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 )
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.
- 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
- 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, which stimulates the gut -- 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.
- 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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