5,6 In some cases, digestive irritation may trigger a temporary shortage of the enzyme needed to properly digest lactose, causing short-term secondary lactose intolerance.8-10 The body’s ability to digest lactose will usually return to normal shortly after the irritation is resolved.10
Some evidence suggests that fermented dairy products, such as yogurt, may also yield certain benefits for preventing or alleviating acute diarrhea.11,12 In fact, a systematic review of 31 studies that explored the health effects of probiotic foods associated certain probiotic milk products, such as yogurt, to a decrease in the duration of episodes of diarrhea that were caused by either an infection or by antibiotics.12 Moreover, a meta-analysis including over 32 000 children found that probiotic yogurt was more effective than a placebo at reducing the duration of acute diarrhea in high-income countries, such as Canada.13
Dietary intolerances. Dietary intolerances require personalized approaches to avoid symptoms, such as diarrhea.14,15 For example, lactose intolerant individuals can often tolerate varying levels of lactose without experiencing gastrointestinal discomfort. Factors include personal tolerance, the type of food consumed, and if the food is consumed alone or with other foods.14,15
Interested in learning more about managing lactose intolerance?Read more here
- National Institute of Diabetes and Digestive and Kidney Diseases. 2021. Diarrhea. https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea. Accessed July 19, 2021.
- UpToDate. 2021. Approach to the adult with acute diarrhea in resource-rich settings. https://www.uptodate.com/contents/approach-to-the-adult-with-acute-diarrhea-in-resource-rich-settings. Accessed July 20, 2021.
- Grave NS. Acute Gastroenteritis. Prim Care 2013; 40: 727–741.
- Lo Vecchio et al. Comparison of Recommendations in Clinical Practice Guidelines for Acute Gastroenteritis in Children. J Pediatr Gastroenterol Nutr 2016; 63:226–235.
- Gouvernement du Québec. 2020. Foods to eat when you have gastroenteritis. https://www.quebec.ca/en/health/health-issues/flu-cold-and-gastroenteritis/gastroenteritis/foods-to-eat-when-you-have-gastroenteritis. Accessed July 28, 2021.
- HealthLinkBC. 2020. Diarrhea, Age 12 and Older. https://www.healthlinkbc.ca/health-topics/diar4#hw87342. Accessed July 28, 2021.
- Guarino A et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. Journal of pediatric gastroenterology and nutrition 2014; 59:132-152.
- Di Costanzo M, Canani RB. Lactose intolerance: common misunderstandings. Annals of Nutrition and Metabolism 2018;73:30-37.
- National Health Service. 2019. Lactose intolerance. https://www.nhs.uk/conditions/lactose-intolerance/. Accessed July 19, 2021.
- American College of Gastroenterology. 2021. Lactose Intolerance in Children. https://gi.org/topics/lactose-intolerance-in-children/. Accessed July 20, 2021.
- Savaiano DA and Hutkins RW. Yogurt, cultured fermented milk, and health: A systematic review. Nutrition reviews 2021;79:599-614.
- Scourboutakos MJ et al. Mismatch between probiotic benefits in trials versus food products. Nutrients 2017. doi 10.3390/nu9040400.
- Florez ID et al. Comparative effectiveness and safety of interventions for acute diarrhea and gastroenteritis in children: a systematic review and network meta-analysis. PLoS One 2018. doi.org/10.1371/journal.pone.020770.
- Corgneau M et al. Recent advances on lactose intolerance: Tolerance thresholds and currently available answers. Critical reviews in food science and nutrition 2017;57:3344-3356.
- Mattar R, de Campos Mazo DF, Carrilho FJ. Lactose intolerance: diagnosis, genetic, and clinical factors. Clinical and experimental gastroenterology 2012. doi:10.2147/CEG.S32368.