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Common Nutritional Issues: Diarrhea

Diarrhea can be caused by many factors such as any gastric surgery, malabsorption, radiation therapy to any part of the abdominal area, chemotherapy or the use of antibiotics.  It is very important to try to avoid dehydration during the challenge of diarrhea, as well as, any weight loss which is common.  Always communicate with your healthcare team to try to determine the true cause of your diarrhea in order to get the proper treatment.

Here are some tips to help alleviate the diarrhea and associated problems:

  • Try the BRAT diet: Bananas, Rice, Applesauce, Tea and/or toast.  This can also be referred to as the “white” diet because potatoes, pasta, tender chicken, plain white fish, egg whites and soft peeled pear/peach, canned pears/peaches, plain crackers or graham crackers can be included usually with good results.  Most of these foods are high in soluble fiber which helps to bind the stool.
  • Cooked vegetables can be well tolerated: try carrots, squash of any kind, asparagus tips, green beans, wax/yellow beans or artichokes.
  • Eat small, frequent meals.  Watch the clock and eat or drink something every 2 hours
  • Sip liquids slowly.  Plan a regimen like taking small sips every 15-20 minutes – throughout the day.
  • Drink plenty of room-temperature liquids.  The best tolerated items include diluted 100% juice (best to avoid citrus), sports drinks like Gatorade, Pedialyte, ginger ale, or fruit nectars (apricot, peach or pear).  Plain water is also helpful for hydration but does not provide any calories.
  • Try rice water (see below)
  • Sip on plain broth or bouillon and snack on salty foods like crackers or pretzels to help replace sodium.
  • Drink fluids between meals instead of with meals
  • Try a little yogurt.  The probiotics in yogurt may help your digestion.  (Avoid: if you are or think you are lactose intolerant)
  • Recline or sit after eating (Do not lie flat).

Things to AVOID:  These items can make diarrhea worse

  • Caffeine: coffee, tea, soda, energy drinks.
  • Spicy items like cayenne pepper and hot sauce.  Be very careful for over seasoned foods with too much garlic, onion or black pepper.
  • High fat or greasy foods: potato chips, french fries or any fried foods, pizza, bacon, high-fat dressings or mayonnaise, donuts/pastries, gravies & cheese or creamy sauces.
  • Fresh fruit with skin or peels
  • Raw vegetables
  • Dense whole-grain high fiber breads & cereals
  • Sugar-free foods, gums or candies.  Most of these items contain sorbitol (a sugar alcohol) which can increase diarrhea and gas.
  • Very hot or very cold foods or fluids.  Room temperature is usually better tolerated.
  • Tobacco (cigarettes, pipe, or chewing tobacco)

Rice Water
The end result is rice water AND cooked rice which can both be enjoyed.

  • Follow cooking instructions on back of rice package (use white rice, but NOT instant), usually 2x the amount of water to rice. 
  • Add an additional 1 ½ cups of water at the beginning of the cooking process. 
  • After the appropriate time (~20 minutes) and rice is done, drain excess water from rice with a fine sieve into a cup.
  • Let the rice water cool to a safe drinking temperature or cool down completely and enjoy. 
  • A small amount of sugar or sweetener can be added if necessary.  Drink about ½ - 1 cup at a time.  This can be consumed 2-3 times during the day.