What to eat and not to eat in case of diarrhea

The story is familiar: as soon as diarrhea starts, people wonder about what they ate that could have made it wrong and what they should eat from there to improve – or at least not make it worse – the situation.

Experts recommend that, first of all, you must ensure that the person does not become dehydrated, especially children and the elderly. And only then can you decide what you should or shouldn’t eat. There are foods that are recommended for the general population, but this “menu” will really depend on the characteristics of each person, such as health history, age and severity of diarrhea.

Also, it is important to understand that it is not just about recommended or not recommended foods, but also about how they are stored, prepared and served.

Each case is different, and it is up to a specialized professional to guide what should be done. But, in general, experts do not recommend some types of foods that tend to aggravate diarrhea in the general population. For example, fatty, spicy, fried and sweet foods, in addition to juices, alcoholic beverages and whole foods or foods with insoluble dietary fiber (such as beans and whole wheat).

Diarrhea is a bowel movement that increases the frequency of defecations, changes the amount and consistency of stools (which become watery and loose) and can be accompanied by abdominal pain and dehydration (dry mouth, very thirsty, dark urine or less quantity and lack of disposition).

There are many possible causes of diarrhea, such as infections, inflammation, food poisoning, food intolerance and allergy, an unbalanced diet, Covid-19, medication side effects, stress, or chronic conditions such as cancer, Crohn’s disease, ulcerative colitis, and diarrhea. irritable bowel.

Diarrhea can be common, but it is a serious health condition that can even kill you if not treated properly. From 2000 to 2015, there were more than 3.4 million hospital admissions and 72,000 deaths in Brazil from diarrheal disease, according to a study by researchers from the UPF and Unoesc.

“(Diarrhea) is considered one of the most common signs of human pathologies, with a high social impact, since it is the third cause of death in children under 5 years of age, and its proper management is fundamental to reduce of infant mortality”, say Victor Kuiava, Ana Thereza Perin and Eduardo Chielle, authors of this study.

Specialists point out that diarrhea affects all age groups and social classes, but it is usually associated with precarious living conditions. According to UNICEF data, almost 60% of deaths from diarrhea are the result of poor access to piped water, hygiene problems and poor sanitation.

According to the Brazilian Society of Family and Community Medicine, symptoms of diarrhea include abdominal discomfort and distension, colic, excess gas, nausea and vomiting. There may also be blood or pus in the diarrhea (dysentery).

Experts and health officials recommend seeking medical attention if you have diarrhea that lasts longer than a week, blood, pus or mucus in your stool, persistent vomiting, ongoing or severe abdominal pain, weight loss, palpitations, signs of dehydration, or changes in color. of feces.

What to eat and not to eat in cases of diarrhea?

“Hydration and nutrition are the pillars of the treatment of diarrhea at all ages, especially in babies and young children,” pediatrician Luciana Rodrigues Silva, vice-president of the Brazilian Medical Association (AMB) and professor at the Federal University of Bahia (UFBA).

As stated above, it can cause dehydration and loss of nutrients, two complications considered urgent and worrying, especially in children and the elderly, who are more sensitive and dehydrate more quickly.

When talking about fighting dehydration, one immediately thinks of homemade serum and the popular recipe released by the Ministry of Health: a 200 ml glass of filtered and boiled water mixed with a handful of sugar and a pinch of three fingers of salt. This mixture is because water hydrates the body, but does not replace the loss of sodium and potassium, for example.

Today, there are also ready-made solutions, usually in powder form, sold in pharmacies without a prescription. This substance is dissolved in water and everyone can take it. To obtain oral rehydration therapy through the Unified Health System (SUS), it is recommended to seek care at a health unit.

But beyond hydration itself, what should be done with food as a whole?

One of the first questions that arise is: should you eat or fast, as a kind of “rest” for the intestines?

In general, studies claim that early feeding can reduce the severity, duration and nutritional consequences of diarrhea. But some health professionals may recommend the opposite for some very specific cases with adults, fasting on the first day to avoid intestinal malabsorption.

In the case of children over six months, it is a consensus among specialists that the diet should be maintained and that, again, it should be examined and monitored by a specialized health professional.

Some studies say that reduced food intake can contribute to the resurgence of diarrhea or malnutrition.

Children and adults often lose their appetite in situations like this, accompanied by vomiting, but you shouldn’t force them to do anything. Feeding should be resumed gradually.

Another common question: should you take medicine or eat food to try to stop diarrhea?

Experts do not indicate any attempt to stop this process because diarrhea is a manifestation of the body’s defense, and trying to stop it can affect the fight against some toxin from some bacteria that causes inflammation in the intestine, for example.

But there are foods that are generally recommended for all people to relieve or not aggravate symptoms, such as fat-free chicken, fish (non-greasy), lean meat, white rice, peeled apples, carrots, potatoes, broth beans and bananas.

These are so-called constipation foods, which often lead to a reduction in the amount of stool and an increase in “intestinal transit” time, which helps to relieve symptoms and prevent complications such as dehydration and weight loss, explains a guide to Federal University of Triângulo Mineiro (UFTM).

It is worth remembering that some people may have specific problems with these foods, such as intolerance or allergy.

There are some popular diets to treat diarrhea and gastrointestinal disorders, such as the Brat and the low Fodmap diet. But both cannot be followed without medical advice because they can lead to nutritional and caloric deficiencies.

The acronym Brat stands for banana, rice, applesauce and toast. It can relieve symptoms, as it has a lot of starch and little fiber, but it should never be used often.

The low Fodmap diet is one of the diets that target conditions like irritable bowel syndrome and disease. In it, it is recommended to consume less legumes such as chickpeas, lentils and beans, fructose such as apples, sweeteners, fruits such as broccoli, brussels sprouts, onions, wheat, rye, milk and dairy products.

But it depends on each person, and those with conditions such as Crohn’s disease, for example, are even advised to keep records of what they eat and the effects of these foods on the intestine so that this control is more precise and individualized.

It is worth remembering that thinking about a diet for a diarrheal condition is not limited to the choice of food, but also to the way these foods were stored, prepared and served.

The next question then is: what should you not eat during diarrhea?

Once again: each case is different, and people can respond differently to different foods.

But there are a number of foods that are usually not recommended for people with diarrhea in the general population. As stated above, this includes fatty, spicy, fried foods, sweets, among others.

Some of these foods are considered laxatives or laxatives because they increase bowel activity, increase the amount of stool and stimulate intestinal peristalsis (linked to the movement of food through the intestines).

The list of generally not recommended foods includes:

• Alcoholic, caffeinated or carbonated beverages;

• Wholemeal and/or seed breads;

• Spices such as paprika;

• Fatty and matured cheeses;

• Refined ultra-processed products;

• High in fat, even if it is salmon;

• Foods that give a laxative effect;

• Juices have a high level of fructose, which speeds up intestinal transit, so they should be avoided;

“Milk and dairy products can irritate the colon and increase the formation of fecal bolus and, with that, cause diarrhea”, says nutritionist Durval Ribas Filho, president of the Brazilian Association of Nutrology, to BBC News Brasil.

“In addition, some foods cause immunological reactions, such as eggs, milk, soy, fish and seafood, that is, they oppose allergens and cause diarrhea, nausea, vomiting, diarrhea, shortness of breath, lip swelling and flushing. of the skin.”

What are the main causes of diarrhea?

The causes can be the most diverse.

According to the Brazilian Society of Family and Community Medicine, from a practical point of view, diarrhea can be acute or chronic.

The acute one, which usually lasts a few days, is usually caused by viruses, bacteria, or parasites; contaminated foods, foods with a large amount of fiber, coffee, teas, soft drinks, milk and its derivatives, chocolate; medications such as antacids, laxatives; ingestion of non-absorbable sugars; intestinal ischemia; fecal impaction; pelvic inflammation.

The chronic, which usually lasts for weeks, is usually caused by inflammatory bowel diseases, intestinal cancers, changes in immunity such as AIDS and food allergies.

Diarrheal conditions can also arise due to stress and medications such as antibiotics, laxatives and bariatric surgery, adds Ribas Filho, from the Brazilian Association of Nutrology.

Regarding the causes of childhood diarrhea, Silva, from the Brazilian Medical Association, states that the main causes are infectious, especially viral and bacterial.

Infectious diarrhea, which comes from eating contaminated food, can manifest itself hours or days after consumption. Bacteria like Salmonella sp. and Escherichia coli (or E. coli) can take days to show symptoms, but Staphylococcus aureus can show symptoms half an hour after ingestion.

Inflammation of the intestinal tract, called acute gastroenteritis, affects the stomach and intestines and can be caused by consuming contaminated food and water. There is currently a vaccine available for children against rotavirus, which is linked to acute childhood diarrhea.

But acute gastroenteritis also affects adults and the elderly. Other viruses can also cause it, such as adenovirus, norovirus and astrovirus. Remembering that the virus is transmitted by contact with other people who are contaminated, or objects, surfaces.

Another possible cause is microscopic colitis, often more common in the elderly, may be associated with celiac disease and other conditions. It can cause chronic diarrhea, but without the presence of blood.

Diarrhea with blood or pus can be a sign of dysentery or be linked to a chronic condition.

One is irritable bowel syndrome, a functional gastrointestinal disorder that can cause both diarrhea and constipation. Others are irritable bowel diseases, ulcerative colitis and Crohn’s disease, marked by inflammation and diarrhea.

Finally, there is diarrhea caused by bowel cancer. This is a malignant tumor that affects the large intestine (colon and rectum), and changes the bowel habit, and can manifest both diarrhea and constipation.

There are three main signs to look for (their presence does not mean that the person necessarily has cancer):

• blood in the stool for no apparent reason — it can be light or dark red;
• changes in defecation time — such as going to the bathroom more often or changes in the stool itself (softer or harder);
• abdominal pain or swelling, with a feeling of a full and hard belly.

This text was originally published here