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Diarrhoea - how is it treated?

Treatment of diarrhoea aims to eliminate the underlying cause (if known), firm up bowel movements, and treat any complications.

General treatment includes rest, fluid intake, and oral opiate-containing medication. Intravenous fluid and electrolyte replacement may be necessary in infants and elderly people.

• If you have a 24-hour viral gastric flu, the best treatment is simply to allow the organisms to be flushed out of your system.

• Most mild cases of diarrhoea don't require antibiotics or over-the-counter anti-diarrhoea products. These may slow the elimination of the infectious agent, so avoid these products at least for the first six hours. Use them only if there are no other signs of illness, such as fever, and if discomfort continues for longer than 24 hours.

• While symptoms last, avoid solid food.

• Avoid very hot or cold liquids, apple juice, milk and alcohol.

• As always, wash your hands after using the toilet and before handling food; dry hands with paper towels and discard these.

• Diarrhoea and/or vomiting depletes the body of large quantities of water and important electrolytes (sodium and potassium), which is why you feel weak after a bout of gastric flu. It is essential to stay hydrated, and to replace the lost electrolytes.

- You can buy special oral electrolyte salts at the chemist, which are mixed with water to produce an oral rehydration solution (ORS). Follow the instructions for preparing the ORS precisely, and always make it using clean, safe (boiled or treated) water.
- If you are unable to obtain a commercial ORS preparation, you can mix up a solution at home. The formula is: six level teaspoons of sugar and half a level teaspoon of salt dissolved in one litre of clean water.
- However, it is not recommended that you rely on a homemade version of ORS to treat dehydration. Use it as a temporary measure while you seek medical attention.
- Take frequent, small sips of water or ORS throughout the day. Adults should drink about two cups of water an hour unless they are vomiting. Rest while rehydrating yourself.

When the diarrhoea starts to improve:

 • When your appetite returns, start by eating bland, low-fat foods such as dry toast, black tea, rice, banana, peeled and grated apple, and soft foods like boiled potato or squash.

• Avoid meat, nuts and beans, and other foods that are hard to digest, like raw fruit and vegetables, fried foods and sweets, whole-grain bread or bran cereal. Go easy on rich, spicy and fatty foods, coffee and alcohol until 48 hours after symptoms disappear. Once the diarrhoea has fully abated, you can eat normally again, but avoid dairy products for about three days.

• As symptoms improve, start to eat low-fibre foods, such as soda crackers, toast, eggs, rice, chicken or other tender cuts of meat.

• Even if you feel ravenous, try not to overeat. Eat small meals at regular intervals.

• To recolonise the “good” microorganisms that have been scoured from your gut by diarrhoea, for about a week you should eat one or two cups per day of plain, fat-free yoghurt containing live cultures. Also use a good probiotic supplement for at least a month. You can buy these supplements at health shops and chemists.

• Don't exercise strenuously until you are free of symptoms.
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