Foods To Avoid When You Have Diarrhoea

Introduction

Diarrhoea, characterised by frequent loose and watery stools, is a frequently encountered gastrointestinal disorder. It can manifest as acute, chronic, or persistent, often as a symptom of underlying health issues. Proper dietary choices are crucial for gastrointestinal health and can significantly impact the occurrence of diarrhoea. Specific foods and beverages can either trigger or alleviate diarrhoea, depending on individual sensitivities and conditions. 

Diarrhoea

Diarrhoea is a common gastrointestinal symptom characterised by the frequent passage of loose, watery, and unformed stools. Diarrhoea is a common problem and is an important health issue as it accounts for 2.5 million deaths around the world each year.¹ Diarrhoea can be acute, chronic, or persistent. Generally, acute diarrhoea resolves in under two weeks, while chronic diarrhoea persists for over a month. When diarrhoea lasts between two to four weeks, it is often referred to as persistent diarrhoea.² It is typically a symptom of an underlying issue or condition rather than a standalone illness. Symptoms of diarrhoea can vary depending on its underlying cause and severity. Common symptoms of diarrhoea include:

• Frequent bowel movements
• Loose or watery stools 
• Abdominal cramps
• Bloating
• Nausea and vomiting
• Fever
• Blood or mucus in stools
• Dehydration

Foods to avoid

The importance of one’s dietary choices and food consumed plays a crucial role in gastrointestinal health and can have a significant impact on the occurrence of diarrhoea. Some individuals experience diarrhoea because of specific food allergies or sensitivities. 

Dairy products

Diarrhoea can often be associated with dairy products in individuals who are lactose intolerant or have dairy sensitivities. However, it's advisable to avoid dairy consumption during episodes of diarrhoea, even for those without such conditions.³ Lactose intolerance is a common condition in which the body lacks sufficient lactase enzymes to properly break down and digest lactose, the sugar found in dairy. The consumption of dairy can lead to gastrointestinal symptoms, such as diarrhoea and abdominal cramps. This is caused by undigested lactose drawing excess water into the intestines, causing discomfort.

Lactose-containing food to avoid includes:

• Cheese
• Milk (including cow's, goat's, and buffalo milk)
• Ice cream and frozen yoghourt
• Butter
• Cream and whipped cream
• Sour cream
• Buttermilk
• Whole-milk yoghourt
• Powdered milk 
• Infant formula

Fatty foods

When consuming foods high in fat, the body may struggle to properly digest and absorb the fats. The excessive build-up of fatty acids in the intestines has two effects: 

1. Stimulation of the colon to release fluids
2. Enhanced intestinal contractions,

These two effects further increase diarrhoea.⁴ Furthermore, high-fat meals can stimulate the release of certain hormones that accelerate bowel movements, increasing the likelihood of diarrhoea.⁵

Fatty foods to avoid include:

• Processed snacks (e.g., crisps, chocolate, biscuits, ice cream)
• Deep-fried foods (e.g., fried chicken, doughnuts, chips)
• Fatty meats (e.g., fatty cuts of pork, beef or lamb)
• Processed meats (e.g., burgers, hot dogs, bacon)
• Oils and butter (e.g., ghee and lard)
• Rich gravies and fatty condiments

Spicy foods

Spicy foods contain a compound known as capsaicin, which can irritate the lining of the stomach and intestines, potentially leading to increased bowel movements. The extent of this effect can vary from person to person, and not everyone experiences the same level of sensitivity to spicy foods.

Spicy foods to avoid include:

• Chilli peppers (e.g., jalapeños, habaneros, scotch bonnets)
• Hot sauces
• Cuisines known for being spicy such as Thai, Indian, Mexican and Sichuan (Szechuan) dishes
• Wasabi (often served with sushi)
• Mustard

Gluten

Gluten is a type of protein found in certain grains, primarily wheat, barely, and rye. It is responsible for elasticity and chewy texture in dough, making it a crucial component in many baked goods such as bread, pasta, and pastries. Coeliac disease is an autoimmune disease in which the immune system mistakenly attacks the lining of the small intestine when gluten is consumed. The damage to the intestine structures reduces the absorption of nutrients. As a result, people with coeliac disease often experience gastrointestinal symptoms such as chronic diarrhoea. Those with gluten sensitivity, and non-coeliac gluten sensitivity (NCGOS), may experience digestive symptoms, including diarrhoea, when they consume gluten-containing foods and drinks, even though they do not have coeliac disease or wheat allergy. 

Sugar

Too much sugar can draw excess water into the intestines and lead to increased bowel movements resulting in diarrhoea. Additionally, high sugar intake may disrupt the balance of gut bacteria, potentially contributing to gastrointestinal issues.^6,7 Fructose, a significant contributor, is naturally present in fruits such as peaches, pears, cherries, and apples, and is also added to various products, including carbonated drinks and fruit juices. While fruits are generally nutritious, it's important to consume them in moderation to reduce the risk of experiencing diarrhoea. 

Sugary foods and drinks to avoid:

• Sweets (e.g., chocolate, gummy bears, lollipops)
• Sugary beverages (e.g., carbonated drinks and fruit juices)
• Sugary cereals
• Pastries and desserts (e.g., cakes, biscuits, pastries)
• Sugary snacks
• Syrups (e.g., maple syrup and golden syrup)
• Honey
• Jams and fruit preserves

Artificial sweeteners

Artificial sweeteners can be associated with digestive symptoms, which can cause a laxative effect. This includes sugar alcohols such as sorbitol, xylitol and mannitol. Sugar alcohols can be fermented by the gut bacteria in the intestines. This fermentation process can produce gas and lead to bloating, cramping, and diarrhoea in those sensitive to these sweeteners.^8,9

These sweeteners are often used as sugar substitutes, which is best to be avoided when experiencing diarrhoea.

Foods with artificial sweeteners to avoid:

• Diet drinks
• Sugar-free/Reduced sugar drinks
• Sugar-free sweets
• Sweeteners

Caffeine

Caffeine is a stimulant that can cause varying effects on the digestive system. These can be related to diarrhoea and exacerbate pre-existing digestive issues. Caffeine can stimulate the muscles in the gastrointestinal tract, known as peristalsis. This increased muscle activity can lead to more frequent bowel movements and, in some cases, diarrhoea. It can cause a diuretic effect, meaning increased urine production, which can lead to dehydration. Dehydration can soften stools, contributing to diarrhoea. Additionally, it has a laxative effect, which leads to diarrhoea. 

It would be advised to avoid the following items when experiencing diarrhoea:¹⁰ 

• Coffee 
• Tea (including herbal teas)
• Soft drinks
• Energy drinks
• Chocolate (e.g., hot chocolate and cocoa beverages)
• Some over-the-counter pain relievers and medications

Alcohol

Alcohol can irritate the lining of the stomach and intestines, increasing gut motility and leading to increased bowel movements. As with caffeine, alcohol is a diuretic. This means that it can increase urine production and contribute to dehydration.¹¹

Alcohol to be avoided if you have diarrhoea:

• Beer (including non-alcoholic beer)
• Wine (including low-alcohol wine)
• Champagne
• Liquor and spirits
• Cider

Summary

Diarrhoea is a widespread digestive problem responsible for 2.5 million deaths globally each year.¹ It can be acute (lasting less than two weeks), chronic (lasting over a month), or persistent (lasting two to four weeks). Its symptoms include frequent bowel movements, loose stools, abdominal cramps, bloating, nausea, vomiting, fever, blood or mucus in stools, and dehydration. Dietary choices play a crucial role in managing diarrhoea, with specific foods and drinks either aggravating or alleviating symptoms.

Food and beverages to avoid include:

• Dairy products
• Fatty foods
• Spicy foods
• Gluten
• Sugary foods and drinks
• Artificial sweeteners
• Caffeine 
• Alcohol

Managing diarrhoea involves making dietary choices that are gentle on the gastrointestinal system. It is essential to stay hydrated and seek medical advice if diarrhoea persists or worsens.