What should an elderly person with diarrhea do?

Oct 7, 2025 4 min read •

Geriatrics senior care digestive health

For elderly adults, diarrhea is more than a simple inconvenience; it can pose a significant health risk, with dehydration being a major concern due to decreased thirst sensation and fluid reserves. Discover what should an elderly person with diarrhea do to ensure safety and comfort.

Quick Summary

An elderly person with diarrhea should prioritize hydration with water and electrolyte drinks, follow a bland diet like BRAT (bananas, rice, applesauce, toast), and seek medical attention if symptoms persist or signs of dehydration appear. Adjustments to diet and medication are key to effective management.

Key Points

Prioritize hydration: Offer clear fluids like water, broth, and oral rehydration solutions to prevent dangerous dehydration, a major risk for seniors with diarrhea.
Follow the BRAT diet: Introduce bland, binding foods such as bananas, rice, applesauce, and toast to soothe the digestive system and help firm up stools.
Avoid trigger foods and fluids: Steer clear of high-fat, spicy, and high-fiber foods, along with caffeine and alcohol, which can irritate the gut and worsen symptoms.
Monitor for danger signs: Seek immediate medical help if symptoms include fever, bloody stools, severe pain, or signs of severe dehydration like confusion and fatigue.
Adjust medications with a doctor: Since medications are a common cause of diarrhea in the elderly, review all current prescriptions with a healthcare provider, especially if symptoms begin after starting a new drug.
Provide gentle hygiene: Use soft, moist wipes and apply barrier creams to prevent skin irritation and infection from frequent loose stools.

Prioritizing Hydration: The First and Most Crucial Step

The most immediate and significant risk for an elderly person experiencing diarrhea is dehydration. Older adults naturally have a lower total body water content, and their sense of thirst can diminish with age, making it difficult to recognize when they need fluids. Replenishing lost fluids and electrolytes is the top priority.

Fluids to Encourage

Oral Rehydration Solutions (ORS): The most effective way to replace lost electrolytes. These balanced solutions are available at pharmacies and contain the right mix of salts and sugars.
Broth: Clear chicken or beef broth provides sodium and fluid, which can be comforting and help replace lost electrolytes.
Diluted Fruit Juice: Juices like apple, grape, or cranberry can be offered in moderation, but should be diluted to prevent their high sugar content from worsening diarrhea.
Herbal Tea: Caffeine-free teas, especially those with ginger or peppermint, can be soothing to the stomach.
Water: Plain water is always an excellent choice, but it's important to supplement with electrolyte-rich options to replace lost minerals.

Fluids to Avoid

Caffeinated Drinks: Coffee, strong teas, and sodas can act as diuretics and stimulate bowel activity, worsening diarrhea and contributing to dehydration.
Alcohol: Alcohol is a diuretic and irritates the gastrointestinal tract.
Dairy Products: Many seniors develop temporary lactose intolerance during a bout of diarrhea, so milk, cheese, and other dairy items should be limited or avoided. Plain yogurt with live cultures, however, can be beneficial.
High-Sugar Beverages: Regular sodas and undiluted juices can pull water into the intestines, worsening diarrhea.

Dietary Adjustments: Soothe the Gut with Bland Foods

During and immediately after a bout of diarrhea, the digestive system is sensitive and needs gentle foods. The BRAT diet, which stands for Bananas, Rice, Applesauce, and Toast, is a well-known approach for a reason: these foods are easy to digest and help to firm up stools.

The BRAT Diet and Beyond

Bananas: Rich in potassium, which is often lost with diarrhea, and pectin, a soluble fiber that absorbs excess fluid.
Rice (White): Plain, white rice is easy to digest and low in fiber.
Applesauce: Contains pectin and is gentle on the stomach.
Toast (White): Plain, dry toast is a good source of carbohydrates.
Other options: Boiled potatoes, scrambled eggs, well-cooked poultry without skin, and crackers can also be introduced as symptoms improve.

What to Exclude from the Diet

Spicy and Fatty Foods: These can irritate the digestive system.
High-Fiber Vegetables and Fruits: While healthy normally, insoluble fiber can worsen diarrhea during an episode.
Artificial Sweeteners: Sugar alcohols like sorbitol can have a laxative effect.

Monitoring Symptoms and When to Seek Medical Attention

While many cases of diarrhea resolve on their own, for the elderly, prompt medical evaluation is often necessary. A caregiver or family member should monitor for specific signs that indicate a more serious condition.

Signs that Warrant Immediate Medical Help

Diarrhea lasting more than two days
Signs of severe dehydration (confusion, sunken eyes, inability to urinate or dark urine, extreme fatigue)
Bloody, black, or tarry stools
Fever above 101.4°F (38.5°C)
Severe abdominal or rectal pain
Inability to keep fluids down

Causes Specific to Seniors

Medications: Many drugs commonly prescribed to seniors, including antibiotics, NSAIDs, and some blood pressure medications, can cause diarrhea. If a new medication was recently started, consult a doctor.
Clostridium difficile (C. diff): This bacterial infection is a leading cause of antibiotic-associated diarrhea in older adults and requires specific treatment.
Fecal Impaction: Counterintuitively, severe constipation can lead to a type of diarrhea where liquid stool leaks around a blockage.

Comparison of Diarrhea Management Approaches


Feature	Acute, Mild Diarrhea (1-2 days)	Persistent or Severe Diarrhea	Chronic Diarrhea (Weeks/Months)
Primary Treatment	At-home hydration and BRAT diet.	Medical evaluation for underlying cause.	Diagnosis and targeted treatment.
Hydration	Water, clear broths, oral rehydration solutions.	Intravenous (IV) fluids if dehydration is severe.	Regular fluid intake; electrolyte monitoring.
Diet	Bland, low-fiber foods (BRAT diet).	BRAT diet, gradual reintroduction of regular foods.	Personalized diet plan, possibly low-FODMAP.
Medication	Cautious use of OTC antidiarrheals (with doctor approval).	Antibiotics for bacterial infections (e.g., C. diff), other prescription drugs.	Medications specific to underlying condition (e.g., IBS, colitis).
Monitoring	Watch for dehydration and worsening symptoms.	Close monitoring for dehydration, fever, bloody stools.	Regular follow-ups with healthcare provider.

Skin Care and Hygiene: Preventing Further Complications

Frequent, loose stools can quickly lead to irritated and broken skin around the rectal area. This is not only painful but can also lead to infection. Good hygiene and protective measures are essential for comfort and preventing secondary infections.

Gentle Cleansing: Instead of harsh toilet paper, use soft, moist wipes or a soft cloth with warm water to clean the area after each bowel movement. Pat dry instead of rubbing.
Barrier Creams: Apply a protective barrier cream or ointment, such as those containing zinc oxide or petroleum jelly, to shield the skin from moisture.
Allow Air Exposure: When possible, allow the skin to air dry completely or expose it to air for short periods.

Conclusion: A Proactive Approach to Senior Digestive Health

Managing diarrhea in an elderly person requires a proactive and vigilant approach, focusing first on preventing dehydration. By encouraging plenty of fluids, adhering to a gentle diet, and carefully monitoring symptoms, caregivers can manage most mild cases at home. However, it is critical to recognize the signs of worsening condition, such as persistent symptoms, fever, or confusion, and seek immediate medical attention when necessary. Working closely with healthcare professionals ensures that any underlying causes are addressed and that the elderly person receives the most appropriate and effective care. For further guidance on senior health issues, a reputable resource is the National Institute on Aging website.

Frequently Asked Questions

The most immediate and serious concern is dehydration. Older adults are at a higher risk because their bodies have less fluid reserve and their sense of thirst may be diminished, making it crucial to replace lost fluids and electrolytes quickly.

The BRAT diet—bananas, rice, applesauce, and toast—is highly recommended. These bland, easily digestible foods can help firm up stools. Other good options include clear broth, boiled potatoes, and well-cooked lean protein.

You should contact a doctor or seek immediate medical attention if diarrhea lasts more than two days, is accompanied by a fever over 101.4°F, or if you notice blood in the stool. Signs of dehydration also warrant a call to the doctor.

Yes, many medications commonly used by seniors can cause or contribute to diarrhea. These include antibiotics, antacids containing magnesium, and some heart or blood pressure medicines. It is important to discuss medication side effects with a healthcare provider.

Yes, avoid caffeinated beverages like coffee and soda, alcoholic drinks, and high-sugar juices, as these can irritate the intestines and worsen dehydration. It's also best to temporarily avoid milk and other dairy products.

Use soft, moistened wipes for gentle cleansing instead of dry toilet paper. After cleaning, apply a protective barrier cream and allow the area to air dry when possible to prevent skin irritation and breakdown.

Anti-diarrhea medications should be used with caution and only after consulting a healthcare provider, especially for older adults. In some cases, such as with certain infections like C. diff, these medications should be avoided completely.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.