The Aztec two-step and Montezuma’s revenge sound like a heap of fun, unless it’s you. Diarrhoea is the frequent passing of watery faeces and it’s nature’s way of ridding the body of toxins. Pronto. If you have been eating or drinking something dodgy, allow nature to take its course. However, if you have a temperature, there is blood or mucus in the stool, or if diarrhoea is accompanied by painful cramps and continues for more than 24 hours, the cause of your diarrhoea needs to be ascertained and treated. Don’t delay. In this country, we are lucky that diarrhoea is generally considered inconsequential and a minor inconvenience. Elsewhere in the world, diarrhoea caused by cholera, typhoid and dysentery can be a major cause of death.


  • Frequent loose or watery stools.
  • Abdominal cramps.
  • Light-headedness due to dehydration.

What causes it?

  • The infamous 24-hour bug that visits and traumatises schools, nursing homes and entire suburbs is either viral or bacterial in origin. Often accompanied by vomiting, this diarrhoea is usually done and dusted in a day.
  • Food poisoning is mostly experienced roughly 4 hours after eating the offending meal.
  • Unless you are the 5-star variety of tourist, travellers often experience diarrhoea, usually from E. coli bacteria that appear in different guises around the world. Our intestinal microflora might be used to ‘home-grown’ E. coli, but are xenophobic and less able to tolerate foreigners.
  • Giardia and cryptosporidium are protozoa. They sometimes appear in our water supply and can also be contracted when travelling. Digestive complaints, including burping, bloating and nausea are symptoms alongside diarrhoea that suggest a protozoa infestation.
  • An antibiotic’s job is to kill bacteria. Unfortunately, this will include some ‘good’ bacteria living in our intestines, as well as the intended bad guys. Disruption to intestinal microflora can cause diarrhoea.
  • Excess alcohol places great strain on the body, particularly the liver, which may result in nausea and diarrhoea.
  • Stress increases the output of the flight or fight hormone, adrenaline. This hormone, which increases the flow of blood to the muscles for the purposes of fleeing and fighting, is also the hormone that dilates the pupils and increases the heart rate. In this world of fear, digesting food is of little importance. The very frightened animal (or human) will defecate on the spot. Ongoing stress can result in chronic diarrhoea.
  • Certain artificial sweeteners and artificial fats are chemically designed not to be absorbed across the intestine. Due to osmosis, where fluid enters from the bloodstream into the bowel, a common side effect is diarrhoea and also what is known as ‘faecal leakage’.
  • Diarrhoea may be the result of a food sensitivity, in particular lactose and gluten intolerance.
  • Diarrhoea is a common symptom of inflammatory bowel disease including Crohn’s disease and ulcerative colitis.
  • Large doses of vitamin C can cause a bout of diarrhoea. As soon as you have a loose bowel movement, you know you’ve reached your ‘bowel tolerance’ and the tissues are saturated with vitamin C. For most people, this occurs after taking 15 g (15 000 mg) in a 24-hour period, but some people are more sensitive and react sooner.
  • Long-term or chronic diarrhoea may be caused by a variety of factors including irritable bowel syndrome (IBS), thyroid problems, cancer or a reaction to medications. The reason for diarrhoea should always be found and treated appropriately.

What to do

Long-term or chronic diarrhoea can be treated in a similar way to an acute episode, however, the cause must be found and treated.

Lactose intolerance, the inability to tolerate milk sugar, often occurs after a longish bout of diarrhoea. Normally, resident bacteria (of the lactobacillus family) produce lactase, the enzyme that digests lactose. During the digestive mayhem of diarrhoea, these lactase-producing bacteria can be wiped or washed out, leaving you unable to digest lactose and causing the symptoms of diarrhoea and bloating all over again. With time, the lactase-producing bacteria will recolonise, especially after some judicious probiotic consumption.


  • Rehydration is key to any treatment for diarrhoea. Diarrhoea is mostly water, so it is mandatory that you replace lost fluid. Rather than plain water, replace some of the nutrients lost along with the fluid. Adding a little honey or sugar allows for more rapid absorption and will increase your blood-sugar levels as they are likely to be low. Some suggestions in addition to plain water include herbal teas with honey, weak black tea with honey, miso soup, an electrolyte replacement drink, chicken or meat broth or fresh coconut juice.
  • Diarrhoea is one of the few conditions where roughage is not recommended. The bowel needs less, not more, stimulation. White rice not brown; white cracker biscuits rather than wholemeal.
  • Rice water is a 3000-year-old remedy, and even today it is recommended by the World Health Organisation. Boil two handfuls of rice with one teaspoon of salt in two litres of water for 20 minutes. Strain and add a tablespoon of honey or sugar to a litre of rice water. Drink a cup every hour or so.
  • An old wives’ tale that is very effective for stopping diarrhoea is to grate a raw apple with skin intact, allow some time for it to turn brown, then eat.
  • Although fluid replacement is by far the most important remedy, after a day or so, try introducing some solids for nourishment. Cooked white rice is sometimes the only thing you can stomach. It is also bland and not likely to cause further diarrhoea. Other possibilities include steamed chicken breast, baked or steamed white fish fillet, bananas, mashed potatoes and pumpkin or stewed fruit. Plain water crackers with a little vegemite also fit the bill, replacing lost salt.
  • If you have become lactose intolerant as a result of the diarrhoea (see Irritable Bowel on page XX), avoid all dairy foods for a week or so. Take some probiotic acidophilus supplements and after a week, start with a little good quality plain yoghurt, increasing dairy daily until your normal quota is reached.
  • Avoid foods that aggravate the bowel such as coffee, alcohol and spicy food.


  • Herbs that can help calm a turbulent belly and reduce diarrhoea include ginger, peppermint, chamomile, sage, meadowsweet, raspberry leaf and cinnamon. Take in tea, tablet or tincture form.
  • Acidophilus and bifidus in powder or capsule form is important to re-establish good gastrointestinal microflora.
  • Saccharomyces boulardii is a friendly yeast (as opposed to bacteria) that helps push out the ‘bad’ bugs in the gut. It can be taken in combination with other probiotics, and is particularly helpful if you suspect a villainous bacteria, parasite or protozoa has taken up residence in your bowel.
  • To prevent traveller’s diarrhoea, two weeks before travelling take 1 teaspoon of probiotics in water, or 2 capsules with breakfast and 1–2 garlic tablets after dinner. Continue this when travelling.
  • Psyllium husks are recommended for both constipation and diarrhoea. In the case of constipation, the psyllium swells to bulk up and soften the stool. In the case of diarrhoea, the psyllium soaks up excess fluid and helps to slow down the transit through the bowel. Take 2–3 tablespoons in water twice a day.
  • Slippery elm powder can soothe an inflamed digestive tract. Particularly good after violent diarrhoea. Take 1 teaspoon twice daily.
  • Take the homoeopathic remedy podophyllum 30 C if the diarrhoea is worse in the morning, looks like pea soup, and involves a lot of wind and cramping. Take arsenicum album 30 C if there is a burning sensation around the anus, the diarrhoea is watery and if there is vomiting, anxiety and/or exhaustion.


  • Rest as much as possible.
  • Drink bottled water when travelling or buy an immersion heater to boil water before drinking. If your home water supply is from a tank or might be dodgy, boil before drinking.
  • If stress and anxiety is the cause of your chronic diarrhoea, addressing this is your first course of action.
  • If there is a diarrhoea bug doing the rounds of your neighbourhood, take basic hygiene precautions such as washing your hands before preparing food.
  • Beware salads not made in your own home and peel fruit before eating when travelling.

At a glance


  • Replacing lost fluids is the primary treatment for diarrhoea. It is easy to become dehydrated with this condition. Rehydrate with a variety of fluids that replace key nutrients as well. Choose from black tea and honey, chicken or meat broth, miso soup, rice water with some added salt or coconut water.
  • Grated apple allowed to turn brown before eating is excellent for stopping diarrhoea.
  • Avoid coffee, alcohol and spicy food.
  • Stick to bland food for a day or so.


  • Herbs for bowels in distress include peppermint, ginger, chamomile, sage, meadowsweet, raspberry leaf and cinnamon.
  • Acidophilus and bifidus in powder or capsule form is important to re-establish good gastrointestinal microflora.
  • Psyllium husks will help to bulk up and slow down the stool. Take 2–3 dessertspoons twice a day.


  • Rest as much as possible.
  • Drink bottled or boiled water when travelling.
  • If there is a diarrhoea bug in your neighbourhood, adopting some basic hygiene principles such as regularly washing your hands can be very helpful.