Most diarrhea clears up on its own within a few days, but the right combination of fluids, food choices, and over-the-counter options can speed things along and keep you comfortable in the meantime. Acute diarrhea typically lasts less than a week. If yours has persisted longer than two weeks, that’s considered persistent diarrhea, and anything lasting four weeks or more is chronic, which points to an underlying issue worth investigating.
Fluids First: Preventing Dehydration
Replacing lost fluids is the single most important thing you can do when you have diarrhea. Your body loses water and electrolytes (sodium, potassium, chloride) with every loose stool, and dehydration is the main reason diarrhea becomes dangerous rather than just unpleasant. Oral rehydration solutions, available at any pharmacy, deliver the right balance of salt, sugar, and water to help your gut absorb fluid efficiently. If you don’t have a commercial solution on hand, broth, diluted juice, or water with a pinch of salt and sugar will work in the short term.
Rice-based rehydration fluids have a slight edge early on. A randomized trial at Johns Hopkins found that a rice-based oral rehydration solution reduced stool output by 20 percent in the first eight hours compared to the standard glucose-based version, though the difference evened out after that initial window. Plain rice water, made by boiling rice and straining off the starchy liquid, follows the same principle and is a low-cost option if you’re managing things at home.
Over-the-Counter Medications
Two widely available options can reduce the frequency of loose stools. Loperamide (sold as Imodium) works by slowing the movement of your intestines, giving them more time to absorb water. It’s available as tablets, capsules, and liquid. It should not be used in children under two, and older adults should use it with caution because it can affect heart rhythm at high doses.
Bismuth subsalicylate (the active ingredient in Pepto-Bismol) takes a different approach. It has mild anti-inflammatory and antibacterial properties that coat the lining of your gut. It can darken your tongue and stool temporarily, which is harmless but worth knowing about so it doesn’t alarm you.
Neither medication is appropriate if you have bloody stools or a high fever, because those signs suggest an infection where slowing the gut down could make things worse. In that situation, your body is trying to flush out a pathogen, and it’s better to let it do its job while focusing on hydration.
What to Eat (and What to Skip)
The old advice to stick to bananas, rice, applesauce, and toast (the BRAT diet) is outdated. While those foods are gentle, limiting yourself to them can actually slow recovery. Randomized trials have shown that returning to a normal, balanced diet as soon as you can tolerate it leads to lower stool output, shorter illness, and better nutritional outcomes compared to restricting food. The key is eating what you can, not starving your gut into submission.
That said, certain foods and drinks reliably make diarrhea worse and are worth avoiding until things settle:
- Caffeine (coffee, tea, energy drinks) stimulates the gut and can speed transit even further.
- Alcohol irritates the digestive lining and pulls water into the intestines.
- High-fat foods like fried dishes, pizza, and fast food are harder to digest and can increase cramping.
- Foods high in simple sugars, including fruit juices, candy, and packaged desserts. Fructose and other sugars draw water into the gut.
- Sugar alcohols found in sugar-free gum and candies (sorbitol, xylitol) are notorious for causing loose stools even in healthy people.
- Dairy products containing lactose. Your gut’s ability to digest lactose can be temporarily impaired during and after a bout of diarrhea, sometimes for a month or more.
Focus instead on starches like rice, potatoes, and bread, along with lean proteins, cooked vegetables, and bananas. These provide calories and nutrients without overwhelming a sensitive digestive system.
Probiotics: Which Strains Actually Help
Not all probiotics are equally useful for diarrhea. The strain with the strongest evidence is Lactobacillus rhamnosus GG. In a randomized controlled trial comparing it against another popular strain (Saccharomyces boulardii) and a control group, Lactobacillus rhamnosus GG shortened the duration of diarrhea by roughly 19 hours and reduced hospital stay by about 23 hours. Saccharomyces boulardii, despite its popularity, did not produce a statistically significant reduction in either measure in the same trial.
If you want to try a probiotic, look specifically for Lactobacillus rhamnosus GG on the label. Generic “probiotic blend” products may not contain the strains with clinical evidence behind them. Probiotics work best when started early in the course of illness.
When Diarrhea Needs Medical Attention
Most episodes resolve without any medical care. But certain warning signs point to something more serious than a routine stomach bug. Seek care if you notice blood or mucus in your stool, a persistent high fever, severe abdominal pain or tenderness, signs of significant dehydration (dizziness, confusion, very little urine output, or fainting), or symptoms lasting seven days or longer.
Recent antibiotic use is another red flag, because antibiotics can trigger an infection with Clostridioides difficile, a bacterium that causes particularly stubborn and sometimes dangerous diarrhea. People who are immunocompromised or recently hospitalized also have a higher risk of severe infections and should have a lower threshold for getting checked out.
Diarrhea in Children
Children dehydrate faster than adults, so fluid replacement is even more critical. Oral rehydration solutions designed for kids are the best option. The World Health Organization recommends zinc supplementation alongside rehydration for children with diarrhea: 20 mg per day for 10 to 14 days, or 10 mg per day for infants under six months. Zinc has been shown to reduce both the severity and duration of episodes. It’s inexpensive and widely available, though it’s more commonly used in resource-limited settings where diarrheal illness carries higher risks.
Resume normal feeding, including breastfeeding, as soon as possible. Just as with adults, restricting a child’s diet to a few bland foods delays recovery rather than helping it. Age-appropriate meals should continue alongside rehydration efforts.
Why Antibiotics Usually Aren’t the Answer
Most acute diarrhea is caused by viruses, which antibiotics cannot treat. Even many bacterial cases resolve without them. Antibiotics are reserved for specific situations: bloody diarrhea with fever, confirmed bacterial infections like Shigella or certain Salmonella strains, signs of sepsis, or illness in people who are immunocompromised or very young. Taking antibiotics unnecessarily can actually worsen diarrhea by disrupting the balance of bacteria in your gut, and it contributes to antibiotic resistance. If your doctor suspects an infection that warrants treatment, they’ll typically order stool tests first to identify the specific pathogen before prescribing anything.