April 2003
Diarrhea: reprinted from Women Alive

Diarrhea is one of the leading side effects that people suffer from that are taking anti-retroviral medication. Aside from being annoying, the biggest concern about diarrhea is that it can cause dehydration. Before starting any therapy, talk to your physician about the risk of side effects from various drugs. This information usually comes from studies conducted on the drug. Ask how often side effects were reported in studies.

Are Women Different? Women may experience a different type or frequency in side effects compared to men, including from therapies not related to HIV. Why this is so is not well understood. It may be due to differences in the way women's bodies break down or store drugs. Generally speaking, women have smaller body weight/sizes than men. It may be that, for their weight, some women take too high a dose of drug. Women's hormones may also affect drugs. Or it might be due to other unknown differences. Still, currently available information about side effects remains useful in guiding the ways women manage them.

Aside from being annoying, the biggest concern is that diarrhea can cause dehydration. So the first course of action is to replenish lost liquids by drinking plenty of fluids, like Gatorade, ginger ale, chicken or beef broth, herb tea or just plain water. Chronic diarrhea may lead to weight loss. Foods that provide nutrients, calories, and absorb liquid (like the BRAT diet—bananas, rice, applesauce and toast) are good tools in dealing with diarrhea. Often simple solutions exist to lessen many side effects. Current and available information about side effects remains useful in guiding the ways women manage them. Here are a few tips to consider when diarrhea occurs:

• Drink plenty of fluids to avoid dehydration.
  
  
• Eat small, frequent meals, and don’t skip meals.
  
  
• Try lactose –free products, or take lactase, the enzyme that allows digestion of lactose.
  
  
• Avoid high-fiber foods such as wheat bran, brown rice, and popcorn.
  
  
• Avoid greasy, fried foods.
  
  
• To replenish sodium and potassium, eat bananas, potatoes, fish and meat; and drink apricot nectar, tomato juice, and sports drinks.
  
  
• Try taking calcium supplements (500mg twice a day).
  
  
• Try psyillium husk fiber bars (another source of soluble fiber). A recent study showed that two bars eaten one hour before bedtime with a large glass of water can really help diarrhea. They can be found at health food stores.
  
  
• Eat foods high in soluble fiber, which slows diarrhea by absorbing liquid these foods include oatmeal, cream of wheat, grits and soft bread (not whole grain), white rice, oatmeal, applesauce, pears, and mashed potatoes..
  
  
• Avoid foods high in insoluble fiber, like the skins of vegetables and fruits. These foods can make diarrhea worse.

Sources for this fact sheet were found in Project Inform Fact sheet, reprinted from AIDS Project Los Angeles “Positive Living” Article by Marcy Fenton, MS RD and Jeffrey Bowan.

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