What is the best remedy for acute diarrhea and dehydration?

From the Guidelines

For diarrhea and inability to retain water, the most effective remedy is oral rehydration solution (ORS), which can be purchased pre-made or made at home by mixing 6 teaspoons of sugar and 1/2 teaspoon of salt in 1 liter of clean water, as recommended by the 2017 Infectious Diseases Society of America clinical practice guidelines 1.

Key Recommendations

• Drink small amounts of ORS frequently, aiming for 2-4 liters daily depending on severity, to replace lost fluids and electrolytes.
• For mild to moderate dehydration, ORS is the first-line therapy, and it can be given to all age groups, with any cause of diarrhea, as stated in the 2017 IDSA guidelines 1.
• Nasogastric administration of ORS may be considered in infants, children, and adults with moderate dehydration who cannot tolerate oral intake 1.
• Isotonic intravenous fluids such as lactated Ringer’s and normal saline solution should be administered when there is severe dehydration, shock, or altered mental status and failure of ORS therapy 1.

Additional Remedies

• Over-the-counter medications like loperamide (Imodium) can help reduce diarrhea frequency, but should be used with caution and only as directed.
• Bismuth subsalicylate (Pepto-Bismol) is another option, but should be used in moderation and only as needed.
• While rehydrating, consume bland, easy-to-digest foods like bananas, rice, applesauce, and toast (BRAT diet), and avoid dairy, caffeine, alcohol, and fatty foods until recovered.

Important Considerations

• If symptoms persist beyond 2-3 days, include blood or mucus, or are accompanied by fever over 102°F (39°C), seek medical attention immediately.
• Breastfed infants should continue nursing throughout the illness, as recommended by the 2017 IDSA guidelines 1.
• After rehydration is complete, maintenance fluids should be resumed along with an age-appropriate normal diet offered every 3–4 hours, as stated in the 2017 IDSA guidelines 1.

From the FDA Drug Label

Loperamide hydrochloride capsules are indicated for the control and symptomatic relief of acute nonspecific diarrhea in patients 2 years of age and older and of chronic diarrhea in adults associated with inflammatory bowel disease. The best remedy for diarrhea is loperamide (PO), as it is indicated for the control and symptomatic relief of acute nonspecific diarrhea 2.

• It is effective for acute nonspecific diarrhea in patients 2 years of age and older.
• It is also effective for chronic diarrhea in adults associated with inflammatory bowel disease.

From the Research

Remedies for Diarrhea

• The best remedy for diarrhea is the use of oral rehydration solutions (ORS) to maintain hydration and replace lost electrolytes 3, 4.
• ORS typically contains glucose and electrolytes, which help to absorb water and salts in the intestine, reducing the duration and severity of diarrhea 3, 4.
• The World Health Organization (WHO) recommends a reduced osmolarity ORS, which has been shown to be effective in treating diarrhea in both children and adults 3, 4.

Effectiveness of ORS

• Studies have shown that ORS is effective in reducing the duration and severity of diarrhea, as well as preventing dehydration and related complications 4, 5.
• ORS has been shown to be particularly effective in children, where it can reduce the risk of dehydration and related mortality 4, 5.
• The use of ORS has also been shown to reduce the need for unscheduled follow-up visits and hospitalizations due to diarrhea 5, 6.

Additional Treatments

• Zinc supplementation has been shown to be effective in reducing the duration and severity of diarrhea, particularly in combination with ORS 7, 6.
• The use of zinc supplementation plus ORS has been shown to be more effective than ORS alone in treating acute diarrhea 6.
• Other treatments, such as sport drinks, juice, and soft drinks, are not recommended as they can exacerbate dehydration and electrolyte imbalances 3.