Many medications can cause chronic diarrhea as a side effect. They can cause it by several different means. Whether they have that effect on you may depend on a variety of other factors, including dosage, diet and other conditions. Your healthcare provider will look at your complete medical profile to determine whether medications are a factor.
NSAIDs (nonsteroidal anti-inflammatory drugs), such as aspirin and ibuprofen.
Proton pump inhibitors (PPIs).
Antibiotics, such as amoxicillin and cephalexin.
Certain herbal supplements and tea ingredients, such as senna.
High doses of certain vitamin and mineral supplements, such as vitamin C and magnesium.
Antacids containing magnesium.
Antidepressants (selective serotonin reuptake inhibitors) such as fluoxetine (Prozac®) and sertraline (Zoloft®).
Beta-blockers.
Metformin.
Chemotherapy.
Laxatives, when overused, as in bulimia nervosa.
Healthcare providers sometimes classify diarrhea into three or four types as a way of narrowing down the cause. These types produce diarrhea with distinct qualities that doctors can recognize in your poop. They represent broad categories of causes. The three main types are inflammatory, fatty and watery. Some divide watery diarrhea into two sub-types (secretory and osmotic) to make four main types.
Watery diarrhea
Watery diarrhea happens when your colon is unable to absorb enough water and electrolytes from your poop and/or when it’s secreting more than it’s absorbing. The osmotic type is caused by poorly absorbed nutrients that draw extra water into your colon. (This is how osmotic laxatives work.) Meanwhile, secretory diarrhea represents a wide variety of diseases that can cause watery diarrhea.
Some of these causes include:
Bile acid diarrhea. (This happens when there’s too much bile in the gut; also known as bile acid malabsorption, or BAM.)
Microscopic colitis.
Diabetes-related neuropathy.
Vagotomy.
Hyperthyroidism.
Adrenal disorders.
Neuroendocrine tumors.
Irritable bowel syndrome (IBS).
Fatty diarrhea
Sometimes, excess fat in your poop changes the consistency to diarrhea. This can happen when your body has trouble breaking down and absorbing fats, or when bacteria in your gut produce excessive fatty acids. Fatty diarrhea may be less frequent but with greater volume. It may be smellier than normal and may leave a visible oil residue in the toilet. It may come with nausea, indigestion and weight loss.
Causes include:
Malabsorption disorders such as pancreatic insufficiency and celiac disease.
Small intestinal bacterial overgrowth (SIBO).
Mesenteric ischemia.
Gastric bypass surgery.
Inflammatory diarrhea
Inflammatory diarrhea is caused by inflammation in your colon (colitis). Inflammation affects the mucous lining of your colon (mucosa). It causes swelling and impairs the colon’s ability to absorb. Inflammatory diarrhea tends to come out more frequently and in smaller amounts. It may be accompanied by stomach pain, fever or bleeding. Inflammatory conditions that can cause chronic diarrhea include:
Persistent infections, such as parasites or C. diff (pseudomembranous colitis).
Inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease.)
Ischemic colitis.
Diverticulitis.
Radiation colitis.
Cancer.
Food and Nutrition supplements
Foods that May Lead to or Worsen Diarrhea in Sensitive Individuals
Milk and other dairy products
Legumes (chickpeas, beans, peas, lentils and lupins) and cabbage family vegetables—these are all high in fiber
Fruits and juices that contain fructose
Caffeine-containing beverages such as coffee and tea
Alcoholic beverages such as beer, wine, and liquor
Fatty meats such as bacon and heavily marbled meats
High fat foods such as fried foods, pastries, and chips
Artificial sweeteners such as NutraSweet®, Splenda®, Equal®, sorbitol, etc.
Sugar-free gums and mints that contain sorbitol, mannitol, or xylitol
Real black licorice (not the candy)
Large quantities of nuts or nut butters
Concentrated sweets
o Dried fruits such as figs, dates, raisins, and prunes
o Prune juice
Foods/Fluids that may Improve Diarrhea
Increase fluids to prevent dehydration. Try to drink these fluids between your meals. Liquids with a meal may speed up stomach emptying and
possibly worsen diarrhea.Eat and/or drink foods and beverages with sodium and potassium. Diarrhea can lead to low levels of both sodium and potassium, so it is important to replace these electrolytes through your diet
Broth (sodium)
Sports drinks (sodium and potassium); however, avoid sugar-free drinks which have artificial sweeteners (see list above)
Equalyte®, Pedialyte® (sodium and potassium)
Bananas (potassium)
Nectars (potassium)
Boiled or mashed potatoes (potassium)
Eat lower fiber foods:
Yogurt (if you are lactose intolerant, may want to avoid)
Rice
Noodles
White bread
Cream of wheat
Smooth peanut butter, a small amount at a time
Lean meats
Drink beverages at room temperature, not too cold or hot
Supplements that May Help to Control Diarrhea
Probiotics may help prevent antibiotic-associated diarrhea. They are found in yogurts that contain Live Active Cultures (LAC) such as lactobacillus acidophilus. Look for the term LAC on the label of yogurts in the dairy aisle (note: frozen yogurt does not contain LAC).
Pectin is a form of fiber found in fruits and some vegetables that may slow the movement of stool in your intestines. It is also sold as a powder in grocery stores. You can find this in the aisle with pudding and gelatin. To help with diarrhea, mix 1 tablespoon of pectin powder with ¼ cup of lemon water and drink it 20–30 minutes before a meal.
The Bottom Line
To prevent complications that can result from frequent bowel movements, do try to do the following:
Keep a food and symptom diary to help identify which foods, drinks, and supplements may be leading to or worsening your diarrhea
Eat smaller, more frequent meals during the day
Sit and relax for 20-30 minutes after you eat
Drink plenty of fluids in between your meals
Eat and drink foods and beverages that contain sodium and potassium
Remember, generalized dietary advice does not work for everyone. The influence of diet is unique to each individual. If you have questions about your symptoms and circumstances, talk to your healthcare provider. They will be able to identify dietary and other changes that may decrease your symptoms and improve your quality of life.
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