Spicy foods, those with a high fat content, and some artifical sweeteners can all cause diarrhea. Dairy and gluten may also cause diarrhea in those with intolerances.
Diarrhea is often the result of infection. However, the food a person eats can sometimes cause diarrhea and related symptoms.
This article explores the foods that cause diarrhea, how to tell if diarrhea is due to something that has been eaten, treatment options, and when to see a doctor.
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Some foods are difficult to digest, increase water levels in the bowel, and irritate the digestive system lining. These factors can all cause or worsen diarrhea.
A person may experience diarrhea after eating food due to specific intolerances, such as lactose or gluten intolerance.
Some foodstuffs, and food types, that can cause diarrhea include:
1. Sugar and artificial sweeteners
Some sugars and artificial sweeteners can have a laxative effect.
Fructose is a component of table sugar and occurs naturally in fruits. The body can only digest a certain amount of fructose at one time. Consuming more fructose than the body may cause diarrhea.
One source estimates that approximately 30–40% of people have trouble absorbing significant amounts of fructose.
Some fruits contain more fructose than others. Some examples of foods high in fructose include:
Sugar alcohols, including sorbitol, mannitol, xylitol, and erythritol, are common sweeteners. The body does not absorb these sugar alcohols well, and they can cause diarrhea in some people, especially if consumed in large amounts.
2. Caffeine
Drinks and foods that contain caffeine can cause diarrhea and loose stools in some people. Caffeine is a stimulant and accelerates the rate that food moves through the intestines.
Common dietary sources of caffeine include:
3. High fat foods
Foods that contain a lot of fat can cause digestive difficulties. The body has difficulty breaking down and processing high fat foodstuffs.
Dietary fat also promotes bile production and increases water levels in the small bowel. The combination of these factors can lead to digestive dysfunction and diarrhea.
4. Spicy foods
Spicy foods containing hot peppers are another cause of diarrhea.
Capsaicin is the compound that makes chili peppers taste spicy. It is a potent chemical that can irritate the lining of the stomach and intestines.
Avoiding foods high in capsaicin may help reduce symptoms and frequency of diarrhea.
5. Lactose
People who are lactose intolerant may experience diarrhea after they consume dairy products. Lactose intolerance and malabsorption are common globally. However, it is most prevalent in the Middle East, Southeast Asia, and Sub-Saharan African communities.
Some people with lactose intolerance may tolerate small amounts of dairy products that are aged or lower in lactose. These products include yogurt, kefir, and hard cheeses.
6. FODMAPs
Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are a category of carbohydrates. High-FODMAP foods are difficult for some people to digest and may cause diarrhea.
A 2021 study of irritable bowel syndrome (IBS) patients with diarrhea found that following a low FODMAP diet improved diarrhea symptoms and increased quality of life.
Some categories in this article, such as fructose, lactose, and sugar alcohols, are FODMAPs. The list of high-FODMAP foods is extensive. However, a few other examples include:
- artichokes
- beans
- garlic
- onions
A low FODMAP diet can be challenging due to its various food restrictions. If someone thinks that FODMAPs may cause diarrhea, a registered dietitian can provide education and guidance.
Learn all about low FODMAP diets here.
7. Gluten
Gluten is the protein in wheat, rye, and barley. Many people may be gluten intolerant to varying degrees. People with celiac disease have a severe reaction to gluten where their immune system reacts trigger damage to the small intestine. This can cause diarrhea.
People that do not have celiac disease may still have issues tolerating gluten. If someone suspects that gluten may be responsible for their diarrhea, they should contact a doctor for proper testing before starting a gluten-free diet.
Learn more about gluten intolerance here.
The American College of Gastroenterology recommends seeing a doctor if diarrhea continues for longer than 48 hours. People should also see a doctor if diarrhea contains blood, is accompanied by severe stomach pain, or if they do not feel well.
Infants and older adults are more prone to dehydration, which means that diarrhea can be particularly dangerous for people in these groups. It is important to look out for signs of dehydration in these groups, such as:
- a reduced amount of urine
- increased heart rate
- dizziness or confusion
DIarrhea can be difficult to diagnose in the absence of an underlying cause.
To assess what foods are causing diarrhea, people may find it helpful to keep a food and symptom diary. This may help to identify links between certain foods and diarrhea symptoms.
Before attributing diarrhea to food, it is also important to check recent medication changes. Diarrhea is a common side effect of many drugs, such as antibiotics and medications that contain magnesium.
If someone has diarrhea, they should assess their diet for any potential diarrhea triggers and eliminate them if necessary. This can help to avoid a recurrence of diarrhea.
However, a person can also take steps to treat the immediate symptoms.
Hydration
Diarrhea can cause dehydration. Staying hydrated is crucial when experiencing diarrhea. Besides drinking plenty of water, people can drink the following to maintain hydration.
- broth
- caffeine-free tea
- diluted juice
- drinks that contain electrolytes, such as sports drinks
Medications
Over-the-counter medications are also available to help treat diarrhea. People should check with their doctor to determine if a store-bought medication is appropriate.
These include:
- loperamide (Imodium)
- simethicone
- bismuth subsalicylate
Probiotics
Probiotics are the beneficial bacteria that live in the gut. They may be helpful in reducing IBS symptoms and preventing diarrhea when taking antibiotics.
Learn all about probiotics here.
Soluble fiber
While foods high in insoluble fiber can worsen diarrhea, foods containing soluble fiber can help promote more formed stools, reducing diarrhea.
Soluble fibers attract water during digestion and form gels. This reduces excess water content in stools. Lentils, barley, and oat bran are high in soluble fiber.
Psyllium is a soluble fiber that is common in many fiber supplements.
Learn more about psyllium and fiber supplements here.
Oily, high fat foods, spicy chili peppers, and artificial sweeteners can all disrupt the digestive system and cause diarrhea. In people with intolerances, gluten and lactose may also cause diarrhea.
Keeping a food and symptom diary can help people to assess what foods are causing their diarrhea. They can then reduce the intake of these foods or eliminate them from their diet entirely.
There are many home remedies and over-the-counter medications that can reduce symptoms. If a person has diarrhea for 2 days or more, has blood in their stool, or feels severe stomach pain, they should contact a doctor immediately.
Why does Chinese food seem to always, almost instantaneously give you the shits? Conversely, assuming Chinese people don't get sick from Chinese cuisine, do they get the shit's after eating American food, say a chicken fried steak or something or that ilk? from NoStupidQuestions
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In India, eating Chinese food has become very popular. We hereby report a case who presented with angioneurotic edema of the uvula and the surrounding structures, after eating Chinese food, which resulted in severe difficulty in swallowing saliva and inability to speak.
Keywords: Monosodium glutamate, spitting, uvula
Chinese food and soups contain monosodium glutamate (MSG) as the main addictive ingredient. A sensitive individual may suffer from headache, giddiness, sweating, abdominal pain, and urticaria within a few hours of consumption of MSG. Angioedema may be delayed up to 8–16 h after the consumption of MSG and it may persist for 24 h.[1] This delayed life-threatening effect in the form of angioedema makes diagnosis difficult.
A 23-year-old male was brought to the General Hospital at Mahad, with complaints of difficulty in speaking, inability to swallow saliva, and continuous spitting. He strongly rejected taking sips of water and was afraid of water like a hydrophobic patient. He gave no history of snake bite or ptosis. The posterior pharynx could not be visualized, even after repeated attempts with depression of the tongue with a spatula. The uvula and surrounding structures, including the soft palate, were edematous. The uvula was touching the base of the tongue [Figure 1].
He was weighing 80 kg, conscious cooperative and well oriented. His blood pressure was 120/80 mmHg; pulse was 88 beats/min and regular. His extremities were warm, the electrocardiograph was within normal limits, and SpO2 was 98% on ambient air. The patient said that he ate only Chinese triple fried rice for dinner the previous night 10 hours earlier. Within an hour of eating, he had giddiness, sweating, and itching all over the body which subsided without any medication. Two hours earlier he had woken up due to difficulty in swallowing and speaking out a few words. He communicated with his family with hand gestures regarding his inability to speak and swallow. There was no history of allergy or bronchial asthma.
The hemoglobin was 14 mg/dl, white cell count 13,000 per cu mm (normal 5000–10,000), eosinophils 1% (normal 1–9), neutrophils 90.9%, random blood sugar 135 mg/dl (normal 70–140), and serum IgE 917.021 IU/ml (normal 3–188).
The patient was admitted and given intravenous crystalline solution of 40mg methyl prednisolone and was monitored continuously for oxygen saturation.
There was no improvement over half an hour, so 0.30 mg of adrenaline was administered as a deep intramuscular injection over the lateral side of the thigh. The swelling of the uvula and surroundings gradually regressed. The patient no longer had drooling of saliva and was able to speak a few words. His throat looked angry around the uvula and surrounding.
On account of raised leukocyte count with neutrophilia, the patient was treated with oral Amoxycillin with clavulinate. At 16 h after the initiation of treatment, he started normal oral communication and was able to swallow liquid.
On the following day, there was a gradual reduction in the size of the uvula and surrounding inflammation. 2 days from admission, the uvula and surrounding structures including the palate returned to normal and he could swallow solids [Figure 2].
Chinese food contains MSG as the main additive ingredient and flavor enhancer. In a graded challenge, MSG alone produced angioedema, 16 h after ingestion, as reported from Australia.[1] In addition to MSG, many other food additives, including preservatives such as meta-bisulfate, soya sauce, coloring agents, such as, carmoisine, sunset yellow, tartrazine, scombroidosis, and seafood may stimulate allergic reactions.[2] Angioedema of the uvula after ingestion of MSG can be fatal unless patients and physicians are aware of unusual reaction to MSG. Many deaths can be avoided with timely diagnosis and treatment.
MSG is monosodium salt of L-glutamic acid. It is prepared by fermentation of carbohydrate sources, such as sugar beet molasses by acid hydrolysis, by the action of micrococcus glutamicus on a carbohydrate and subsequent partial neutralization, or by hydrolysis of vegetative proteins. Precipitation of severe bronchial asthma following MSG intake has been reported in two patients.[1,3]
MSG is a flavor enhancer. Large amount of MSG is used in Japanese, Chinese, and South Asian food preparation. Even free glutamate that exists in tomatoes, mushrooms, and parmesan Chinese is responsible for Chinese restaurant syndrome.[4] This syndrome was first described by Kwok in 1968.[5] The exact etiology of the “Chinese restaurant syndrome” is not known but, animal studies have shown neurotoxic and neuroexcitatory properties of MSG in the hypothalamic region of the central nervous system. The delay of uvular swelling for > 8 h such as in our patient can be explained by the time taken for the synthesis and release of hormonal factors from the hypothalamic-pituitary region.[1] A systematic review by Obayashi and Nagamura evaluating causal relationship between MSG and headache was inconclusive and suggested the need of more blinded studies.[6] However, consumption of MSG in high concentration without solid food (as in soups) was found to be associated with higher incidence of headache and other symptoms.[6,7]
Consumption of Chinese food is popular in India. Severe reaction to MSG, a common active ingredient in Chinese cooking may result in fatal outcome if not treated in time. Delayed occurrence of serious symptoms are to be expected.
There are no conflicts of interest.
We are grateful to Professor Dr. Abhijit Pakhare, and Punishi Parekh, AIIMS, Bhopal and Topiwala Medical College, Mumbai, respectively, for editing the manuscript.
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