Diarrhea, Antibiotic-Associated

Taking antibiotics to fight bacterial infections can sometimes cause loose, watery stools. This is called antibiotic-associated diarrhea. If you have it, you might have three or more loose bowel movements a day.

A significant number of people – roughly one in five – who take antibiotics experience this type of diarrhea. In many cases, it's mild and goes away on its own. The diarrhea usually stops within a few days after you finish taking the antibiotic. However, if the diarrhea is more severe, your doctor might need to stop or change the antibiotic you're taking.

Antibiotic-related diarrhea is a common side effect of taking antibiotics. Most people experience mild symptoms. These usually include loose stools and needing to go to the bathroom more often than usual.

This diarrhea typically starts around a week after you begin taking the antibiotic. However, it's possible for the diarrhea and other symptoms to develop days or even weeks after you've stopped taking the medicine.

Antibiotic-related diarrhea happens when antibiotics disrupt the natural balance of bacteria in your gut. This upset happens because antibiotics kill off not only the harmful bacteria they're meant to target, but also the helpful bacteria that normally live in your digestive system. The loss of these helpful bacteria can cause problems, including diarrhea. Scientists aren't entirely sure why this happens in every case, but it's a common side effect of antibiotic use.

Antibiotic-related diarrhea can affect anyone taking antibiotics. However, some people are at higher risk. This includes people who:

• Have had antibiotic-related diarrhea before: If you've experienced this problem with antibiotics in the past, you might be more prone to it happening again. Your body's gut bacteria may be more susceptible.
• Are taking antibiotics for a long time: Taking antibiotics for a prolonged period disrupts the balance of good bacteria in your gut. This disruption can lead to diarrhea. The longer the treatment, the greater the risk.
• Are taking multiple antibiotics at once: Combining different antibiotic medications can further upset the delicate balance of bacteria in your gut, increasing the chances of diarrhea. Each antibiotic targets different types of bacteria, and the combined effect can be more damaging.

Diarrhea often leads to a serious problem: losing a lot of fluids and important salts (electrolytes). This loss of fluids, called dehydration, can be dangerous and even deadly. Dehydration shows up in several ways. You might have a very dry mouth and feel incredibly thirsty. You might not be urinating much, if at all. You might also feel dizzy or weak.

Antibiotic-associated diarrhea can be a problem for some people. Here are some ways to lower your risk:

1. Use antibiotics only when needed: Doctors prescribe antibiotics to fight bacterial infections. They won't work against viruses like the common cold or the flu. So, only take antibiotics if your doctor thinks they're absolutely necessary.

2. Promote hand hygiene: If you're getting care at home or in a hospital, ask everyone who touches you to wash their hands thoroughly with soap and water, or use an alcohol-based hand sanitizer. This is crucial for preventing the spread of germs that can cause diarrhea.

3. Tell your doctor about past experiences: If you've had antibiotic-associated diarrhea or a condition called Clostridium difficile (C. difficile) in the past, be sure to tell your doctor. This is important because having these problems before can increase the chance of them happening again. Your doctor might choose a different antibiotic to reduce the risk.

By following these tips, you can help lower your chances of getting antibiotic-associated diarrhea.

If you have diarrhea after taking antibiotics, your doctor will likely ask you about your health history, including any recent antibiotic use. This helps them understand your symptoms. If your doctor thinks you might have a C. difficile infection, they'll need a stool sample. This sample will be tested to see if the C. difficile bacteria are present.

Antibiotic-related diarrhea treatment depends on how bad your symptoms are.

If your diarrhea is mild, it probably will go away on its own within a few days after you finish your antibiotic course. Sometimes, your doctor might suggest stopping the antibiotic until the diarrhea clears up. This allows your gut bacteria to recover.

If you have a more serious infection called Clostridium difficile (C. diff) diarrhea, your doctor will likely stop the antibiotic you're currently taking. They might prescribe a different antibiotic specifically designed to fight the C. diff bacteria. They might also tell you to stop taking any medications that reduce stomach acid, as these can sometimes make C. diff worse. Unfortunately, with C. diff, the diarrhea can come back, and you might need more treatment to fully get rid of the infection. This is because C. diff can be tough to eliminate.

Dealing with Diarrhea: What to Do

Diarrhea can lead to fluid loss. It's important to replace those lost fluids.

Stay Hydrated:

If you have mild diarrhea, drinking more water or electrolyte drinks will help. Electrolyte drinks have minerals that your body needs. For more severe diarrhea, try drinks with water, sugar, and salt, like oral rehydration solutions. Broth and low-sugar fruit juices are also good choices. Avoid sugary drinks, alcohol, and caffeine (like coffee, tea, and soda) as these can make your diarrhea worse.

Babies and young children with diarrhea should ask their doctor about using an oral rehydration solution like Pedialyte. This will help them replace the fluids and minerals they've lost.

What Foods to Avoid:

While you have diarrhea, it's best to avoid dairy products, fatty foods, and spicy foods. You can usually return to your normal diet once your diarrhea stops.

When to Consider Medications:

Sometimes, a doctor might recommend anti-diarrheal medications, like loperamide (Imodium A-D), for mild cases of diarrhea caused by antibiotics. However, it's crucial to talk to your doctor before taking any anti-diarrheal medication. These medications can sometimes prevent your body from getting rid of toxins, which can be serious. Don't take these medications if you think you might have C. difficile infection.

Probiotics:

You might hear about probiotics, often found in yogurt. These are helpful bacteria that can help your digestive system. However, there's no strong evidence that over-the-counter probiotics will stop antibiotic-related diarrhea. Taking probiotics is usually safe, unless you have a weakened immune system.