From the Guidelines
For individuals with viral gastroenteritis experiencing severe watery diarrhea, I strongly recommend resuming an age-appropriate usual diet during or immediately after the rehydration process is completed, as this approach has been shown to be effective in managing the condition. This recommendation is based on the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1. The guidelines suggest that human milk feeding should be continued in infants and children throughout the diarrheal episode, and resumption of a usual diet is recommended for all individuals.
When it comes to specific foods, the following are recommended:
- Clear liquids like water, broth, and oral rehydration solutions to prevent dehydration
- Bland, easy-to-digest foods such as bananas, rice, applesauce, and toast
- Small, frequent meals to minimize intestinal irritation
- Avoidance of dairy products, fatty, spicy, or fried foods, caffeine, alcohol, and high-fiber foods that can worsen diarrhea
It is essential to note that the primary concern with severe diarrhea is dehydration, and adequate fluid intake is crucial to prevent this complication. Drinking at least 2-3 liters of fluid daily, or more if diarrhea continues, is recommended. The 2001 guidelines for adults on self-medication for the treatment of acute diarrhoea also suggest maintaining adequate fluid intake and avoiding irritants like fatty, heavy, spicy, or stimulant foods 1. However, the most recent and highest-quality evidence supports the recommendation to resume a usual diet during or immediately after rehydration 1.
Key considerations for managing viral gastroenteritis with severe watery diarrhea include:
- Preventing dehydration through adequate fluid intake
- Minimizing intestinal irritation with bland, easy-to-digest foods
- Avoiding irritants that can worsen diarrhea
- Resuming a usual diet as soon as possible to support the recovery process.
From the FDA Drug Label
Patients should receive appropriate fluid and electrolyte replacement as needed
- The FDA drug label does not provide specific recommendations for foods for individuals with viral gastroenteritis (infectious diarrhea) experiencing severe watery diarrhea.
- However, it mentions the importance of fluid and electrolyte replacement as needed.
- No specific dietary advice is given, and the label only discusses the dosage and administration of loperamide hydrochloride capsules for the treatment of diarrhea 2.
From the Research
Recommended Foods for Viral Gastroenteritis
For individuals experiencing severe watery diarrhea due to viral gastroenteritis, the following foods are recommended:
- Bananas, rice, applesauce, and toast (BRAT diet) 3
- A diet containing probiotics, such as Streptococcus thermophilus, Bifidobacterium lactis, and Lactobacillus acidophilus 4
- Foods enriched with zinc, such as zinc-fortified cereals 4
- Oral rehydration solutions to replace lost fluids and electrolytes 5, 6, 7
Key Considerations
- The World Health Organization recommends oral rehydration salts as the primary treatment for acute gastroenteritis 5
- Probiotics have been shown to reduce the duration and severity of diarrhea 4, 3
- Zinc supplementation can also help reduce the duration and severity of diarrhea 4
- Antibiotics should only be used in severe cases or when specifically indicated, such as in cases of bacterial infection 6, 7