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AIDS Factsheet

Side Effects And Their Treatments

Diarrhea

WHAT IS DIARRHEA?

AIDS FACT-SHEET

Background Information
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-Immune Therapies in Development
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-Opportunistic Infections

Side Effects and Their Treatments
-Side Effects
-Fatigue
-Anemia
-Body Shape Changes (Lipodystrophy)
-Diarrhea
-Peripheral Neuropathy
-Mitochondrial Toxicity
-Bone Problems
-Depression and HIV

Patient Populations

-Women and HIV
-Pregnancy and HIV aids
-Children and HIV
-Older People and HIV

Alternative and Complementary Therapies
-Alternative and Complementary Therapies
-Ayurvedic Medicine
-Chinese Acupuncture
-Chinese Herbalism
-Cat's Claw
-DHEA
-DNCB (Dinitrochlorobenzene)
-Echinacea
-Essiac
-Marijuana
-Silymarin (Milk Thistle)

-Nutrition
-Nutrition
-Vitamins and Minerals
-Exercise and HIV
-Smoking and HIV

Diarrhea is an increase in the water content, frequency, and volume of bowel movements. It is frequent in people with HIV disease.

Diarrhea can be a serious problem. Mild cases disappear within a few days. Severe cases can cause serious dehydration or nutritional problems.

IS DIARRHEA DANGEROUS?
The greatest risk of diarrhea is dehydration. You can lose up to a gallon of water each day. Along with the water, you lose minerals (electrolytes) that are important for normal body functions. The main electrolytes are sodium and potassium.

Severe dehydration can cause the body to go into shock and is potentially fatal. Dehydration is more serious for infants and children than for adults. Anyone with diarrhea should drink plenty of clear liquids. Tea, chicken broth, ginger ale, or soda are good choices. These are better than plain water, which does not replace any electrolytes.

Diarrhea that continues over a long period of time can cause poor absorption of nutrients. This can lead to wasting.

Diarrhea can be dangerous. Be sure your doctor knows if your diarrhea lasts more than a few days.

WHAT CAUSES DIARRHEA?
It can be difficult to find out what is causing diarrhea. Diarrhea is sometimes caused by an infection in the stomach or intestines. It can also be caused by an inability to digest milk products (lactose intolderance), by problems with the pancreas, or by emotional stress. Bacteria, parasites, fungi, or viruses can cuase the infection.

Parasites: The parasites cryptosporidium or microsporidium used to cause diarrhea in many people with HIV. The use of combination antiviral therapy has greatly reduced the rates of these problems.
Anti-HIV medications: These can cause diarrhea. This is often true with nelfinavir (Viracept), ritonavir (Norvir), Kaletra, ddI (Videx), tipranavir (Aptivus), foscarnet (Foscavir), and interferon alfa (Roferon or Intron).
Other causes: Taking antibiotics can kill off "good" bacteria in your gut and may cause diarrhea. Diarrhea can also be caused by an inability to digest milk products (lactose intolerance), by problems with the pancreas, or by emotional stress.

HOW DO I KNOW WHAT IS CAUSING MY DIARRHEA?
It can be difficult to find out what is causing diarrhea. Your doctor will ask you what you have been eating and drinking recently, and whether you have been traveling. Samples of your bowel movement (or "stool") may be tested for signs of bacteria or parasites. Your doctor may repeat this test if nothing shows up the first time. In some cases your blood or urine will also be tested.

If these tests do not show the cause of diarrhea, your doctor may look inside your digestive tract with a special tool or scope. The name of this procedure depends on where the doctor is looking. "Endoscopy" is a general term that means "to look inside". A colonoscopy is a procedure where the doctor examines the colon, and so on.

The cause of about one third of all cases of diarrhea cannot be determined.

HOW IS DIARRHEA TREATED?
1. CHANGE WHAT YOU EAT:
Some foods can cause diarrhea, and others can help stop it.

Don't eat:

dairy products (milk or cheeses)
greasy or fried food
fatty foods including butter, margarine, oils, or nuts
spicy foods
foods high in "insoluble" fiber. This includes raw fruits or vegetables, whole wheat bread, corn, or any fruit or vegetable skins or seeds

Do eat:

bananas
plain white rice
applesauce
cream of wheat or farina cereal
toasted white bread or plain crackers
plain macaroni or noodles
boiled eggs
oatmeal
mashed potatoes
yogurt (This is a dairy product, but it's partially "digested" by the bacteria used to make it)

2. DRUG TREATMENTS:
Different medications are used to treat different types of diarrhea. Your doctor will not be able to prescribe a medication without some idea of what is causing your diarrhea.

You do not need a prescription for over-the-counter treatments. Some of these work very well for diarrhea, including:

The amino acid L-glutamine
Pepto-Bismol (Bismuth subsalicylate)
Kaopectate (attapulgite)
Imodium AD (loperamide)

Some other products that are usually sold to treat constipation can also help with diarrhea. These products contain "soluble" fiber that adds bulk and absorbs water. This includes products like Metamucil, Citrucel, or other products that contain psyllium.

3. ALTERNATIVE THERAPIES FOR DIARRHEA
Acidophilus capsules (which contain helpful bacteria) can help restore normal digestion, especially when you are taking antibiotics. Some types of yogurt contain "live cultures" of acidophilus that work the same way.

Peppermint, ginger and nutmeg are believed to help with digestive problems. Peppermint or ginger tea or ginger ale would be good choices for "clear liquids". Try adding nutmeg to your food or drinks.

Studies have shown that calcium supplements helped relieve diarrhea in people taking nelfinavir (Viracept.) This might work for diarrhea caused by other medications.

THE BOTTOM LINE
Diarrhea is a common problem for people with HIV. It is usually caused by an infection in the digestive system. Stress, some medications, or problems digesting milk products can also cause diarrhea.

The most serious result is dehydration. This is more of a problem for children than for adults. If you have diarrhea, you should drink plenty of clear liquids.

Some simple changes in your food can help with diarrhea. So can some over the counter medications or acidophilus.

Be sure you tell your doctor if your diarrhea lasts more than a few days.

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AIDS Factsheet

Side Effects And Their Treatments

Diarrhea