Diarrhea is a medical condition defined by having three or more loose bowel movements within a twenty-four-hour period. It often occurs when an imbalance in gut microbes (microbial dysbiosis) produces toxins that irritate the gastrointestinal lining. This irritation can lead to an overload of the intestinal TRPV1 receptors, resulting in increased water in our intestines and accelerated peristalsis (gut movement). Essentially, diarrhea serves as a defense mechanism for our body, aiming to expel irritants, pathogens, toxins, and metals from our intestinal tract. Various factors can cause diarrhea, including microbial dysbiosis, food poisoning, inflammatory bowel diseases, and the use of certain medications.
The following are some of the best supplements for diarrhea, their mechanisms of action, and brand recommendations to help you quickly find relief. My blog will also include some general diet and lifestyle recommendations. Addressing the underlying cause is crucial for effective relief, but this short guide should hopefully bring you relief.
Supplement Recommendations For Diarrhea Relief
Mechanism of action: Activated charcoal is effective in absorbing microbial toxins and excessive gas that result from microbial dysbiosis. This helps to reduce bloating and abdominal pain, while also limiting diarrhea by firming up stools. By absorbing microbial toxins, activated charcoal minimizes their potential to irritate the mucosal lining of the intestinal tract, which can lead to increased fluid secretion in the intestines and cause diarrhea.
Brand recommendation: Bulletproof Coconut Charcoal
Considerations: Take two capsules every thirty minutes until diarrhea stops, with a maximum of twelve capsules per day during severe illness.
Generally, one to two capsules should be taken an hour after antimicrobial supplements to avoid interfering with their absorption. Long-term use can cause constipation or intestinal blockages.
Bifidobacteria longum
Mechanism of action: Bifidobacteria longum increases probiotic gut flora populations, helps improve lactose intolerance, prevents diarrhea, alleviates some food allergies, and fights colonization of opportunistic microbes. Bifidobacteria longum binds with excessive bile acid within our colon, which benefits those with bile acid malabsorption and fat digestion issues.
Brand recommendation: Custom Probiotics Bifidobacteria longum
Considerations: Consume one adult sized scoop mixed well in filtered or bottled water daily. Consider daily use for continuous diarrhea related to bile acid malabsorption.
Mechanism of action: Bismuth binds to bacterial endotoxins and binds with hydrogen sulfide within our digestive tract to form bismuth sulfide, eliminating them in our stool, which can help relieve symptoms of hydrogen sulfide SIBO. Bacterial endotoxins and hydrogen sulfide can irritate the mucosal lining of our intestinal tract, increasing fluid secretion into our intestines and causing diarrhea. Bismuth also has weak antimicrobial properties within our upper gut.
Brand recommendation: Devrom
Considerations: Take one to two tablets in divided doses up to three times daily, with meals if possible.
If your stools turn black when supplementing with bismuth, it may indicate hydrogen sulfide dysbiosis.
Do not use it if you have intestinal bleeding, salicylate sensitivity, or ulcers.
Enteric-Coated Peppermint Oil
Mechanism of action: Enteric-coated peppermint oil is recommended as an antimicrobial agent for SIBO-D (hydrogen bacterial dysbiosis).
The menthol in peppermint oil reduces migrating motor complex (MMC) impulses, slowing down intestinal spasms and motility. It also has antimicrobial and anti-inflammatory properties. Thus, it may calm intestinal spasms and regulate bowel movements, therefore relieving diarrhea in people with SIBO-D.
Brand recommendation: Nature’s Way Pepogest
Considerations: Take one to two soft gels thirty to sixty minutes before meals, twice daily.
Avoid liquid peppermint oil if you suffer from reflux disorders.
Ginger
Mechanism of action: Ginger works very similarly to Zofran, relieving diarrhea. Ginger is also anti-inflammatory within our intestines, which can also help to relieve diarrhea.1
Brand recommendation: New Chapter Ginger Force
Considerations: Take one soft gel up to three times daily with meals. Ginger can be consumed as tea or freshly grated.
Sangre De Drago
Mechanism of action: Sangre de Drago is a latex herb that helps bind bile (a great herb for bile-acid absorption diarrhea) and bulk up stools. It has also been clinically proven to help stop diarrhea.
Brand recommendation: Raw Garden Sangre De Drago
Considerations: Follow supplement bottle recommendations. I recommend using it for severe cases of diarrhea (multiple times daily, type six or seven on the Bristol Scale) or if no other recommendations have stopped it.
Saccharomyces boulardii (S. boulardii)
Mechanism of action: Saccharomyces boulardi competes with Candida and relieves dysbiosis, which is beneficial for acute diarrhea, inflammatory bowel disease, and traveler’s diarrhea. Saccharomyces boulardi relieves Clostridioides difficile infection by reducing its colonies and inhibiting its toxin production.
Brand recommendation: Jarrow Formulas – Saccharomyces boulardii
Considerations: Take one to three capsules on an empty stomach daily when you first wake up. Use caution in people with severely compromised immune systems due to the rare chance of systemic fungal infection (fungemia).
Saccharomyces boulardi may also cause allergic symptoms in people with yeast allergies and can sensitize our gut to histamine in those with an elevated Th2 immune system. It is considered a “specialty probiotic” and should not necessarily be supplemented daily.
Mechanism of action: Zinc carnosine is one of the most effective supplements for addressing various stomach issues, such as ulcers, H. pylori dysbiosis, and gastritis. It helps protect the stomach lining, promotes the repair of gut tissues, enhances gastric emptying, and reduces gut inflammation. Additionally, it can alleviate increased gut permeability (often called leaky gut) and diarrhea.
Brand recommendation: Pure Encapsulations Peptic-Care
Considerations: Take one to two capsules twice daily with meals in divided doses.
Mechanism of action: Zofran reduces the activity of the vagus nerve in the medulla oblongata. In individuals with Irritable Bowel Syndrome (IBS), Ondansetron has been shown to decrease colonic contractions and motility. This reduction in intestinal movement can help alleviate diarrhea. Serotonin, specifically at the 5-HT3 receptors, regulates proper gut peristalsis by triggering intestinal muscular contractions. By antagonizing these receptors, Zofran can slow down intestinal motility.
Considerations: Ondansetron is generally well-tolerated with few systemic side effects. However, the most common side effects include constipation, dizziness, and headaches. A significant concern arises when individuals with severe dysbiosis use it, as it may lead to toxin retention without effectively absorbing toxins. This can result in serious health issues, such as toxic megacolon.
It is essential to note the key difference between Ondansetron (known as Zofran) and binding agents like activated charcoal or bismuth, which are designed to absorb toxins.
Recent findings indicate that high doses of Ondansetron (greater than thirty milligrams) can cause long QT syndrome and heart arrhythmias.
General Support and Lifestyle Recommendations For Relief
Maintaining proper hydration is crucial, especially when vomiting and/or suffering from diarrhea. Hi-Lyte is a recommended electrolyte supplement.
If you are suffering from hydrogen-producing bacterial SIBO, consider a low-FODMAP diet for two weeks to see if you find relief.
Limit resistant starch consumption, if Klebsiella dysbiosis is suspected.
Overexertion, including exercise, can also cause diarrhea. Some marathon runners, for example, have diarrhea during marathons due to the stress of overexertion, increased colonic contractions from running, and anxiety about the race. Limit overexertion if you are suffering from diarrhea.
If you have lactose intolerance, avoid ingesting lactose-containing foods, including ice cream, milk, cream, yogurt, kefir, half-and-half, and soft cheeses.
If you have Celiac disease like me, YOU should be avoiding gluten and cross-contamination as much as possible.
Avoid ingesting sugar alcohols, including xylitol, sorbitol, mannitol, and erythritol.
Avoid ingesting the food additive carrageenan, which can cause or worsen gastrointestinal inflammation, causing or worsening diarrhea.2 3
Avoid using, if possible, or ask your doctor about reducing your dosage of certain medications or supplements that can cause or worsen diarrhea.4 5 6 7 8 9 10
- Ace inhibitors
- Angiotensin II receptor blockers
- Anti-diarrheal medications like Imodium should generally be avoided, especially with food poisoning or C. difficile infections. Diarrhea is the body’s defense mechanism to expel toxins, and taking Imodium can lead to toxin retention and cause or worsen conditions like toxic megacolon.
- Chemotherapy agents
- Colchicine
- Digoxin
- Hypothyroid medications (natural or synthetic thyroid hormones if they are causing your hyperthyroidism)
- Laxative medications
- Magnesium
- Most antibiotics cause or worsen diarrhea.
- Metformin
- NSAIDS
- Proton Pump Inhibitors
- SSRI antidepressants
- Vitamin C
Are you tired of rushing to the toilet during important business meetings? End unpredictable diarrhea and restore your gut health with personalized functional medicine coaching from John Brisson. I will work closely with you to uncover the root causes of your symptoms and say goodbye to suffering from diarrhea for good!
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- https://pmc.ncbi.nlm.nih.gov/articles/PMC7489045/ ↩
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11085445/ ↩
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8539934/ ↩
- https://www.webmd.com/digestive-disorders/what-meds-cause-diarrhea ↩
- https://www.ncbi.nlm.nih.gov/books/NBK431102/ ↩
- https://journals.lww.com/ajg/fulltext/2013/10001/thedifficilediarrhea_digoxin_disaster__1049.1049.aspx ↩
- https://www.cancer.gov/about-cancer/treatment/side-effects/diarrhea ↩
- https://pmc.ncbi.nlm.nih.gov/articles/PMC1774951/ ↩
- https://www.mayoclinic.org/drugs-supplements/levothyroxine-oral-route/description/drg-20072133 ↩
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6503325/ ↩
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