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Diarrhea and HIV/AIDS

February 2013

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Over-the-Counter Medications

  • Pepto-Bismol or Kaopectate (bismuth subsalicylate)
  • Imodium AD (loperamide), Kaopectate 1-D (bismuth subsalicylate), or Maalox (calcium carbonate +/- magnesium +/- aluminum +/-simethicone )

Supplements

In some cases a nutritional supplement may help reduce diarrhea. Be sure to talk to your HIV provider before adding supplements to your diet. Some of these supplements include:

  • L-glutamine: 10 to 30 grams per day. This supplement is often helpful if your diarrhea is caused by HIV drugs. You may want to try mixing the powder in juice or applesauce several times a day.
  • Calcium carbonate: 500 milligrams twice a day. Researchers are not sure how much this supplement actually helps diarrhea, but in most cases it does not hurt to try. It is thought that calcium carbonate helps the most if your diarrhea is caused by Viracept (nelfinavir) or Kaletra (lopinavir + ritonavir).
  • Probiotics: these are the "good bacteria" normally found in your gut. They usually need to be refrigerated, and contain live active cultures of bacteria such as acidophilus or bifidus. They can be found in yogurts, milks, and kefir. If you are allergic to or intolerant of dairy products, some probiotics are available in pill form. Probiotics are often used if your diarrhea is caused by taking antibiotics, but they can also work for other types of diarrhea.

Dietary Changes

  • Eat small meals at room temperature every two to three hours
  • Make sure you drink lots of fluids and replace electrolytes
  • Try not to eat high fat or greasy meals, especially fried foods
  • Avoid fat substitutes like olestra
  • If you have gas or stomach pains, try not to eat gas-forming foods like onions, beans, broccoli, cabbage, and cauliflower
  • Spicy foods and very sweet foods may make gas and diarrhea worse
  • Stay away from caffeine - caffeine is found in coffee, some teas, sodas, and chocolate
  • Eat soluble fiber in foods like oats & oatmeal, potatoes, white rice, and apples (without the peel)
  • Avoid insoluble fiber, or "roughage," which is found in lettuce, greens, bran, seeds, whole grain breads, and corn
  • Avoid eating raw or undercooked foods (such as meat, fish, chicken and eggs) or un-pasteurized dairy products

Sometimes the BRATT diet can help:

  • B ananas
  • R ice (white)
  • A pples (without peels), applesauce, or juice
  • T oast (white)
  • T ea (unsweetened and non-caffeinated)

After your diarrhea clears up you may slowly return to a normal, healthy diet. However, you may want to start with more bland foods like bananas, plain rice, boiled potatoes, baked chicken (with skin and fat removed), eggs, plain toast, and crackers.

Other Tips

  • Keep a diary of food and other things you feel might trigger your diarrhea and discuss this with your health care provider and dietitian
  • Wash fruits and vegetables before eating
  • Wash your hands often and thoroughly
  • Ask your HIV or primary care provider about a referral to a gastrointestinal specialist if diarrhea does not go away after some time


Taking Care of Yourself

Remember, diarrhea is manageable. It may take several tries to figure out what works for you. Try to be patient and do not give up. With the help of your health care provider and dietitian, you can find the best options for managing or eliminating your diarrhea.

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This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with TheBody.com to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from TheBody.com or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.
 
See Also
HIV & You: Managing Gut Symptoms
More Advice on Coping With Diarrhea

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