Hydration:
- Oral rehydration solution (ORS) is crucial to prevent dehydration. Mix 6 tsp sugar + ½ tsp salt in 1 liter of clean water.
- Drink small, frequent sips of fluids (coconut water, rice water, or clear broths).
- Avoid caffeine, alcohol, and sugary drinks.
- Dietary Adjustments:
- BRAT diet (Bananas, Rice, Applesauce, Toast) for 24–48 hours to rest the gut.
- Gradually reintroduce bland, low-fiber foods (steamed rice, boiled potatoes, plain noodles).
- Avoid dairy, spicy, fatty, or fried foods.
- Medications:
- Loperamide (Imodium) can reduce stool frequency (2 mg initially, then 1 mg after each loose stool; max 8 mg/day). Avoid if fever, blood in stool, or suspected infection.
- Probiotics (e.g., Saccharomyces boulardii or Lactobacillus strains) may help restore gut flora.
- Infection Control:
- Wash hands frequently with soap or alcohol-based sanitizer.
- Avoid raw foods, uncooked vegetables, and street food until symptoms resolve.
- Boil or filter water if source is questionable.
- When to Seek Medical Help:
- Persistent diarrhea (>48 hours), high fever, severe abdominal pain, or bloody stools.
- Signs of dehydration (dizziness, dry mouth, reduced urine output).
Rationale: Diarrhea in Thailand is often due to bacterial (e.g., E. coli, Salmonella) or viral infections, or foodborne illness. Hydration is critical due to high ambient temperatures and risk of dehydration. Loperamide is safe for uncomplicated cases but contraindicated in invasive infections. Probiotics may shorten duration by restoring gut microbiota balance.