Most episodes of diarrhea go away by themselves and don’t require treatment apart from staying hydrated, according to Benjamin Levy, a gastroenterologist at the University of Chicago. However, certain symptoms warrant medical attention, and knowing how to manage symptoms at home can speed recovery and prevent complications.
When to see a doctor
Levy notes that the majority of diarrhea episodes resolve on their own after three or four days. But if diarrhea lasts longer than a week or is accompanied by fever or other concerning symptoms, seek care. These warning signs include a fever of 101°F or higher, blood or mucus in your stool, severe abdominal pain, vomiting for more than two to three days, or feeling like you need to poop but not producing anything when you go to the bathroom.
Dehydration is another key symptom to watch for. While thirst is the most well-known sign, a more reliable indicator is a drop-off in urine production. If you’re drinking plenty of fluids but not absorbing enough to make urine at least every six hours, that’s concerning. Symptoms can include lightheadedness, confusion, and dark urine. If you experience these, see a clinician—and avoid walk-in “hydration spa” IV drips. Levy warns that if you’re dehydrated enough to need IV fluids, “there may be something more serious going on.”
Who should seek care sooner
Some individuals should have a lower bar for seeking care. If you’re 65 or older, you may be less aware of thirst, so let your clinician know within a day of diarrheal symptoms. The same applies if you have kidney disease, a weakened immune system, or a recent hospitalization or course of antibiotics.
Your clinician may order testing for a range of infectious or non-infectious conditions. If you suspect a specific cause, such as cyclosporiasis—a parasitic infection often traced to contaminated produce that has affected more than 17,000 people in the US as of late August—ask if special testing might be helpful.
What to eat and drink
The priority is staying hydrated. Replace fluids and electrolytes by drinking plenty of water, tea, or sports drinks early on. If you’re starting to become dehydrated, switch to an over-the-counter oral rehydration solution like Pedialyte. These drinks have a lower concentration of dissolved sugar and salt than regular sports drinks, which helps them be absorbed better and curb poop output more effectively.
There’s no need for a strict liquid diet or the formerly recommended BRAT diet (bananas, rice, applesauce, toast). However, certain foods can aggravate symptoms. Levy recommends skipping fatty and spicy foods, as well as high-fiber foods like whole grains and raw fruits and vegetables. He also suggests avoiding alcohol, caffeine, and drinks that are overly sugary or contain artificial sweeteners.
As long as you have an appetite, eat modest portions of whatever you feel like outside those categories—broth-based soups with chicken or tofu, starchy foods, and eggs are all good choices. Diarrhea often causes temporary lactose intolerance, so Levy also recommends skipping dairy other than yogurt.
Medications and home remedies
For symptom relief, most adults can safely take bismuth subsalicylate (Pepto-Bismol is a common brand) for a couple of days to reduce poop frequency and cramping. Note that your stool may turn black, which is a benign side-effect.
Many people can also safely take a few doses of loperamide (e.g., Imodium), but only if specific conditions are met: the diarrhea doesn’t contain blood, you don’t have a fever, and you haven’t taken antibiotics in the past three months. Always follow package directions for dosing, and check with your doctor before taking these medicines if you have any medical conditions.
To reduce the risk of an irritated anus, Levy recommends slightly wetting soft toilet paper at the sink and patting, rather than rubbing, when you wipe. Avoid alcohol-based wipes, which dry out the skin and may cause more irritation. Zinc oxide, dimethicone, or petroleum-based barrier ointments applied after each cleanup help protect irritated skin. A plain-water sitz bath—sitting in a few inches of warm water in the tub—can also provide relief. For severe itching or inflammation, low-dose over-the-counter creams containing hydrocortisone, lidocaine, or both may help.
One thing not worth reaching for: probiotics. “Not recommended,” Levy says flatly, despite what some influencers say.
Protecting others
If a contagious condition is causing your diarrhea, you may be contagious for days to weeks after symptoms resolve, and it typically spreads hand-to-mouth. Wash your hands, fingernails, and wrists with soap and water—especially after using the bathroom and before and after handling food. Skip preparing food for anyone else while you’re sick, and if you can, stay home from work until your symptoms resolve.
