No one should have to live with diarrhea. Let your doctor know if you are experiencing diarrhea, especially if there is blood along with the stool or if you have other symptoms such as high fever, abdominal pain, nausea or vomiting.

What Might Be the Cause?

It should not be assumed diarrhea is just due to HIV. There can be multiple reasons:

• Anti-HIV drugs such as Norvir, Kaletra, Videx (ddI) and Viracept.
• Parasites such as Cryptosporidium parvum, Giardia lamblia or microsporidia.
• Bacteria such as Salmonella, Shigella or E. coli.
• Spicy, fatty and/or greasy foods, caffeine, dairy products that contain lactose, diabetic or sugar-free candy (which contain sorbitol) and liquid supplement drinks.
• Vitamin C at doses greater than 1,000 mg or some herbal preparations.

What Can I Do?

Avoid eating suspicious or unsafe foods such as raw or undercooked fish, chicken or meat, unpasteurized dairy products, raw cookie dough and hard to clean fruits and vegetables such as berries, lettuce and sprouts. Be sure to wash ALL fruits and vegetables before peeling or cutting.

Proper and frequent hand washing can help prevent the spread of harmful bacteria.

Keep a diary of food and other things you feel might trigger your diarrhea and discuss this with your physician and dietitian.

Your doctor can make a referral to a gastrointestinal specialist if diarrhea persists beyond a few weeks.

What Medications Are Available?

There are medications, both over the counter (OTC) or prescribed (Rx), which can be used to treat diarrhea, depending on the cause. Talk to your doctor about what's right for you.

Some commonly used medications are listed below. Discuss with your doctor and pharmacist the recommended dose, how to take them, drug interactions and possible side effects.

Prescription Medication

• Albendazole
• Amoxicilin
• Azithromycin
• Cholestryamine
• Ciprofloxacin
• Clarithromycin
• Doxycycline
• Metronidazole/Flagyl
• Octreotide
• Pancreatic Enzymes: Ultrase MT 20,Viokase
• Paromomycin
• Pyrimethamine
• Tincture of opium

Over the Counter

• Bulking Agents: Psyllium, Metamucil FiberCon, Citrucel, Konsyl, oat bran
• Calcium Carbonate: OsCal, TUMS, Viactiv
• Ceralyte: Rice-based electrolyte solution
• Certo: Pectin used to make jam and jelly. Can be found in the supermarket.
• Glutamine: Powder form
• Imodium, Imodium A-D
• Kaopectate, Kaopectate II
• Lomotil
• Maalox Anti-Diarrheal
• Normal Stool Formula
• Probiotics: Preparations that contain "friendly bacteria:" L. acidophilus, L. casei, L. johnsonii, LGG, S. boulardii, Bifidus, Florastor (Bicodex)
• Specialized Liquid Supplements: Subdue, Peptamen, Optimental

Janelle M. L'Heureux, M.S., R.D. is a nutritionist with AIDS Project Los Angeles.

Bertrand Toulouse is a Treatment Advocate with AIDS Project Los Angeles.