For most cases of acute diarrhea, the single most important thing to take is fluids with electrolytes. Beyond that, over-the-counter medications like loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol) can reduce symptoms, while probiotics and simple dietary choices help your gut recover faster. What works best depends on the type and severity of your diarrhea.
Fluids and Electrolytes Come First
Diarrhea pulls water and salts out of your body quickly. Replacing them is more urgent than stopping the diarrhea itself. Oral rehydration solutions are the gold standard because they contain a specific balance of sodium and glucose that helps your intestines absorb water efficiently. The World Health Organization’s formula uses a 1:1 ratio of sodium to glucose, which optimizes absorption through a dedicated transport system in your gut lining.
You don’t need to mix your own solution. Premixed commercial products like Pedialyte or DripDrop work well despite having a slightly different sodium-to-glucose ratio (about 1:3). If you can’t get a rehydration product, clear broths, diluted fruit juices, and water are reasonable substitutes. Avoid drinks that are very sugary or caffeinated, as these can pull more water into the intestines and make diarrhea worse.
Over-the-Counter Medications
Loperamide (Imodium)
Loperamide is the most widely used anti-diarrheal medication. It works by slowing the movement of your intestines, giving them more time to absorb water and firm up your stool. The standard adult dose is 4 mg (two capsules) after the first loose bowel movement, then 2 mg (one capsule) after each subsequent loose stool. The maximum is 8 mg per day for the over-the-counter tablet form, or 16 mg per day for prescription use.
One downside: because loperamide slows gut movement, it can cause constipation and may trap bacteria in your intestines. For that reason, you should avoid it if you have a high fever or see blood in your stool, as these signs suggest a bacterial infection where slowing things down could make the situation worse.
Bismuth Subsalicylate (Pepto-Bismol)
Bismuth subsalicylate is a gentler option that reduces inflammation in the intestinal lining and has mild antimicrobial properties. It’s particularly useful for mild diarrhea and is commonly recommended for traveler’s diarrhea. However, it contains a compound related to aspirin, so it should not be given to children under 12. Children and teenagers recovering from the flu or chickenpox should also avoid it due to the risk of Reye’s syndrome, a rare but serious condition affecting the brain and liver.
Probiotics That Actually Help
Not all probiotics are equal when it comes to diarrhea. Two strains have the strongest evidence: Saccharomyces boulardii and Lactobacillus rhamnosus GG. A meta-analysis of six randomized trials found that S. boulardii shortened diarrhea duration by an average of 1.6 days compared to standard treatment alone. Both strains are recommended as add-on therapies by major gastroenterology guidelines.
Look for these specific strain names on the label. A generic “probiotic blend” may not contain strains studied for diarrhea. You can start taking them alongside other treatments, as they work by supporting your gut’s natural defenses rather than by stopping symptoms directly.
What to Eat During Diarrhea
The old BRAT diet (bananas, rice, applesauce, toast) was once the standard recommendation, but it’s no longer advised as a strict regimen. It lacks protein, calcium, vitamin B12, and fiber, and following it for more than a day or two can actually slow recovery. The American Academy of Pediatrics specifically advises against it for children, noting it’s too restrictive to support gut healing.
The current guidance is simpler: eat soft, bland foods as tolerated, and return to a normal diet as soon as you feel able. Good choices include plain crackers, boiled potatoes, chicken soup, oatmeal, and steamed vegetables. Avoid greasy, spicy, or heavily seasoned foods until things settle down. Dairy can be problematic for some people during a bout of diarrhea because the inflamed intestinal lining temporarily loses some ability to digest lactose.
Herbal Teas Worth Trying
Several herbal teas can ease the cramping and discomfort that come with diarrhea. Chamomile tea may help relax digestive muscles and soothe symptoms including gas, nausea, and diarrhea. Peppermint tea contains oils that relax intestinal muscles and relieve abdominal pain, with the strongest evidence coming from studies on irritable bowel syndrome. Green tea extract has shown promise in one study for improving diarrhea and shortening recovery time in children with stomach flu. Black tea may improve stool consistency and reduce the frequency of bowel movements.
These teas are mild enough to use alongside other treatments and double as a way to keep up your fluid intake.
Traveler’s Diarrhea
Diarrhea that hits during or shortly after international travel follows a slightly different playbook. The CDC recommends a severity-based approach. For mild cases that don’t interfere with your plans, bismuth subsalicylate or loperamide alone is usually sufficient, and antibiotics aren’t recommended. For moderate diarrhea that disrupts your activities, a short course of antibiotics may be warranted, sometimes as a single dose.
If you’re traveling to a region where traveler’s diarrhea is common, talk with a healthcare provider beforehand about carrying a standby antibiotic. Loperamide can safely be combined with antibiotics to get faster symptom relief. However, if your diarrhea is bloody or accompanied by fever, loperamide should be avoided and antibiotic treatment becomes more important.
Zinc for Children
For children with acute diarrhea, the WHO recommends zinc supplementation: 20 mg per day for 10 to 14 days (10 mg per day for infants under six months). Zinc helps reduce the duration and severity of diarrhea episodes in children and is a standard part of treatment protocols in many countries. This recommendation applies primarily to children in settings where zinc deficiency is common, but it’s worth asking a pediatrician about regardless of location.
Signs That Need Medical Attention
Most diarrhea resolves on its own within a couple of days. But certain symptoms signal something more serious. Contact a doctor promptly if you experience diarrhea lasting more than two days, a high fever, six or more loose stools per day, severe abdominal or rectal pain, black or tarry stools, blood or pus in your stool, or signs of dehydration like dizziness, dark urine, or extreme thirst.
For children, the timeline is shorter. Diarrhea lasting more than one day, any fever in infants, or refusal to eat or drink for more than a few hours warrants a call to the doctor. Infants under 12 months, premature babies, and children with existing medical conditions need especially prompt attention.