Antibiotic-Associated Diarrhea – Diagnosis and Treatment

Diagnosis

Doctors usually begin by asking about recent or current use of antibiotics and evaluating for symptoms such as watery stools, abdominal pain, fever, bloating, or nausea.

The timing and duration of symptoms relative to antibiotic use help determine whether the diarrhea is likely related to the medication.

Age and health status are considered, as older adults, hospitalized patients, and those with weakened immune systems are at higher risk for complications, especially infections like Clostridioides difficile (C. difficile).

To confirm an infection—particularly C. difficile, a common cause of antibiotic-associated colitis—doctors may order a stool test to detect toxins or bacterial DNA.

If symptoms are severe or persistent, additional tests such as blood work to evaluate inflammation or sigmoidoscopy may be considered.

Doctors also assess for signs of dehydration, including low blood pressure, dry mouth, dizziness, and reduced urine output, which may require prompt fluid replacement.

Treatment

Most people with mild diarrhea from antibiotics get better soon after they stop the antibiotic. A healthcare provider may tell the patient to pause the medication to help the symptoms go away.

Simple home care includes:

• Drinking plenty of fluids to prevent dehydration
• Eating small, bland meals
• Using anti-diarrheal medication only if a doctor advises

Doctors sometimes suggest probiotics like Lactobacillus or Bifidobacterium to support gut health, but patients should check with a healthcare provider before use.

Steps to Treat C. difficile Infections and Related Issues

When Clostridioides difficile (C. diff) causes diarrhea, doctors change the treatment plan. They may stop the current antibiotic and start a specific one to target the harmful bacteria.

This helps remove C. diff and lowers the risk of complications like colitis, inflammation, or pseudomembranous colitis. Serious issues such as toxic megacolon, sepsis, or recurring infections require close care, sometimes in a hospital.

People in healthcare settings or those using fluoroquinolones, cephalosporins, or lincosamides have a higher risk of C. diff colonization and infection.

Taking Care of Yourself

Simple changes can help with comfort and recovery during antibiotic-associated diarrhea (AAD). Staying hydrated is important. Water and drinks with electrolytes help replace lost fluids.

In more severe cases, oral rehydration solutions that combine water, sugar, and salt can help. Broth or diluted fruit juice (without high sugar) are good choices.

Avoid drinks with extra sugar, alcohol, or caffeine—such as coffee, tea, soda, or energy drinks—because they might make diarrhea worse.

Table: Good and Bad Drink Choices

Recommended	Avoid
Water	Alcohol
Oral rehydration solutions	Coffee
Broth	Tea (with caffeine)
Low-sugar juice	Soda (especially with sugar)

Eating habits also matter during this time. Avoid fatty, spicy foods, and foods with milk or cream. Stick to bland foods until symptoms improve.

Usually, people can return to a regular diet soon after diarrhea stops. Some people try probiotics (like those in yogurt) hoping to help their gut recover.

There is not enough evidence to say if store-bought probiotics will prevent or treat AAD, but they are usually safe for healthy people.

People with a weak immune system should be extra careful before using these products. If symptoms are mild, a doctor might suggest anti-diarrheal medicines such as loperamide.

These medicines are not safe for everyone and should not be used if someone develops a C. difficile infection.

It is important to talk with a healthcare provider before using these treatments, especially for people recovering from gastrointestinal surgery or with specific risk factors.

Getting Ready for Your Visit

Steps You Can Take Beforehand

Preparing before meeting the doctor helps make the appointment more useful. Patients should make a detailed list of their symptoms, including anything that might not seem related.

Even small details can help with the diagnosis. They should note any recent life events, especially if they stayed in a hospital or nursing home, as this can affect recovery and the need for isolation.

Bring a full list of any medicines, vitamins, or supplements being taken. Include names, doses, and when each was last used, especially if antibiotics were recently stopped.

Consider writing down any questions, such as:

• What tests might be needed?
• Is this a short-term problem or long-term?
• What treatment choices are available?
• Are there specific foods, drinks, or activities to avoid?
• Will gloves or a gown be required for home care or isolation?

These steps help make sure all important concerns are discussed.

What Questions the Doctor Might Ask

During the appointment, the doctor will likely ask for details about the start and type of symptoms.

Patients should be ready to describe their bowel movements, how often they occur, and any bowel diseases in the past, like Crohn’s or ulcerative colitis.

The doctor may also ask about any recent contact with others who have diarrhea or if any protective actions, like wearing gloves or a gown, were used.

Clear answers help the doctor choose the best approach for care and isolation, if needed.

Helpful Steps Until the Doctor Visit

Keep taking prescribed antibiotics as your doctor instructed. Avoid foods and drinks that make diarrhea worse.

Task	What to Do
Staying Hydrated	Drink plenty of fluids.
Diet	Eat bland, non-spicy foods.
Medication	Take antibiotics as directed.
Hygiene	Use gloves/gown if needed.

Eat simple meals with bland foods. Drink water or electrolyte drinks to stay hydrated.

Wear gloves or a gown if you care for someone with symptoms. This helps prevent the spread of illness.