Diarrhea isn't something many people feel comfortable talking about. Unfortunately, diarrhea and associated stomach pain can be symptoms of drug withdrawal, particularly opiates. It can also occur after a period of intense substance use.
Symptoms may range from mild to severe. This can often lead to distress and can even be a major factor impacting the decision to quit drugs for many people.
This article explores strategies that can help minimize diarrhea and stomach pain caused by drug withdrawal. It also covers what causes these unpleasant symptoms and when you should see a doctor.
How to Cope With Withdrawal Diarrhea
While it may not be possible to avoid this symptom altogether, you can take steps to minimize the problem and cope with it when it happens. The following strategies can help controldiarrhea, gastrointestinal spasms, stomach pain, and vomiting caused by detox and withdrawal:
- Eat bland foods: White toast, white rice, and bananas may help. If you also suffer from withdrawal nausea and vomiting, you may prefer to avoid food intake until the initial acute withdrawal phase has passed.
- Get plenty of electrolytes: You may have lost vital electrolytes, especially if you've been vomiting. Drinking rehydration fluid, available from drug stores, can help avoid this.
- Stay hydrated: Although it may seem counterintuitive, one of the main risks of diarrhea is dehydration, so sip plenty of water.
- Try over-the-counter medications: Kaopectate, Pepto-Bismol (bismuth), or Imodium (loperamide) may help control diarrhea and slow the bowel process.
- Eat probiotics: Yogurt with live/active cultures contains bacteria that, in some cases, can help reduce the severity and length of time that diarrhea lasts.
- Avoid stomach irritants: Avoid hot drinks, acidic fruits, and spicy foods, which can induce spasms leading to diarrhea and related stomach pain.
Recap
Sticking to a bland diet, staying hydrated, eating yogurt with live cultures, and taking OTC medications can help when you are coping with withdrawal diarrhea.
How Long Do Withdrawal Symptoms Last?
The duration and severity of withdrawal symptoms depend on several factors. Physical withdrawal symptoms often last three to five days; however, the type of substance a person has been using can play a role. For some substances, such as alcohol, benzodiazepines, and long-acting opiates, withdrawal symptoms may last one to two weeks.
Along with diarrhea and stomach pain, you might also experience other physical symptoms such as chills, fatigue, muscle pain, nausea, shakiness, sweating, and vomiting. While these symptoms often last only a few days or a week, the psychological symptoms of withdrawal can last much longer.
Causes of Withdrawal Symptoms
Substance use leads to changes in how neurotransmitters function in the brain. Neurotransmitters are chemical messengers that transmit signals and help regulate various bodily functions. When alcohol or substance use is halted, the brain is forced to readjust to its sudden absence. This leads to unpleasant physical and mental withdrawal symptoms.
Diarrhea, stomach pain, and vomiting are often experienced by people going through withdrawal from opioids and other drugs.
Although this can be a normal reaction by the body, the severity and discomfort you experience can be reduced by correct treatment. Therefore, it is a good idea to talk to your pharmacist or doctor for advice on over-the-counter medications.
However, it is important to be aware of other potential causes of diarrhea. It is essential to get the correct diagnosis and treatment. For example, diarrhea can also be caused by:
- Viral and bacterial infections stemming from ingesting contaminated food or water
- Drugs or medications
- Some sexual activities
Safely Treating Dehydration
Dehydration happens when your body loses too much fluid and electrolytes through urination, sweating, vomiting, and/or diarrhea. However, drinking only water, particularly in large quantities, can be harmful and lead to water intoxication. Water intoxication can be life-threatening, so it is important to take steps to avoid it.
If you have been experiencing severe diarrhea, drink rehydration fluid (available from drug stores) rather than plain water to replace lost fluids.
Make your own rehydration fluid inexpensively by adding 1 quart of water, 3/4 teaspoon of table salt, and 2 tablespoons of sugar. You can also add lemonade or an orange-pineapple flavor sugar-free mix for taste.
Fruit juice can also help replace lost electrolytes but can exacerbate diarrhea. Talk to your doctor or pharmacist for advice on the right way to replace lost fluids.
When to See the Doctor
If your diarrhea, stomach pain, or vomiting are severe or last for longer than a few days, you should consult a doctor as soon as possible. While this withdrawal symptom is sometimes considered no more than a nuisance, for some people, it can be troubling enough that it derails their attempts at quitting. If a person quits a substance and then relapses, it can increase the risk of overdose.
Warning
You should consult a doctor sooner if diarrhea is accompanied by other symptoms such as fever or dehydration.
Stomach symptoms can be an indication of an underlying, treatable infection, and they can lead to life-threatening dehydration. You can go to an emergency room where an IV drip can quickly replace fluids and electrolytes.
One of the most severe consequences of alcohol withdrawal, called delirium tremens ("the DTs"), impacts about 3% to 5% of people who withdraw from heavy drinking. If left untreated, this condition can be fatal.
Medical Treatments for Withdrawal Symptoms
Withdrawal from substances can be done at home or in a healthcare setting. Quitting substance use is often easier under medical supervision because medications can be used to make the transition easier and less uncomfortable. Different treatments are available for different substances.
Alcohol
If alcohol withdrawal symptoms are moderate to severe, you may need to be in a supervised clinical setting. Whether you seek treatment as an inpatient or outpatient, you may be given sedatives to help make the transition to complete withdrawal in a medically safe way.
Treatment with B vitamins is also critical for someone withdrawing from alcohol. It can prevent Wernicke-Korsakoff syndrome (or alcohol dementia), a set of neurological conditions resulting from athiamine(vitamin B1) deficiency.
Barbiturates
Because of the potential complications of stopping barbiturate use, withdrawal should always take place under medical supervision. You may be givenphenobarbital to help make the transition.
Stimulants
Treatment for stimulant withdrawal will likely involve psychotherapy but may also include antidepressants or other mood-affecting medications.
Opiates
Treatment may include clonidine, which helps with anxiety, sweating, irritability, muscle cramping and aching, and runny nose, and/or buprenorphine or methadone, both of which can decrease the amount of time it takes to detoxify and also help withdrawal symptoms.
Gabapentin can help with several symptoms, including diarrhea. Antispasmodics like Bentyl may also help ease gastrointestinal symptoms.
Coping With Tramadol Withdrawal Symptoms
Recap
While detox and withdrawal can often be done at home, there are also medications that can help ease symptoms. The type of medication your doctor will prescribe depends on the substances you have been using, so talk to a healthcare practitioner about your options.
Takeaways
Diarrhea can be a distressing and unpleasant symptom of substance withdrawal. However, some strategies can help you cope and minimize the effects of diarrhea and associated stomach pain. Because the physical symptoms of withdrawal typically last for a few days to a week, you may find relief by sticking to a bland diet, staying hydrated, and utilizing OTC diarrhea remedies.
If you are experiencing severe diarrhea that isn't getting better or is causing symptoms of dehydration, contact your doctor. They can determine if something else might be contributing to your symptoms and decide if you need prescription medications or IV fluids to avoid serious complications.
How to Ease Withdrawal Insomnia During Recovery
9 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
Lin S, Pan C, Chen C. A Double-blind, Placebo-controlled Trial of dextromethorphan Combined With Clonidine in the Treatment of Heroin Withdrawal. Journal of Clinical Psychopharmacology 34(4): 508–512. 2014. doi: 10.1097/JCP.0000000000000144
Manatsatihit S, Dupont H, Farthing M, et al. Guideline for the Management of Acute Diarrhea in Adults. Journal of Gastroenterology and Hepatology. 7:71.2002. doi:10.1046/j.1440-1746.17.s1.11.x.
Salehi M, Kheirabadi GR, Maracy MR, Ranjkesh M. Importance of Gabapentin Dose in Treatment of Opioid Withdrawal. Journal of Clinical Psychopharmacology. 31(5):593-596.2011. doi:10.1097/JCP.0b013e31822bb378.
By Elizabeth Hartney, BSc, MSc, MA, PhD
Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada.
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