Diarrhea—loose, watery stools—is often a short-term side effect of HIV meds and usually improves after a few days or weeks of treatment, unless there is an infection-related cause. Diarrhea is a symptom of many diseases and complications that can occur in HIV-positive people, so it is important that you report it to your doctor.
Generally speaking, diarrhea that occurs five times or more a day, for five or more consecutive days, and results in five pounds or more of weight loss, should always be reported and managed to prevent dehydration.
Diarrhea can also be a long-term problem for people taking certain ARV drugs, including Viracept (nelfinavir). While the diarrhea associated with nelfinavir doesn't usually lead to dehydration or other life-threatening problems, it can be a nuisance and may have a profound affect on a person's quality of life.
Here are a few tips for managing diarrhea:
Make dietary adjustments. Some foods can cause or worsen diarrhea, while others can help to relieve it.
The BRATT diet – consisting of Bananas, Rice (white), Apple juice or sauce, Toast and Tea (herbal) – may help control diarrhea.
Foods high in fiber are high in starch are recommended.
Clear juices (apple, peach or pear) are less harsh than those high in acid (orange or grapefruit).
Eat small amounts of food throughout the day, instead of three large meals.
Add nutmeg to foods to slow down the movement of material through the intestines.
Avoid foods that can make diarrhea worse, such as coffee or other caffeinated beverages, alcohol, chocolate, fried and fatty foods, spicy foods, fat substitutes, dairy products, highly processed foods and foods high in soluble fiber, such as raw vegetables, potato peels, beans and brown rice.
Increase your fluids. Try to drink at least three quarts of fluid per day, unless your doctor tells you not to do so. This will help to prevent dehydration and malnutrition, which may result from diarrhea. Drinking clear juices and sports drinks at room temperature is recommended.
Over-the-counter and prescription drugs. There are several over-the-counter (OTC) drugs available, including Imodium AD, Kaopectate and Metamucil. Metamucil is commonly used as a laxative, but its fiber contents can also absorb water in the colon and help control diarrhea. Some of the anti-diarrheal drugs available by prescription include Fulyzaq (crofelemer), Lomotil (diphenoxylate), pancrelipase (a pancreatic enzyme sold under many brand names), and tincture of opium. As with drugs used to control nausea and vomiting, anti-diarrhea drugs work best if taken 30 to 45 minutes before taking the medication causing the diarrhea.
Complementary therapies. Peppermint and ginger may calm the gut and are often used to control diarrhea. Other complementary therapies include the probiotic Lactobacillus acidophilus (available in capsules and yogurt), glutamine and the Chinese herbal blend Quiet Digestion.
Last Revised: February 26, 2015
This content is written by the POZ and AIDSmeds editorial team. For more information, please visit our "About Us" page.