Q: Would you please explain what causes diarrhea? It comes on me suddenly. Afterwards, I take a tablespoon of milk of magnesia and one or two Imodium caplets, which helps somewhat.
I watch my diet. I can’t eat fruit, some vegetables, gravy, sauces or cold cuts. Would vitamin supplements help the situation? Can you recommend anything to help the situation?
— L., Stamford, Conn.
A: Why are you taking the milk of magnesia with your bouts of diarrhea? For most people this causes looser stools. Some people use it to treat their constipation.
The formal definition of diarrhea is having frequent, watery, loose stools. And frequent, in this case, usually means more than four times in an eight-hour period.
Since you immediately take the Imodium, it’s difficult to tell if you would have had the multiple loose stools required to meet the formal definition.
Diarrhea is one of the most common signs of intestinal upset and is usually caused by an infection, which can be either due to a virus or bacteria. But diarrhea can be caused by a wide range of diseases such as diverticulitis, celiac disease, lactose intolerance and Crohn’s disease, among others.
Diarrhea is also a side effect of many drugs, and it’s good to think about that as a possibility, especially if you developed the problem within a few days to weeks after starting a new medication.
You can almost always treat diarrhea effectively at home. Certainly the most important first step it to try to determine if there’s something you’re doing that’s causing the diarrhea and stop it. In general, it’s also helpful to cut back or eliminate, at least for awhile, such things as caffeinated drinks, alcohol, milk and fatty foods.
It’s also very important to drink extra fluids to prevent dehydration. That means drinking enough so that you continue to produce your normal amount of urine.
Rest is also important, especially if your diarrhea is accompanied by fever, indicating you may have an infection. Strenuous physical activity also causes increased motility of the intestines, a good reason to use exercise as treatment for constipation.
During bouts of diarrhea, it may be helpful to adhere to the BRAT diet (i.e., to limit your food intake to bananas, rice, apple sauce and bland toast.) Over-the-counter bulk expanders or bran may be helpful, especially for chronic diarrhea.
One of the most effective drugs for stopping acute diarrhea is loperamide (Imodium is a brand name for this drug). It can be found in a number of over-the-counter preparations. Please read and follow the label carefully, don’t use it for prolonged periods of time unless advised to do so by a physician, and be very cautious in using it for young children.
If you experience any of the following symptoms, I recommend you consult a health professional.
*Your diarrhea is black or bloody.
*You have very severe abdominal pain.
*You become dehydrated.
*Diarrhea continues for more than 48 hours.
*Diarrhea comes and goes for more than 2 weeks.
(Write to Allen Douma in care of Tribune Media Services, 2225 Kenmore Ave., Suite 114, Buffalo, NY 14207; or contact him at DRFamily(AT)aol.com. This column is not intended to take the place of consultation with a health-care provider.)
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