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Ideally, fluid replacement utilizes solutions that contain the important minerals potassium, sodium, and calcium. The following are some suggestions:
- A useful recipe for fluid replacement calls for two glasses of fluid: the first containing 8 oz. of fruit juice, 1/2 tsp. of honey or corn syrup, and a pinch of salt; the second filled with 8 oz. of purified or carbonated water and 1/4 tsp. of baking soda. The traveler should drink alternately from each glass until the thirst is quenched.
- Parents with small children should bring commercial oral rehydration solutions such as Pedialyte, Lytren, Gastrolyte, or Ricelyte. Products containing rice flour work slightly faster than others. If the child finds the taste unpleasant, adding a half-teaspoon of Jell-O or Kool Aid to sweeten the solution may help, and does not appear to reduce its benefits.
- Adding a soluble fiber supplement and eating as soon as possible helps the intestine absorb water, and is beneficial for children and adults.
- Children with diarrhea should not drink apple juice, colas, or sports beverages, because they do not contain the proper balance of salts and sugar.
Helpful Foods. Foods that help slow diarrhea include rice, bananas, and apples. Drinking tea is also helpful.
Adding milk (but not soy milk) to these foods may help many children. In fact, eating yogurt that contains active lactobacilli cultures may have positive benefits. (However, yogurt drinks in developing countries may carry a high risk for contamination.)
Bismuth subsalicylate (Pepto-Bismol). Pepto-Bismol can be used for treatment of mild diarrhea and nausea. Treatment generally consists of 1 fluid ounce or 2 tablets every 30 minutes for up to 8 doses in a 24-hour period. If diarrhea continues, treatment can be repeated for a second day.
Antimotility Drugs. Antimotility drugs provide prompt but temporary symptomatic relief by reducing muscle spasms in the gastrointestinal tract. They include:
- Loperamide (Imodium). Loperamide is the agent of choice, even when used in combination with antibiotics.
- Diphenoxylate (Lomotil).
- Opiates (such as paregoric, tincture of opium, and codeine). Opiates are often poorly tolerated, and can affect the central nervous system.
Antimotility drugs should be discontinued if symptoms persist beyond 48 hours. They should NOT be used at all in patients with high fever, if there is blood in the stool, or in children under age 2. Imodium is approved for children 2 years and up, but its use in children is controversial because of reports of severe side effects. Experts do not recommend it.
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Review Date: 01/30/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
