Diarrhea in Adults and Children: Causes, Symptoms, Remedies, and Diet

What is Diarrhea?

Diarrhea is a change in normal defecation characterized by an increase in the daily quantity of stools, which are looser and less formed than usual. It is typically, but not always, accompanied by an increased frequency of bowel movements.

The formal clinical definition most commonly used requires three or more loose or watery stools per day, though many clinicians and patients use the term more broadly for any episode of notably loose stools.

• Acute diarrhea, which lasts up to 14 days, is extremely common and in most cases resolves spontaneously within 1–2 days, without requiring specific treatment beyond hydration. When diarrhea lasts longer than two days, it could signal a more serious underlying condition. At this point, the risk of complications, especially dehydration, rises significantly.

• Chronic diarrhea is defined as diarrhea lasting more than 4 weeks, and virtually always indicates an underlying chronic disease or condition requiring medical evaluation.

Among the most common causes of diarrhea:

• Contaminated food or water consumption
• Viral gastroenteritis, which includes the so-called intestinal flu
• Medications, most commonly antibiotics
• Food intolerances and other forms of hypersensitivity
• Functional bowel disorders such as irritable bowel syndrome (IBS)

When diarrhea resolves within a few days without specific treatment, identifying the exact cause is often unnecessary. However, medical consultation is strongly recommended in case of:

• Symptoms or signs of dehydration
• Persistence beyond 2 days in adults, or 24 hours in children
• Severe abdominal pain or rectal pain
• Fever
• Blood or pus in the stool
• Black, tarry stools

Diarrhea vs. Dysentery

These two terms are often used as if they were synonymous, but they refer to distinct clinical entities:

• Diarrhea: Characterized by the passage of loose, watery, or unformed stools, typically without visible blood.
• Dysentery: A form of infectious gastroenteritis where diarrhea occurs alongside blood in the stool. This symptom indicates mucosal damage or invasion by the causative organism.

In the absence of blood in the stool, dysentery is the incorrect term. The two are not synonyms and should not be used interchangeably.

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Causes of Diarrhea

The causes of diarrhea differ substantially depending on whether the episode is acute or chronic:

• Acute diarrhea is most commonly caused by infections (bacterial, viral, or parasitic) or by medication reactions.
• Chronic diarrhea is typically associated with functional bowel disorders (such as IBS) or inflammatory bowel diseases (IBD), and always warrants medical investigation.

Bacterial Infections

Bacteria are among the most significant causes of acute diarrhea, particularly through contaminated food or water:

• Escherichia coli (E. coli): Multiple pathogenic strains, transmitted through undercooked meat (particularly ground beef), unwashed produce, or contaminated water. Enterohemorrhagic E. coli (EHEC/O157:H7) can cause severe, bloody diarrhea and the life-threatening hemolytic uremic syndrome (HUS), particularly in children.
• Campylobacter: The most common cause of bacterial gastroenteritis in many developed countries; typically associated with undercooked poultry. Particularly affects children and young adults, especially in summer.
• Salmonella: Found in contaminated poultry, eggs, and unpasteurized dairy. A major cause of food-borne illness, especially in warm months when food storage conditions are more challenging.
• Shigella: Highly contagious; spreads readily in households, hospitals, and nurseries. Children aged 2–4 are particularly susceptible. Can cause dysentery (bloody diarrhea).
• Clostridium difficile: A bacterium that overgrows in the colon when normal gut flora is disrupted by antibiotic use, causing antibiotic-associated diarrhea ranging from mild to life-threatening colitis. Important to consider in any patient with diarrhea following recent antibiotic exposure.

Viral Infections

Viruses are the most frequent cause of acute gastroenteritis:

• Rotavirus: The leading cause of severe diarrheal illness in young children worldwide. Before widespread vaccination, it was responsible for hundreds of thousands of deaths annually in low-income countries. An effective oral vaccine (Rotateq) is available and recommended.
• Norovirus (Norwalk virus): The most common cause of epidemic gastroenteritis in adults and older children; responsible for the majority of cruise ship and institutional outbreaks. Highly contagious, with an infectious dose as low as 10–100 viral particles.
• Cytomegalovirus (CMV): An important cause of severe diarrheal illness in immunocompromised individuals.
• Herpes simplex virus: Can cause gastrointestinal infection particularly in immunocompromised patients.
• Viral hepatitis: Hepatitis A and E in particular can present with gastrointestinal symptoms including diarrhea.

Parasitic Infections

Parasites enter the body through contaminated food, water, or contact, and colonize the digestive tract:

• Giardia lamblia: One of the most common intestinal parasites globally. Particularly prevalent in contaminated water sources, such as swimming pools, water parks, aquariums, and natural streams. Resistant to standard chlorination. Causes prolonged, often non-bloody diarrhea with bloating and foul-smelling stools.
• Entamoeba histolytica: This parasite causes amoebiasis, which may lead to bloody dysentery. In severe cases, it can also result in liver abscesses. More prevalent in developing countries with poor sanitation.
• Cryptosporidium: Found primarily in water, including both drinking water and recreational water sources. Responsible for many outbreaks in schools and public settings. Causes profuse watery diarrhea lasting 2 weeks or more; particularly severe in immunocompromised patients. Highly resistant to chlorination.

Food Intolerances and Hypersensitivity

Certain individuals cannot adequately digest specific dietary components, leading to osmotic diarrhea:

• Lactose intolerance: Deficiency of the enzyme lactase means undigested lactose reaches the colon, where bacterial fermentation produces gas, bloating, cramping, and diarrhea.
• Fructose malabsorption: Excess fructose from fruit, certain vegetables, and high-fructose corn syrup overwhelms intestinal absorption capacity.
• Sorbitol and other artificial sweeteners: Poorly absorbed sugar alcohols (sorbitol, mannitol, xylitol) draw water into the intestinal lumen through osmosis, causing diarrhea, particularly when consumed in large quantities.
• Celiac disease: An autoimmune enteropathy triggered by gluten ingestion, causing villous atrophy and malabsorptive diarrhea.

Medications

Several commonly used medications can cause or worsen diarrhea:

• Antibiotics: Disrupt the normal gut microbiome, allowing pathogenic species (especially C. difficile) to overgrow. Virtually all antibiotics can cause diarrhea, with ampicillin, clindamycin, cephalosporins, and fluoroquinolones being among the most commonly implicated.
• Antihypertensives: Some blood pressure medications affect intestinal motility.
• Chemotherapy agents: Many cytotoxic agents cause diarrhea through direct mucosal damage and altered gut motility.
• Magnesium-containing antacids: Magnesium has osmotic laxative effects at doses present in many antacid preparations.
• NSAIDs: Can cause colitis and diarrhea through prostaglandin inhibition.
• Metformin: A first-line diabetes medication with well-known gastrointestinal side effects including diarrhea, particularly when first introduced.

Inflammatory Bowel Disease (IBD)

Chronic, relapsing inflammatory conditions of the bowel are important causes of chronic diarrhea:

• Crohn’s disease: Can affect any portion of the gastrointestinal tract; transmural inflammation causes diarrhea, abdominal pain, weight loss, and constitutional symptoms.
• Ulcerative colitis: Mucosal inflammation confined to the colon and rectum; produces bloody diarrhea with mucus, urgency, and abdominal cramping.

Functional Bowel Disorders

Irritable bowel syndrome (IBS), particularly its diarrhea-predominant subtype (IBS-D), is one of the most common causes of recurrent diarrhea. It affects approximately 10 to 15% of the population. It is characterized by abdominal pain related to defecation, altered stool frequency, and altered stool consistency, in the absence of structural or biochemical abnormalities.

Post-Surgical Causes

Some individuals develop diarrhea following gastrointestinal surgery:

• Gastric surgery: Altered gastric emptying and dumping syndrome can produce post-prandial diarrhea.
• Cholecystectomy (gallbladder removal): Increased bile salt delivery to the colon stimulates secretory diarrhea in a proportion of patients; this may be chronic.

Traveler’s Diarrhea

Travelers to countries with lower sanitation standards are at significantly elevated risk of acute diarrhea from contaminated food and water. The diarrhea of travelers is most commonly bacterial (ETEC strains of E. coli account for the majority), though viral and parasitic causes also occur. High-risk destinations include many parts of Asia, Africa, Latin America, and the Middle East. Travel to the USA, Canada, most of Western Europe, Japan, Australia, and New Zealand carries minimal additional risk.

Intestinal Flu: Contagion and Transmission

A common misconception is that viral gastroenteritis (“intestinal flu”) spreads primarily through direct respiratory contact, as influenza does. In fact, the contagion routes are different:

The viruses responsible for gastroenteritis (norovirus, rotavirus) are shed primarily through vomit and feces. Transmission occurs through:

• Fecal-oral route: Insufficient hand hygiene after using the toilet leads to contamination of surfaces, food, and other people.
• Contaminated surfaces: Viruses can survive on hard surfaces (toilet seats, toys, door handles, food preparation surfaces) for hours to days. Touching a contaminated surface and then touching the mouth transmits the virus. This is particularly relevant in childhood settings.
• Contaminated food or water: Consuming food prepared by an infected person who has not washed their hands, or water contaminated with sewage.
• Aerosolized vomit: Norovirus can be transmitted through aerosols generated by vomiting. This explains the explosive outbreaks seen in enclosed settings, such as cruise ships, hospitals, and schools.

Children are particularly vulnerable to surface-mediated transmission. A classic transmission route involves touching contaminated toys or surfaces and then putting their fingers in their mouths.

Common Infections in Detail

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Symptoms of Diarrhea

Diarrhea is itself a symptom, but it is almost always accompanied by other findings that reflect the nature and severity of the underlying cause:

Gastrointestinal Symptoms

• Abdominal pain and cramping: Ranges from mild discomfort to severe, incapacitating cramps. The pain usually matches intestinal spasm, which involves the muscular contractions of the bowel wall as it tries to move watery contents.
• Urgency: The sudden, compelling need to defecate, which can precede episodes of fecal incontinence in severe or prolonged cases.
• Nausea and vomiting: Particularly common in viral gastroenteritis. In children, vomiting often precedes diarrhea as the first symptom.
• Bloating and excessive gas: Common particularly in functional causes and parasitic infections (especially Giardia).

Systemic Symptoms (Particularly with Infections)

• Fever: Present particularly with bacterial and parasitic infections; mild or absent in most viral gastroenteritis. High fever (>39°C/102.2°F) warrants prompt medical assessment.
• Loss of appetite: Extremely common; typically resolves as the diarrhea improves.
• Unintentional weight loss: More significant in prolonged or chronic diarrhea.
• Blood in stool: This symptom indicates mucosal damage and always warrants medical evaluation. It may suggest bacterial dysentery, IBD, or other serious causes.
• Dehydration: The most important systemic complication; discussed in detail below.

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Diarrhea in Children

Children, especially infants and toddlers, are more vulnerable to the consequences of diarrhea than adults. This is mainly because they have smaller body fluid reserves and a limited ability to communicate their symptoms. Dehydration can develop rapidly, sometimes within just a few hours, and may become life-threatening.

The most important cause of acute diarrhea in young children is rotavirus infection, which is typically self-limiting over 3–9 days but can cause severe dehydration. Children between 6 and 32 weeks of age can be vaccinated against rotavirus with the oral Rotateq vaccine.

When to Seek Immediate Medical Advice for Children

For infants (under 12 months): Contact a pediatrician urgently if there are:

• Six or more episodes of diarrhea in 24 hours
• Three or more vomiting episodes in 24 hours
• Signs of dehydration (see below)
• A sunken fontanelle (the soft spot on the top of the head)
• Absence or marked reduction of tears during crying
• Dry mouth and tongue
• Insufficient wet nappies (fewer than expected for age)
• Dark yellow urine
• Drowsiness or unusual lethargy
• Rapid breathing
• Cold hands and feet

For older children, seek medical attention for:

• Six or more loose stools in 24 hours
• Vomiting combined with diarrhea
• Profuse, watery diarrhea
• Blood in the stool
• Severe, continuous abdominal pain
• Signs of dehydration
• Stools containing blood, mucus, or pus
• Black stools
• Temperature above 39°C (102.2°F)

Over-the-counter antidiarrheal medications, such as loperamide, should not be given to children except under explicit medical supervision. These medications can be potentially dangerous in pediatric patients.

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Dehydration: The Main Danger

Diarrhea can cause dehydration, an excessive loss of fluids and electrolytes that impairs the body’s ability to function normally. Dehydration is the most serious and potentially life-threatening complication of diarrhea.

It is particularly dangerous in:

• Infants and young children: Small body mass means rapid fluid depletion
• Elderly adults: Reduced thirst sensation, impaired renal concentrating ability, and multiple comorbidities increase vulnerability
• Immunocompromised individuals
• Patients with severe, prolonged diarrhea from any cause

Signs of Dehydration in Adults

Mild-to-moderate:

• Increased thirst
• Reduced urine frequency
• Dry skin and mucous membranes
• Fatigue
• Lightheadedness, particularly on standing
• Dark-colored urine

Severe (requiring emergency care):

• Lethargy (profound drowsiness)
• Severe vertigo
• Severely reduced or absent urine output
• Rapid, weak pulse
• Convulsions
• Loss of consciousness

Signs of Dehydration in Children

• Dry mouth and tongue
• Crying without tears
• Nappies not wet for 3 hours or more
• Sunken eyes or cheeks
• High fever
• Listlessness or excessive irritability
• Skin that does not return to normal position promptly when gently pinched (reduced skin turgor)

Oral Rehydration

The cornerstone of dehydration management is oral rehydration: replacing lost fluids and electrolytes. Water alone is insufficient because it does not replace the sodium, potassium, and glucose lost during diarrhea; without electrolytes, simply drinking water can dilute remaining blood sodium to dangerous levels.

The WHO oral rehydration solution (ORS) formula, which can be approximated at home when commercial preparations are unavailable:

• 1 liter of water (or freshly squeezed orange juice)
• 1 tablespoon of sugar
• 1 teaspoon of salt
• A small pinch of baking soda

Commercial ORS preparations (available from pharmacies) are preferred when available, as they provide precisely calibrated electrolyte concentrations.

Broth, soups, and diluted fruit juices also contribute to fluid and electrolyte replacement and are easier for some patients to tolerate than plain ORS.

Avoid: Sports drinks (excessive sugar, insufficient sodium), caffeinated beverages, and carbonated sodas, which can worsen diarrhea through osmotic effects or gut motility stimulation.

For adults with moderate dehydration who can drink adequately, oral rehydration at home is generally sufficient. Intravenous fluid therapy in hospital is required when:

• The patient cannot tolerate oral intake (persistent vomiting)
• Dehydration is severe
• The patient is an infant or young child whose status is declining rapidly

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When to Call a Doctor

Adults

Contact your doctor for:

• Diarrhea persisting beyond 2 days
• Early signs of dehydration: dizziness, headache, fatigue, dry mouth, reduced urine output with dark yellow color
• Blood in stool
• Persistent, uncontrollable vomiting
• Significant weight loss
• Recent antibiotic use (risk of C. difficile infection)
• Black, tarry stools (melena, indicating upper GI bleeding)
• High fever (>39°C / 102.2°F)

Go to the emergency department immediately for:

• Severe lethargy
• Severe vertigo or near-fainting
• Minimal or absent urine output
• Rapid, weak pulse
• Convulsions
• Loss of consciousness

Elderly Patients

Older adults should seek medical advice at the first signs of fatigue and dehydration; do not wait for symptoms to worsen. The physiological reserves of older adults are reduced, dehydration develops more rapidly, and consequences are more severe.

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Diagnosis

When diarrhea persists, recurs frequently, or is accompanied by alarm features, a medical evaluation is needed to identify the cause.

Medical History and Physical Examination

The physician will ask about:

• Duration, frequency, consistency, and character of stools (watery, bloody, mucousy)
• Associated symptoms (fever, vomiting, abdominal pain, weight loss)
• Recent dietary history: any suspect meals, water sources, raw or undercooked foods
• Medication history, particularly recent antibiotics
• Travel history, especially to high-risk destinations
• Contact with ill individuals
• Medical history: previous GI conditions, immunosuppression

Laboratory Investigations

Stool tests:

• Stool culture: To identify specific bacterial pathogens. Indicated when fever is present, stools are bloody, or symptoms are severe or prolonged.
• Ova and parasite examination (O&P): Detects Giardia, Cryptosporidium, Entamoeba, and other parasites.
• C. difficile toxin assay: Indicated when recent antibiotic use is a factor.
• Fecal occult blood test: If blood is not visible but is suspected.

Blood tests: Full blood count (CBC), CRP, electrolytes, renal function. These assess severity of illness and degree of dehydration.

Specific food-related testing: The physician may recommend a structured elimination diet to assess for lactose intolerance, gluten sensitivity, or other food-related triggers.

Endoscopic and Imaging Investigations

When chronic or recurrent diarrhea requires further evaluation:

• Colonoscopy: Direct visualization of the colonic mucosa, which is essential for diagnosing IBD, microscopic colitis, and colorectal pathology.
• Scintigraphy: Functional imaging that can exclude structural abnormalities.
• Upper endoscopy (gastroscopy) with small bowel biopsy: For suspected celiac disease or small intestinal pathology.

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Remedies: What to Do

What to Take

Rehydration: The Priority

The single most important intervention in acute diarrhea is adequate oral rehydration, which replaces the fluid and electrolytes lost through loose stools. This is particularly critical in children and older adults.

Probiotics

Probiotics (live microorganisms that confer health benefits on the host) are probably useful in infectious diarrhea. A Cochrane systematic review concluded that probiotics are safe and can meaningfully reduce the duration and severity of acute infectious diarrhea, particularly in children. The benefit appears most robust for viral gastroenteritis. Lactobacillus GG, Lactobacillus reuteri, and Saccharomyces boulardii are among the best-studied strains.

Adsorbent Agents

Diosmectite (dioctahedral smectite): A natural clay mineral with high adsorptive capacity that physically binds bacterial toxins, viruses, and irritants in the gut lumen, reducing their contact with the intestinal mucosa and decreasing water secretion. It is safe, well-tolerated, and supported by clinical evidence, particularly in children with acute infectious diarrhea. It is widely used and recommended.

Antidiarrheal Medications (with Important Cautions)

Loperamide (e.g., Imodium®): Reduces intestinal motility and secretion, providing rapid symptomatic relief. However, routine use is not recommended in infectious or parasitic diarrhea. By stopping stool passage before the causative organism has been eliminated, loperamide can prolong the duration of the illness and increase the risk of complications. Specific contraindications include:

• Bloody diarrhea or suspected bacterial dysentery
• High fever
• Children under 12 without medical supervision
• Suspected C. difficile infection

Loperamide may be appropriate for short-term use in adults with clear functional or non-infectious diarrhea, or for traveler’s diarrhea when rapid, temporary symptom control is necessary.

Antibiotics

Antibiotics are not routinely prescribed for acute diarrhea. Most cases are viral (antibiotics are ineffective against viruses) or self-limiting bacterial infections that resolve without treatment.

Antibiotics are indicated for specific confirmed or strongly suspected bacterial infections:

• Severe Campylobacter infection
• Shigellosis (dysentery)
• C. difficile colitis (with specific antibiotics, such as oral vancomycin, fidaxomicin, or metronidazole)
• Traveler’s diarrhea with significant severity
• Infections in immunocompromised patients

Antiparasitic medications are prescribed for confirmed parasitic infections (metronidazole or tinidazole for Giardia, nitazoxanide for Cryptosporidium, etc.).

What to Eat During Diarrhea

The standard dietary advice for diarrhea has evolved significantly in recent decades. Current evidence suggests that excessive dietary restriction is unnecessary and potentially harmful, particularly in children, for whom adequate nutrition supports recovery.

General Principles

Stay well hydrated: This is the priority. Water, oral rehydration solutions, clear broths, soups, and diluted juices all contribute to fluid and electrolyte replacement.

Eat when appetite allows: It is normal to have reduced appetite during an episode of diarrhea. Do not force eating. When appetite returns, a normal diet can generally be resumed sooner than traditionally recommended.

Foods to avoid during active symptoms:

• Caffeinated beverages: coffee, tea, and energy drinks stimulate intestinal motility
• Dairy products (in adults during acute illness): Temporary lactase deficiency following intestinal inflammation can cause secondary lactose intolerance
• High-fat or fried foods: Difficult to digest and can stimulate bowel contractions
• High-fiber foods: During active diarrhea, additional fiber can increase stool output, though fiber restriction should not be excessive or prolonged
• Sweets and sugary foods: High osmotic load can worsen diarrhea
• Alcohol: Irritates the intestinal mucosa
• Spicy foods: Stimulate intestinal motility
• Foods containing artificial sweeteners: Sorbitol, mannitol, and xylitol have osmotic laxative effects

Foods that are generally well tolerated: As symptoms begin to improve, the following are gentle on the intestinal tract:

• Bananas (rich in potassium, contain pectin, a soluble fiber that may help bind stools)
• Plain boiled rice
• Boiled or baked potatoes (without added fat)
• Toast, plain crackers
• Cooked carrots
• Skinless, baked or steamed chicken without added fat
• Plain oatmeal

This pattern is sometimes referred to as the BRAT diet (Bananas, Rice, Applesauce, Toast), though current evidence does not support strict adherence to this approach because it is nutritionally inadequate if followed for more than a day or two.

The evidence consistently shows that returning to a normal, balanced diet as soon as tolerated is beneficial. Strict dietary restriction does not speed recovery in most cases and may delay the nutritional support needed for mucosal healing.

For more detailed dietary guidance, see the dedicated article: Diet during diarrhea, nausea, and vomiting.

Managing Diarrhea in Children

Rehydration First

The cornerstone of diarrhea management in children is prompt oral rehydration. Commercial oral rehydration solutions (ORS), available from pharmacies, are preferred over homemade preparations when available, as they are precisely formulated to match the electrolyte losses of diarrheal illness.

The WHO home formula (when commercial ORS is unavailable):

• 1 liter of water (or fresh orange juice for potassium)
• 1 tablespoon of sugar
• 1 teaspoon of salt
• A small pinch of baking soda

Plain water is insufficient, as it does not replace electrolytes and can worsen hyponatremia.

Nutrition During Childhood Diarrhea

A child with mild diarrhea, no dehydration, and no vomiting can generally continue eating normally; there is no need to stop breast milk, formula, or other foods. Slightly reducing fiber-rich foods (fruits and vegetables) may be helpful.

Evidence shows that continuing normal feeding during and after diarrheal illness in children reduces illness duration, supports intestinal repair, and maintains nutritional status. Prolonged dietary restriction is not beneficial.

Antibiotics and Antivirals in Children

Antibiotics are not prescribed for most childhood diarrhea. The majority of cases are viral (to which antibiotics are ineffective) or self-limiting bacterial infections.

Antibiotics in children are reserved for:

• Very young infants (where bacterial spread is a concern)
• Immunocompromised children
• Specific confirmed bacterial infections (Salmonella in at-risk children, Shigella, C. difficile)
• Situations where bacteremia is suspected

Antiparasitic treatment is indicated for confirmed parasitic infections.

Severe Childhood Diarrhea

Children with severe or prolonged diarrhea that causes significant dehydration may require intravenous fluid replacement in hospital, administered over several hours until adequate rehydration is achieved.

The optimal management depends on the child’s age, weight, the causative organism, and the severity of illness. Always seek pediatric advice, particularly for infants under 12 months.

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Prevention

Most forms of diarrhea cannot be specifically prevented beyond general hygiene measures. However, two important forms are preventable through vaccination:

• Rotavirus diarrhea: The oral rotavirus vaccine (Rotateq and Rotarix) is highly effective at preventing severe rotavirus gastroenteritis in infants and young children and is incorporated into routine immunization schedules in many countries.
• Traveler’s diarrhea: A vaccine targeting the most common causative agent (ETEC) is available in some countries; hepatitis A vaccination is recommended for travel to endemic areas.

General Hygiene Measures

These are the most broadly applicable and effective prevention strategies:

• Wash hands thoroughly with soap and water:

  • After every toilet visit
  • Before preparing or handling food
  • After changing diapers
  • After contact with ill individuals
  • Alcohol-based hand sanitizers are effective against bacteria and most viruses but are not effective against norovirus (use soap and water)

• Disinfect bathroom surfaces after every episode of diarrhea, as viruses and bacteria can persist on surfaces for hours to days.

• Avoid sharing personal items during episodes of diarrhea: towels, cutlery, glasses, and other personal items.

• Stay home from school or work for at least 48 hours after the last episode of diarrhea; this is the minimum period during which the affected individual remains contagious to others.

• Food safety:

  • Cook meat thoroughly, especially ground beef and poultry
  • Refrigerate perishable foods promptly
  • Avoid cross-contamination between raw meat and other foods
  • Wash fruits and vegetables before consumption

• Water safety: When traveling to areas with uncertain water quality, drink bottled water, use purification tablets, or boil drinking water. Avoid ice from unknown sources.

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Bibliography and Sources

• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH. Diarrhea. https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea

• Guarino, A., Ashkenazi, S., Gendrel, D., et al. (2014). European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe. Journal of Pediatric Gastroenterology and Nutrition, 59(1), 132–152.

• Allen, S.J., Martinez, E.G., Gregorio, G.V., & Dans, L.F. (2010). Probiotics for treating acute infectious diarrhea. Cochrane Database of Systematic Reviews. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003048.pub3/full

• World Health Organization. Oral rehydration salts. https://www.who.int/news-room/fact-sheets/detail/cholera

• DuPont, H.L. (2014). Acute infectious diarrhea in immunocompetent adults. New England Journal of Medicine, 370(16), 1532–1540.

• Riddle, M.S., DuPont, H.L., & Connor, B.A. (2016). ACG Clinical Guideline: Diagnosis, treatment, and prevention of acute diarrheal infections in adults. American Journal of Gastroenterology, 111(5), 602–622.

• Lacy, B.E., Mearin, F., Chang, L., et al. (2016). Bowel disorders (Rome IV). Gastroenterology, 150(6), 1393–1407.

• Collinson, S., Deans, A., Padua-Zamora, A., et al. (2020). Probiotics for treating acute infectious diarrhea. Cochrane Database of Systematic Reviews, Issue 12.

• Centers for Disease Control and Prevention (CDC). Food safety. https://www.cdc.gov/foodsafety/

• Thielman, N.M., & Guerrant, R.L. (2004). Clinical practice: Acute infectious diarrhea. New England Journal of Medicine, 350(1), 38–47.