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Wed 24 Aug, 2011
By Sam Bristowe

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Eat to beat diarrhoea

Eat to beat diarrhoea

Diarrhoea is one of the most common problems for people living with HIV. It affects as many as four out of every five HIV-positive people and can have profound effects on lifestyle. In this article we look at what causes diarrhoea and how it affects the body, and give some practical tips and recipes for how to control diarrhoea.


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Eat to beat diarrhoea

Diarrhoea is one of the most common problems for people living with HIV. It affects as many as four out of every five HIV-positive people and can have profound effects on lifestyle. In this article we look at what causes diarrhoea and how it affects the body, and give some practical tips and recipes for how to control diarrhoea.

What causes diarrhoea?




The most common causes of diarrhoea in HIV are:

- Damage to the gut caused by HIV itself;
- Infections - caused by either bacteria, parasites living in the gut, or viral infections;
- Side-effects of HIV medications (particularly protease inhibitors), antibiotics or other medications;
- Malabsorption (difficulty absorbing nutrients from food);
- Stress and anxiety.

How does diarrhoea affect the body?
When you have diarrhoea your body loses fluids, meaning that you can become dehydrated easily. In addition to water, your body also loses minerals, called ‘electrolytes’, such as potassium and sodium. Dehydration and loss of electrolytes can leave you feeling dizzy and weak so it’s important to tell your doctor if you have diarrhoea. Although it can be embarrassing to talk about, your doctor will be able to help you identify the cause of your diarrhoea and recommend appropriate treatments.

Which treatments are best for me?
Diarrhoea can be caused by a number of different things. Working out the cause of your diarrhoea will help you to find the best treatment for you. For example, if your diarrhoea is caused by an infection or a parasite, then getting rid of these will help to clear up your diarrhoea. If your diarrhoea is caused by your HIV medication, or side effects of other medications, then you may find it clears up after a couple of weeks on the drug. If necessary your HIV medication can be changed, but never just stop taking your medication.

Treating your diarrhoea
There are a number of over-the-counter and prescription drugs available to treat diarrhoea. If you have frequent or persistent diarrhoea, or diarrhoea with fever, pain, weakness, a low CD4 count or weight loss, speak to your doctor about anti-diarrhoeal medications. There are also many dietary measures that can help in the management of diarrhoea. Different people find different things work, and what helps one person may not necessarily work well for you. Try the tips below for controlling your diarrhoea and keep a diary recording changes in bowel movements as well as foods or other things that appear to trigger or calm your diarrhoea.

Recipes for controlling diarrhoea
Try the following recipe ideas to help control your diarrhoea:

• Clear chicken soup with rice, carrots and butternut squash;
• Grilled chicken breast with plain rice and apple sauce;
• Turmeric rice and grilled tuna steak;
• Quince jelly with toasted white bread and cottage cheese;
• Apple sauce with toasted white bread and cottage cheese;
• Apple or blueberry jelly with slices of ripe banana;
• Rice or oat porridge made with soya milk, served with slices of ripe banana or a handful of blueberries.

More information
For more information on managing diarrhoea speak with your doctor or dietitian. The Food Chain runs free practical cookery and nutrition classes for people living with HIV in London where you can learn more about controlling diarrhoea through diet and learn to cook the above recipes. For more information contact The Food Chain (http://www.foodchain.org.uk/) on 020 7354 0333 or email info@foodchain.org.uk PN

Tips for controlling your diarrhoea through diet:
• Drink plenty of electrolyte-replacing fluids. Good choices include fruit juices (such as apple juice or pineapple juice) diluted 1:1 with water; flat non-caffeinated fizzy drinks (e.g. flat lemonade or orangeade); clear soups and broths; or sports drinks such as PowerAde;
• Try making a rehydrating drink by mixing one litre of apple juice, or cooled boiled water, with the juice of 2 lemons, 3 tablespoons of sugar and 1 tablespoon of salt;
• Make your own ‘congee’, a type of rice porridge, by boiling 1 cup of white rice with a teaspoon of salt in 3 ½ cups of water and drinking the rice water;
• Avoid caffeinated drinks, fizzy drinks and alcohol, as these can irritate the bowel;
• Eat small, frequent meals (every 2-3 hours) at room temperature. Large meals may stimulate bowel action;
• Avoid foods that are high in fat, especially fried and greasy foods;
• Avoid spicy foods and very sweet foods as these can make diarrhoea and gas worse;
• Eat more foods containing soluble fibre, such as oats and oatmeal, peeled apples and pears, butternut squash and peas and beans;
• Limit foods containing insoluble fibre (roughage) such as wholegrain breads and breakfast cereals, bran, brown pasta, brown rice and fruit and vegetable skins. Limit these on a short-term basis only as, overall, these foods are good for your health;
• Try the BRATT diet [Bananas, Rice (white), Apples (peeled/apple puree), Toast (white) and Tea (herbal)]. Remember that this diet is not nutritionally complete so you should only follow it for a short period of time;
• Make sure that you pay attention to personal hygiene and food hygiene – wash your hands often and thoroughly (particularly after going to the toilet), wash or peel fruits and vegetables before eating them and avoid raw or undercooked foods such as meat, eggs and fish.

 

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