With worsening sanitation and hygiene, there will likely be an increase in infectious disease, many of which cause diarrhea. Diarrhea is defined as frequent loose bowel movements. If a person has 3 liquid stools in a row, it’s important to watch for signs of dehydration. Diarrhea lasting less than three weeks is usually related to an infection, and is known as Acute Diarrhea. Chronic Diarrhea lasts longer than three weeks and is more likely related to disorders such as irritable bowel syndrome.

Diarrhea, generally, is a common ailment which should go away on its own with attention to rehydration methods. In aome circumstances, however, diarrhea can be a life-threatening condition. Over 80,000 soldiers perished in the Civil War, not from bullets, but from dehydration related to diarrheal disease.

Common causes of diarrhea are:

• Bacterial infections caused by food or water contamination, such as Salmonella, Shingella, E. Coli and Campylobacter
• Viral Infections like rotavirus, cytomegalovirus, herpes simplex virus, Norwalk virus
• Food Intolerances or Allergies, such as lactose intolerance and seafood allergies
• Medication Reactions, like antibiotics, laxatives
• Parasites, such as Cryptosporidium, Entamoeba and Giardia
• Chronic Intestinal diseases
• Overeating heavy greasy foods or unripe fruit

Danger Symptoms of Diarrhea

In most cases, diarrhea will resolve itself simply by staying hydrated and staying away from solid food for 6-12 hours. However, there are some symptoms that may present in association with diarrhea that can be a sign of something more serious. Those symptoms are:

• Fever equal to or greater than 101 degrees Fahrenheit
• Bloody, mucus, or frothy yellow stool
• Black or grey-white stool
• Severe vomiting
• Major abdominal distension and pain
• Moderate to severe dehydration, which is not getting better
• Diarrhea lasting more than 3 days in adults
• Diarrhea lasting more than 1 day in children and the sick or elderly
• In children also, abdominal pain causing crying for over 2 hours

All of the above may be signs of serious infection, intestinal bleeding, liver dysfunction, or even surgical conditions such as appendicitis. As well, all of the above will increase the likelihood that the person affected won’t be able to regulate their fluid balance.

The end result (and most common cause of death) of untreated diarrheal illness is dehydration. 75% of the body’s weight is made up of water; the average adult requires 2 to 3 liters of fluid per day to remain in balance. Children become dehydrated more easily than adults: 4 million children die every year in underdeveloped countries from dehydration due to diarrhea and other causes.

Rehydration Treatment for Diarrhea

Fluid replacement is the treatment for dehydration caused by diarrhea. Oral rehydration is the first line of treatment, but if this fails, intravenous fluid (IV) may be needed, which requires special skills. Always start by giving your patient small amounts of clear fluids.

For pediatric diarrhea, the problem can become life threatening much faster. Be diligent in fluid replacement and continue breast-feeding if the infant is still nursing. Do not use watered down fruit juices or Gatorade products for these infants or children. The best fluid replacement according to one study called Evaluation of Infant Rehydration Solutions, by James F. Wesley, states, “The most appropriate product would have an acceptable taste and a hypotonic osmolality. That would be unflavored Gerber Liquilyte.” https://osmolality.com/pdf/InfantRehydrate.pdf

Oral rehydration packets are commercially available, but you can produce your own homemade rehydration fluid very easily: For adults use 1 liter of water, and for children use 2 liters of water, then add:

• 6-8 teaspoons of sugar (sucrose)
• 1 teaspoon of salt (sodium chloride)
• ½ teaspoon of salt substitute (potassium chloride)
• A pinch of baking soda (sodium bicarbonate)

 

As the patient shows an ability to tolerate these fluids, advancement of the diet is undertaken. It is wise to avoid milk, as some are lactose intolerant. A popular strategy for rapid recovery from dehydration is the BRAT diet, used commonly in children. This diet consists of:

• Bananas
• Rice
• Applesauce
• Plain Toast (or crackers)

Once the patient keeps down thin cereals, you can add more solid foods. Additional energy needs may be met with these foods, as the patient gets better:

 

• Brown Rice water
• Chicken or Beef broth, with rice or noodles
• Oatmeal or grits
• Boiled eggs
• Boiled potatoes
• Baked Chicken
• Vegetable broth with very soft carrots, potatoes
• Jell-O
• Organic Yogurt for probiotics after diarrhea stops

 

The advantage of this strategy is that these food items are very bland, easily tolerated, and slow down intestinal motility (the rapidity of movement of food/fluids through your system). This will slow down diarrhea and, as a result, water loss. In a survival setting, you will probably not have many bananas, but hopefully you have stored rice and/or applesauce, and have the ability to bake bread.

Various natural substances have been reported to be helpful in these situations. Herbal remedies that are thought to help with diarrhea include:

• Ginger (fresh is best)
• Meadowsweet (mild and highly recommended)
• Blackberry leaf
• Raspberry leaf
• Chamomile
• Peppermint
• Goldenseal
• Sunflower leaf
• Garden Sage
• Yarrow
• Mullein
• Nettle
• Slippery Elm
• Oak Bark (very strong, last resort)

Make a tea (infusion) by pouring 1 cup of boiling water over 1-2 teaspoon of dried herbs and let them brew with a lid for 10-15 minutes, strain, then drink a cup every 2-3 hours, or until the patient feels better. A small amount of raw honey may be added for taste and a pinch of cinnamon.

Half a clove of fresh crushed garlic and 1 teaspoon of raw, unprocessed honey 3-4 times a day is thought to exert an antibacterial effect in some cases of diarrhea. A small amount of nutmeg may decrease the number of loose bowel movements.

Of course, there are medicines that can help and you should stockpile these in quantity. Pepto-Bismol and Imodium (Loperamide) will help stop diarrhea. They don’t cure infections, but they will slow down the number of bowel movements and conserve water. These are over the counter medicines, and are easy to obtain. In tablet form, these medicines will last for years if properly stored. Don’t use medication as a first option; some causes of diarrhea are made worse with these medications.

There are some theories about creating homemade IV solutions. This is problematic and all the obstacles cannot be overcome. How do you make a 100% sterile solution that is exactly normal saline, get it into a sterile bag/delivery system and keep it 100% sterile in the process? You’ll also need a tubing system, which must also be sterile, to an I.V. catheter, which must be sterile until used. A standard IV bag is created in a specialized environment and remains sterile until punctured by a sterile (hopefully) tubing. Any exposure to the air will eliminate the sterility, which means that it is possible that you might be infusing bacteria directly into your patient’s bloodstream, a very bad idea.

As a last resort to treat dehydration from diarrhea (especially if there is also a high fever), you can try antibiotics or anti-parasitic drugs. Ciprofloxacin, Doxycycline and Metronidazole are good choices, twice a day, until the stools are less watery. Some of these are available in veterinary form without a prescription (discussed later in this book). These medicines should be used only as a last resort, as the main side effect is usually…diarrhea!

Joe Alton MD