Fortunately, diarrhea is usually a short-term side effect of HIV medicines. Diarrhea usually improves after a few days or few weeks of treatment. However, loose, watery stools can become 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. Thus managing diarrhea, no matter how severe, is very important. Consider some (or all) of the following:
Make changes in your diet: Making dietary adjustments may help control diarrhea. Some foods can actually cause diarrhea – or make it worse – while others can help to relieve it. Here are some specific suggestions:
No matter what the underlying cause of the diarrhea, the BRATT diet – consisting of Bananas, Rice (white), Apple juice or sauce, and Toast and Tea (herbal) – may help to control it.
Foods that are high in starch – such as white rice, mashed potatoes, and white bread – are a good bet, along with oatmeal and tofu.
Clear juices, such as apple, peach, or pear – all of which contain much needed sugar to fuel the body – are much less harsh on the gut than other types of juices that are high in acid content (e.g., orange or grapefruit juice).
Another good tip: Eat small amounts of food five to six times throughout the day, instead of three large meals.
Add nutmeg to foods in order to slow down the movement of material through the intestines. This works!
Foods to avoid: Food that can make diarrhea worse include coffee and other caffeinated beverages (cola, certain soft drinks, tea, etc.), alcohol, chocolate, fried and fatty foods, spicy foods, food high in insoluble fiber such as raw vegetables, potato peels, beans, and brown rice, fat substitutes (Olean or Olestra) and highly processed foods with little nutritional value such as Twinkies, cookies, cakes, donuts, etc. Dairy products – such as milk and cheese – can also make diarrhea worse.
Increase your fluid intake: 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. Here are some specific suggestions:
Drink sports drinks, such as Gatorade, which help to replace some of the electrolytes lost in diarrhea. To make a sports drink at home, add five tablespoons of sugar and one tablespoon of salt to one gallon of water. You can also flavor it with some fresh lime or lemon.
Drink clear liquids, including clear fruit juices, ginger ale, and water.
Drink liquids at room temperature.
Drugs that can be used to manage diarrhea: To help control diarrhea, there are several over-the-counter (OTC) remedies available, including Imodium AD (a prescription version, loperamide, is available for those who need larger amounts of the drug), Kaopectate, and Metamucil (though Metamucil is commonly used as a laxative, its fiber contents can also absorb water in the colon and help control diarrhea). Some of the anti-diarrheal drugs available by prescription include 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 seem to work best if taken 30 to 45 minutes before taking the medication causing the diarrhea.
Consider complementary therapies: Two herbs said to be helpful in controlling diarrhea are peppermint and ginger. Drinking peppermint or ginger tea, or ginger ale, may help calm the gut and help you to regain some control over your diarrhea. Other complementary therapies for diarrhea includelactobacillus acidophilus (available in capsules and yogurt), which can help replace helpful bacteria in the gut lost during therapy with antibiotics, as well as the amino acid glutamine and the Chinese herbal blend Quiet Digestion.
Last Revised: January 30, 2013
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