What to Take for Diarrhea and Vomiting (and What Not To)

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This survival-medicine website provides general information, not individual advice. Most scenarios assume the victim cannot get expert medical help. Please see the disclaimer.

Are Your Diarrhea Treatments Making You Worse?

Sick childby James Hubbard, M.D., M.P.H.

Many things people do or take for diarrhea and vomiting at home just make things worse. And since these are common complaints in my office, I expect they’ll be in disasters. In fact, the dehydration from vomiting and diarrhea is a major cause of death in Third World countries where getting to a doctor may be next to impossible. Children are especially vulnerable.

At the clinic where I work, we usually treat at least a couple of diarrhea/vomiting cases a week with IV fluids. But what if they’re not available? What can you take or do at home that actually will help?

Perhaps just as important, what should you not do to make things worse?


What Not to Do for Diarrhea

These things can make diarrhea worse:

  1. Over-the-counter medicines. They may decrease diarrhea for a while, but they don’t limit the time you’re going to have it. Sometimes they can make it last longer. Taking Pepto-Bismol for traveler’s diarrhea is an exception.
  2. Sports drinks. Do drink the proper fluids, starting with water. Pedialyte is ideal for children or adults. Sports drinks have too much sugar, which may make the diarrhea worse. Try diluting them 1:1 with water. Nursing babies can continue breast milk but may need extra fluids to avoid dehydration.
  3. Not eating as you’re getting better, or eating the wrong things. Replenish your strength and start the BRAT diet after the diarrhea has calmed down. That’s Bananas, Rice, Applesauce, Toast (no butter). Plain boiled potatoes and noodles are also good. But nothing else for 24 hours.
  4. Greasy foods and milk (other than breast milk). Avoid them for several days. Some people, especially children, may be unable to digest milk properly for days, even up to a month.

Finally, don’t automatically take antibiotics. Even with bacterial infections, like e. coli and salmonella, they don’t decrease the length or severity of the infection. There are exceptions, so check with your doctor for any diarrhea not letting up within 24 hours.

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What Not to Do for Vomiting

These things can make vomiting worse:

  1. Testing your tolerance. I learned this lesson when I caught a bug in college. A few minutes after vomiting, I’d try swigging some fluids because I was worried about getting dehydrated. I’d vomit them up and drink some more. I was harming myself more than I was helping. Every time I vomited I lost not only what I had drunk but also electrolytes like sodium and potassium from my stomach juices.
  2. Not letting your stomach rest. Sometimes a rest is all it takes. Wait a few hours. Then start sipping, slowly. For a baby or adult, start with a teaspoon at a time. Wait ten minutes and try another. If it doesn’t stay down, wait fifteen or twenty minutes. After a few times, increase it to two teaspoons, then four.
  3. Gulping large amounts. Avoid the temptation even if you’re thirsty. Your stomach tolerates smaller amounts better. Don’t test the limits. Remember, vomiting is worse than not drinking at all.
How to Make Your Own Dehydration Fighter

salt shakerDehydration from diarrhea is a major killer of children in Third World countries. Many can’t get medical help. That’s why the World Health Organization has come up with an Oral Rehydration Salts packet that can be dissolved in clean water. If used properly, the WHO says it can treat up to eighty percent of even the worst cases of diarrhea.

Pedialyte is a commercial version of oral rehydration salts. If you make the following homemade recipe, be sure to measure ingredients accurately. Too much sugar will make the diarrhea worse. Too much salt could be dangerous. Preferably use a measuring device. (Although the WHO thinks this is the ideal strength, if you have a question of measurement, err on the dilute side.)


Recipe for Homemade Rehydration Salts

For every quart (liter) of water add:

  • 6 level teaspoons of sugar
  • 1/2 teaspoon of salt

This version obviously lacks potassium, so you can mix in about 4 ounces of orange juice (use a teaspoon or two less of the pure sugar) or have a bite of a banana.

At least one study has shown you can substitute up to 10 teaspoons (50 ml) of honey for the sugar.


How Much to Drink

According to the World Health Organization, if you have diarrhea, you should drink the following amounts to avoid dehydration:

  • Children under two years old: ¼ to ½ cup (50-100 ml, or 2 to 3 ounces) after each loose stool, up to ½ quart (1/2 liter) per day.
  • Children two to nine: ½ cup to 1 cup (100-200 ml, or 3 to 7 ounces) after each loose stool, up to 1 quart (1 liter) per day.
  • People ten and over: as much as they want, up to 2 quarts per day.

If the person seems to be getting dehydrated, give up to 1 ounce per pound (80 ml per kg) within a four-hour period.

Signs of dehydration include:

  • Dizziness
  • Lethargy
  • Sunken eyes
  • Not tearing when crying
  • Not urinating/wetting diaper

The following are reasons to get to medical help ASAP, even if it’s difficult, since you may need IV fluids and prescription medications—sometimes even hospitalization:

  • Signs of dehydration
  • Bloody bowel movements
  • Fever over 101 F
  • Abdominal pain that doesn’t go away after a bowel movement
  • Vomiting that lasts more than a few hours
  • Diarrhea that lasts more than a day
  • The victim is a baby, chronically ill or elderly person, or diabetic

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Sick child photo © 2009 by Sean Dreilinger on Flickr.
Salt photo by Jim Forest on Flickr.

  • Janis Snider

    My wife is vomiting and has diarreah. The worst of her life. What should she do? How do we know if it’s not food poisioning?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      See a doctor this morning to see what it is and to see if she needs some IV fluids.

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  • Sharon

    What about adding instant tea for the potassium. My MIL was told to drink it instead of the nasty tasting potassium and it worked.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Just be careful of too much caffeine and caffeine-like ingredients. Thanks

  • jham

    hi, just asking if the person had vomiting and diarrhea and having potassium level 2 mEq/L what kind of food will advice to him to take

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      That level of potassium is dangerously low. It could be lethal. If at all possible, he/she should see a doctor, have the heart beat checked, and have an IV with potassium in it. Adding teaspoon of NoSalt or any salt substitute contain potassium to a quart of fluids might help. Bananas and oranges are good. Greens are good. But, of course, if the person is vomiting he/she won’t be able to get these down.

  • Carl Muschik

    my abdominal pains are usually caused by bloating and indigestion, i better control my diet.-

    Take a look at the most popular post at our own online site
    http://www.foodsupplementdigest.com/turmeric-tea/

  • Teresa S

    I drank Guava juice the last time I had diarrhea. It really seemed to help me.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Interesting, Teresa.

  • David Deitsch

    To give your homemade oral rehydration solution some extra class, try these recipe tips.:

    Use salt without iodine. The only reason for this is to make the recipe safer for someone who is allergic to iodine. Otherwise, it does not matter. You can use sea salt if you want, but kosher salt and the cheap salt (you will find it on the lowest shelf in the grocery store) that is labeled to not have iodine are just fine.

    In addition to the salt and sugar mentioned by the doctor, add 1/4 teaspoon of salt substitute (which is potassium chloride) and 1/3 teaspoon of baking soda, for pH balance. If you do not have thes, no problem. Just use the salt and sugar. Do NOT add more salt or sugar to compensate for not having the KCl or baking soda. Just leave them out.

    You can prepare your O. R. S. mix in advanced. I have measured out the correct amount of “Nurse David’s Instant O. R. S. Drink Mix” to make 1 quart of O. R. S. into separate, pre measured small, zip lock bags (the real itty bitty ones) labeled them (with instructions) and taped the little bags onto my stored water containers. If I need it, all I have to do is pour the pre measured powder into a quart of water, shake, and serve without having to grub around trying to find and measure the 4 ingredients from scratch.

    One last point and then I will shut up. If you use contaminated water to make your O. R. S. you can make the patient sicker instead of helping them. The solution, store your water disinfecting chemical with your water and O. R. S. powder all together,again with instructions. Now you are all ready to be the hero who saves the day!

    • Ron Sanders

      Thanks David, I am sure the other readers will appreciate your comments as I have. Really good tips on making up the O.R.S. prep. for when it is needed. I will certainly heed your advice. I will use this when I teach our emergency responders about survival techniques in a future meeting.

      Thanks.
      Ron

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Thanks, David. All good and useful tips.

      • maria santana

        hi dr. i have a question .. right now as we soeak my 13 yr old daughter is vomiting and throwing up? has been doing this for 2hrs now .. what should i do? should i try the salt rehydration recipe? please help me:(

        • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

          Maria, this is the first I’m seeing of your post. I’m sorry but I can’t treat individually without examining a person. In general, for a typical stomach virus, Pedialyte is great and essentially the same thing as the salt rehydration recipe. Water and broth are good as is Jello, and watered down sports drinks.
          Also, please consider taking her to a doctor if she’s not holding down fluids or looking dehydrated.

  • Dave, RN

    What would be nice is a link to down load posts lik this as a PDF so we can easily download for reference withot being connected to the web.
    Keep up the good work!

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Thanks, Dave. I’ll have to mull that over a bit.

  • Ron Sanders

    I use Molassas instead of Sugar or Honey, it has a higher Potassium content than bananas or honey.

    If you would can you comment on subing sea salt for regular salt and iodized vs non iodized.

    Thanks.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Ron,

      Molasses is a good idea. I really don’t know anything abou subing sea salt. I”d use any kind I had for fluid rehydration. For every day use, everyone needs a little iodine for your goiter. Unless you’re getting it another way, iodized salt is pretty handy.