Herbs and Supplements for Diarrhea Management

Diarrhea varies significantly in its severity, from a mild, brief inconvenience to a condition that can be life-threatening.

Diarrhea often triggered by infectious agents like viruses, bacteria, and parasites, leading to unusually fluid or watery bowel movements. There’s also an increased urgency and frequency in using the restroom. Typically, it resolves spontaneously within a day or two.

Annually, the global incidence of diarrheal diseases reaches[1] approximately 4 billion cases. Furthermore, diarrhea claims the lives of nearly 1.3 million children under five years old annually, predominantly in less developed nations, positioning it as the second most common cause of mortality among this demographic (Birhan TA, et al., 2023).

Diarrheal disease ranks as the second leading cause of death among children under five years old, claiming the lives of approximately 525,000 children in this age group annually.

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It’s important to distinguish that not all frequent bowel movements indicate diarrhea, especially if the stool’s consistency remains normal. Additionally, it’s common for breastfed infants to have soft, mushy stools, which is considered normal and not indicative of diarrhea.

Symptoms and Triggers

Diarrhea marks a common health issue, manifesting through frequent, liquid bowel movements. It can abruptly disrupt daily routines, signaling the body’s attempt to rid itself of harmful substances.

Let’s dive into its symptoms and causes with clarity.

Recognizing the Symptoms

Initially, diarrhea presents as an increase in the urgency and frequency of bowel movements. These are notably loose or watery, deviating from the normal consistency.

Individuals may also experience abdominal discomfort or cramps, signaling the intestines’ struggle. In some cases, there’s a presence of nausea or vomiting, further complicating the body’s distress. Chronic cases might include weight loss and dehydration, a dangerous reduction in the body’s fluids and essential salts (electrolytes), necessitating immediate attention.

Unpacking the Causes

The journey to understanding diarrhea begins with its diverse causes. Often, infections lead the charge, introduced by viruses (like the norovirus or rotavirus) or bacteria (such as salmonella or E. coli), which invade the digestive system.

These organisms can enter through contaminated food or water, breaching our defenses. Parasites, tiny organisms living in contaminated water or food, also play a role. They settle in the digestive tract, disrupting its natural rhythm.

Beyond infections, certain conditions like Irritable Bowel Syndrome (IBS), characterized by ongoing digestive system irritation, or inflammatory bowel diseases (IBD) such as Crohn’s disease and ulcerative colitis, which cause long-term inflammation of the digestive tract, contribute to chronic diarrhea.

Moreover, some medications, especially antibiotics, can inadvertently disturb the balance of beneficial bacteria in the gut, leading to this condition. Dietary factors, including intolerance to substances like lactose (the sugar in milk) or artificial sweeteners, further complicate the picture.

Diarrhea and Gastroenteritis Trends in the Netherlands

A community-based study in the Netherlands on the incidence of gastrointestinal diseases, including diarrhea, identified two grades of severity.

The [2] of the incidence of gastrointestinal diseases in The Netherlands. Epidemiology and Infection, 112, 481 – 487. https://doi.org/10.1017/S0950268800051189.” class=”js–wpm-format-cite”>study[2] found the incidence of gastrointestinal episodes, including diarrhea, to be 630 for grade 1 and 180 for grade 2 disease per 1000 person-years, after adjusting for age and sex. The incidence was higher among women than men, with a relative risk of 1.25.

It was lower for individuals in the 19–64-year-old age group compared to those younger or older. About 20% of the patients consulted a general practitioner, either in person or by telephone (Hoogenboom-Verdegaal et al., 1994).

Another [3] on gastroenteritis in the Netherlands: incidence and etiology.. American journal of epidemiology, 154 7, 666-74 . https://doi.org/10.1093/AJE/154.7.666.” class=”js–wpm-format-cite”>study[3] focused on the incidence and etiology of gastroenteritis in the general Dutch population found the standardized gastroenteritis incidence to be 283 per 1,000 person-years. The study highlighted that viral pathogens were the leading cause of gastroenteritis, with Norwalk-like virus being the number one cause of illness in all age groups but one (de Wit et al., 2001).

Foods to Avoid

1. Dairy Products: While not everyone needs to avoid dairy during diarrhea, those with temporary lactose intolerance resulting from a diarrheal episode will find that milk, cheese, and other dairy products may worsen symptoms.
   The inflamed digestive system struggles to break down lactose, leading to increased gas, bloating, and loose stools.
2. Fatty and Fried Foods: High-fat foods, including fried dishes, can be hard to digest under the best circumstances. When your digestive system is already under duress, these foods can be particularly challenging, potentially increasing the frequency and liquidity of bowel movements.
3. Spicy Foods: Spicy ingredients can irritate the digestive tract, leading to heightened symptoms of diarrhea. It’s best to stick to bland, simple foods that are gentle on the stomach until symptoms subside.
4. Sugary Foods and Artificial Sweeteners: Foods high in sugar can draw water into the intestine, worsening diarrhea. Similarly, artificial sweeteners like sorbitol and xylitol, often found in sugar-free gum and candies, can have a laxative effect and should be avoided.
5. Caffeine: Found in coffee, tea, chocolate, and some soft drinks, caffeine can stimulate the intestines, increasing diarrhea. Opting for caffeine-free beverages can help minimize symptoms.
6. Certain Types of Fiber: While fiber is crucial for digestive health, not all types are helpful during a diarrheal episode. Insoluble fiber, found in whole grains, bran, and some vegetables, can accelerate the passage of food through the intestines, exacerbating diarrhea. Instead, focusing on soluble fiber sources, such as oatmeal and bananas, may be beneficial.
7. Legumes and Cruciferous Vegetables: Beans, lentils, broccoli, and cauliflower are known for causing gas and bloating under normal conditions. When experiencing diarrhea, consuming these foods can increase discomfort and should be temporarily avoided.

Individuals suffering from diarrhea due to specific infections may lose up to 20 liters of fluid per day.

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Conventional treatments

When diarrhea strikes, it’s more than just an inconvenience; it’s a signal from your body that something’s amiss.

Thankfully, conventional medicine offers a range of treatments to manage symptoms and address underlying causes. Let’s explore these solutions, ensuring we understand the science behind them.

Rehydration Solutions

First and foremost, combating dehydration is critical. Oral Rehydration Solutions (ORS) are a frontline defense, effectively restoring the body’s fluids and electrolytes (salts and minerals) lost during episodes.

These solutions, available over the counter, mix water with precise amounts of salts and sugars to enhance absorption and recovery.

Anti-diarrheal Medications

For immediate relief, anti-diarrheal medications play a pivotal role. Loperamide, commonly known by its brand name Imodium, slows down gut movement, reducing the frequency of bowel movements.

It’s suitable for short-term relief but isn’t recommended for diarrhea caused by infections, as it can trap pathogens inside the gut, potentially worsening the situation.

Another option, Bismuth subsalicylate (Pepto-Bismol), serves a dual purpose: it can soothe the digestive tract and reduce the number of bowel movements. This medication also has antimicrobial properties, offering a shield against bacteria that may be causing the diarrhea.

Antibiotics and Antiparasitics

When bacteria or parasites are the culprits, antibiotics or antiparasitic medications become necessary. These treatments target and eliminate the specific organisms causing the infection.

However, they are only prescribed after a definitive diagnosis, as unnecessary use can lead to resistance, making bacteria harder to kill in the future.

Dietary Adjustments

Alongside medication, dietary modifications can aid in managing symptoms.

The BRAT diet (Bananas, Rice, Applesauce, Toast) is often recommended for its gentle nature on the stomach, providing nourishment without aggravating symptoms. Avoiding dairy, fatty foods, and high-fiber items during recovery can also prevent further irritation to the digestive system.

Medicinal Herbs

Chamomile (Matricaria recutita)

Chamomile is renowned for its anti-inflammatory and antispasmodic properties, primarily due to its active components like bisabolol and matricin.

These compounds can help soothe the digestive tract, reduce intestinal inflammation, and alleviate spasms that contribute to diarrhea.

Scientific literature suggests chamomile’s effectiveness in treating gastrointestinal disorders. Research[4] published in Journal of ethnopharmacology Indicated that chamomile extract demonstrated strong antidiarrheal and antioxidant effects in rats, corroborating its application in traditional medicine practices (Sebai, Hichem, et al., 2014).

Peppermint (Mentha piperita)

Peppermint oil is another potent herb for managing digestive issues, including diarrhea. Its main component, menthol, has a calming effect on the gastrointestinal tract, reducing muscle spasms in the intestines.

Research[5] published in Gastroenterology journal has highlighted peppermint oil’s efficacy in treating Irritable Bowel Syndrome (IBS), which can include symptoms of diarrhea (Weerts, Zsa Zsa RM, et al., 2020).

Ginger (Zingiber officinale)

Ginger contains several active components, such as gingerols and shogaols, which have anti-inflammatory and antioxidant effects. These compounds can help regulate the movement of the intestines, reducing diarrhea.

Studies in sources like[6] one published in the BMC complementary medicine and therapies have investigated ginger’s role in gastrointestinal health, supporting its use for various symptoms, including nausea and diarrhea (Zhang, Changrong, et al., 2020).

The frequency of diarrhea is highest in infants aged 6 to 11 months, coinciding with the period when complementary foods are introduced to their diets.

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Psyllium (Plantago ovata)

Psyllium husk is a fiber supplement known for its ability to absorb water in the gut, making it beneficial for both diarrhea and constipation. By forming a gel-like substance, it can help solidify loose stools and promote regular bowel movements.

Research[7] in the American journal of clinical nutrition has explored the impact of psyllium on bowel function, showcasing its versatility in digestive health management (Zhang, Changrong, et al., 1998).

Berberine-containing Herbs

Herbs like Goldenseal (Hydrastis canadensis), Barberry (Berberis vulgaris), and Oregon Grape (Mahonia aquifolium) contain the alkaloid berberine, known for its antimicrobial and anti-inflammatory properties.

Berberine can combat diarrhea-causing bacteria and regulate intestinal movement.

Various studies[8] have delved into berberine’s therapeutic potential, highlighting its benefits in treating diarrhea, especially those caused by infections (Yu, Mingkun, et al., 2020).

Nutritional Supplements

The role of food supplements, especially probiotics, in managing diarrhea is well-documented. These supplements work by enhancing gut health, restoring the balance of gut microbiota, and supporting the immune system.

Here’s an overview of notable supplements and their active components known for aiding in diarrhea treatment.

Probiotics

Probiotics are live bacteria and yeasts beneficial to the digestive system. They are often called “good” or “friendly” bacteria.

1. Lactobacillus: This genus of bacteria, particularly strains like Lactobacillus rhamnosus GG (LGG) and Lactobacillus reuteri, has been extensively studied[9] for its efficacy in reducing the duration and severity of acute infectious diarrhea including it’s duration in children (Van Niel, Cornelius W., et al., 2002).
2. Bifidobacterium: Specific strains like Bifidobacterium lactis have been found[10] to be effective in treating antibiotic-associated diarrhea by restoring gut flora balance disrupted by antibiotic use (XU, et al., 2017).
3. Saccharomyces boulardii: A yeast probiotic that has shown[11] effectiveness in reducing the duration of acute diarrhea and preventing antibiotic-associated diarrhea. S. boulardii acts by inhibiting bacterial toxin effects, enhancing immune responses, and restoring the natural balance of the intestinal flora (Surawicz, Christina M., et al., 1989).

Zinc Supplements

Zinc plays a crucial role in immune function, and zinc supplementation has been found to be effective in reducing the duration and severity of diarrhea episodes, especially in children.

Zinc supplementation is thought[12] to improve gut mucosa integrity and modulate the immune response to fight off pathogens causing diarrhea (Hassan, Abbas, et al., 2020).

Prebiotics

Prebiotics are non-digestible food components that promote the growth of beneficial microorganisms in the intestines.

Supplements containing fructooligosaccharides (FOS) or galactooligosaccharides (GOS) can support[13] the growth of healthy bacteria in the gut, which in turn can help manage and prevent diarrhea (Rigo-Adrover, Mar, et al, 2017).

Dietary Fibers

Soluble fibers, such as psyllium husk, can absorb water in the gut, helping to form more solid stools.

Supplements containing soluble fiber may help manage[14] diarrhea by improving stool consistency and promoting regular bowel movements (Nakao, Makoto, et al., 2002).

Annually, between 1.7 and 5 billion cases of diarrhea are reported. This condition is predominantly observed in developing countries, where young children experience diarrhea an average of three times each year.

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Bibliography