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💧 Side Effect Guide

Managing Diarrhea

Learn how to identify triggers, prevent dehydration, and manage diarrhea while on GLP-1 medications.

Educational Purposes Only

This information is provided for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Always consult your healthcare provider before starting, stopping, or modifying any treatment or medication.

Why It Happens

Diarrhea can occur with GLP-1 medications, particularly during the first few weeks of treatment or after dose increases. These medications alter gut motility and can affect how quickly food moves through your digestive system. While some patients experience slower digestion (constipation), others may have faster transit times leading to loose stools. Diarrhea is often temporary and improves as your body adjusts, but persistent diarrhea requires attention to prevent dehydration, which can harm your kidneys.

⚠️

Important: When Diarrhea Means Dose is Too Strong

If diarrhea occurs daily throughout the week (not just 1-2 days after injection):

  • This indicates your dose is too strong
  • Contact your provider to discuss dose adjustment
  • Persistent diarrhea can lead to dangerous dehydration

Common Dietary Triggers

Certain foods are more likely to cause or worsen diarrhea on GLP-1 medications.

🚫 Foods to Avoid

  • Fried, fatty, greasy foods: Hard to digest and can trigger diarrhea
  • Alcohol: Irritates the digestive tract
  • Dairy products: If lactose intolerant
  • Caffeine: Can stimulate bowel movements
  • Spicy foods: Can irritate the GI tract
  • Sugar alcohols: Sorbitol, mannitol, xylitol (in sugar-free products)

✓ Better Food Choices

  • BRAT diet: Bananas, Rice, Applesauce, Toast
  • Plain proteins: Baked chicken, turkey, fish
  • Cooked vegetables: Carrots, green beans, potatoes (without skin)
  • Plain grains: White rice, oatmeal, plain pasta
  • Probiotics: Plain yogurt (if tolerated), kefir

Management Strategies

1

Prevent Dehydration (Critical!)

Dehydration is the most dangerous complication of diarrhea on GLP-1 medications and can cause kidney damage:

  • Drink plenty of fluids: 8-12 glasses of water daily
  • Electrolyte drinks: Pedialyte, Gatorade, or coconut water
  • Clear broths: Chicken or vegetable broth
  • Monitor urine color: Should be pale yellow (dark urine = dehydration)

⚠️ Critical: If you become dehydrated on GLP-1 medications, it can harm your kidneys. Stay vigilant about fluid intake.

2

Modify Your Diet

Temporary dietary adjustments can help firm up stools:

  • Eat smaller, more frequent meals
  • Avoid raw fruits and vegetables temporarily
  • Choose low-fiber, easily digestible foods
  • Eliminate trigger foods (see above)
  • Consider keeping a food diary to identify your specific triggers
3

Add Probiotics

Probiotics may help restore healthy gut bacteria:

  • Probiotic supplements: Look for products with multiple strains
  • Probiotic foods: Plain yogurt (if tolerated), kefir
  • Give it 2-4 weeks to see benefits
4

Use Imodium for Short-Term Relief

Loperamide (Imodium) can provide relief for acute episodes:

  • Initial dose: 4 mg (2 capsules) after first loose stool
  • Follow-up: 2 mg (1 capsule) after each loose stool
  • Maximum: 8 mg (4 capsules) in 24 hours
  • Duration: Up to 72 hours (3 days) total
  • Do NOT use daily or long-term without provider approval

⚠️ Important: If you need Imodium for more than 3 days, contact your provider—your GLP-1 dose likely needs adjustment.

🚨

When to Contact Your Provider

Contact your healthcare provider immediately if you experience:

  • Diarrhea lasting more than 3 days
  • Daily diarrhea throughout the week (not just after injection)
  • Signs of dehydration (dizziness, dry mouth, dark urine, confusion)
  • Severe abdominal pain or cramping
  • Blood or mucus in stool
  • Fever above 101°F (38.3°C)
  • Significant weight loss
  • Unable to keep fluids down
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Quick Tips

  • Diarrhea in the first 1-2 days after injection is normal for some patients
  • Track bowel movements to identify patterns
  • Stay near a bathroom if you experience post-injection diarrhea
  • Use barrier cream if experiencing frequent bowel movements
  • Most patients find diarrhea improves after dose stabilization
  • Never ignore persistent diarrhea—dehydration is dangerous

References

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