Tips for Managing Diarrhea

Diarrhea can occur unexpectedly and (sometimes) for no specific reason.  When you’re experiencing diarrhea, it is important to notify your doctor and/or gastroenterologist since it can be related to your IBD or a type of infectious etiology that may need more exploring.  When diarrhea is present, there are a few tools that we can utilize to improve one of the most common symptoms that IBD patients experience. Continue reading for our recommendations!

Soluble Fiber

Soluble fiber is one of the two types of fiber that can help with diarrhea.  It has many functions where it can improve diarrhea and loose stools.  Examples of soluble fiber that we often recommend include psyllium seed powder, SunFiber, green banana, and resistant starches.

Functions of soluble fiber:

• Can help with bulking stool 
• Dissolves in water and forms a gel within the digestive tract, helping to bulk stool
• Food sources: Oats, peas, beans, carrots, apples, barley, and psyllium

SunFiber – in GutLove Back to Balance

• Uses: Can help with both constipation and diarrhea. It’s one of the only true regulating prebiotics that helps with both!
• How it works: Forms a gel and helps support butyrate production + soaks up excess moisture in the gut
• Benefits: It’s a 100% water-soluble dietary fiber – meaning it dissolves in water so there is no risk of complications with strictures, j-pouch etc. It is a prebiotic fiber produces short chain fatty acids which can increase water absorption and alleviate diarrhea (2). 
• How to use: Mix 1-2 scoops with an 8 oz. glass of water. 
• Where to find it: Use code CCD10 for 10% off – Back to Balance 

Green Banana

• What it is: Bananas with some green on them have higher content of resistant starch- see below to read more on resistant starch! (3)
• How it works: The resistant starches in green-ish bananas reach the colon and produce short chain fatty acids and absorb water and salt.
• Great tool for Adults & Kids: Can be a helpful tool in the management of diarrhea in children where cooked green bananas decrease stool output/volume and increase quality of life (4).  In this study, children were provided with 180-200 grams of cooked green banana which is 1.5-2 uncooked fruits per day. 

Resistant Starch

• How it works: Resistant starches “resist” digestion. Resistant starches are not digested in the small intestine of humans. Resistant starches ferment in the gut and produce SCFA’s- short chain fatty acids include butyrate, propionate, and acetate. SCFA’s support our gut by helping with inflammation reduction, repairing the gut lining and more. Technically all the food sources and prebiotics on this list also do this!
• Where to find it: Food sources include cooked and cooled rice, potatoes, oats, barley, and green bananas

Psyllium seed powder

• How it helps: Can help with diarrhea
• How does it work: Forms a gel and helps support butyrate production + soaks up excess moisture in the gut
• Remember: Psyllium seed is different than psyllium husk- Only the outer shell is used in psyllium husk 
• How to take: It is recommended to take psyllium with an 8 oz. glass of water and to continue drinking water throughout the day
• Where to find it: Starwest botanicals has a line of this

Pelvic Floor Therapy

• What is the pelvic floor: The pelvic floor involves the rectum, uterus (for women), and bladder
• What is pelvic floor therapy: Pelvic floor therapy is biofeedback-based physical therapy for pelvic floor dysfunction (PFD)
• How it works: A physical therapist uses a tool that can be either placed rectally and can receive feedback on how well certain muscles are functioning. This type of biofeedback can be used to help strengthen the pelvic floor muscles thereby improving constipation and incontinence.

Other Ideas:

• Modifying foods and textures that can contribute to looser bowel movements
• Checking digestive enzymes, stool culture, and stool panel to determine possible cause of diarrhea
• Testing for celiac disease (common in microscopic colitis)
• Exploring a low FODMAP (3-phased plan) under the guidance of a Registered Dietitian can help with IBS-D subtype. Remember- low fodmap is NOT technically a diet though- it’s a several week protocol and not meant to be long term. Also- keep in mind that it only relieves symptoms and does NOT help with inflammation reduction. If you are interested in exploring dietary patterns + protocols that do reduce inflammation see our previous post titled “START HERE” and consider working directly with us.

 

References

1. Slavin J. Fiber and Prebiotics: Mechanisms and Health Benefits. Nutrients. 2013; 5(4):1417-1435. https://doi.org/10.3390/nu5041417
2. Yasukawa Z, Inoue R, Ozeki M, Okubo T, Takagi T, Honda A, Naito Y. Effect of Repeated Consumption of Partially Hydrolyzed Guar Gum on Fecal Characteristics and Gut Microbiota: A Randomized, Double-Blind, Placebo-Controlled, and Parallel-Group Clinical Trial. Nutrients. 2019 Sep 10;11(9):2170. doi: 10.3390/nu11092170. PMID: 31509971
3. Sarmin M, Hossain MI, Islam SB, Alam NH, Sarker SA, Islam MM, Chisti MJ, Islam SMR, Mahfuz M, Ahmed T. Efficacy of a Green Banana-Mixed Diet in the Management of Persistent Diarrhea: Protocol for an Open-Labeled, Randomized Controlled Trial. JMIR Res Protoc. 2020 Mar 6;9(3):e15759. doi: 10.2196/15759. PMID: 32224490
4. Rabbani, GH., Teka, T., et al. Clinical studies in persistent diarrhea: Dietary management with green banana or pectin in Bangladeshi children. Gastroenterology. 2001;121:554-560. https://doi.org/10.1053/gast.2001.27178