DEAR DR. ROACH: Other than the traditional “BRAT” diet for occasional bouts of diarrhea, is there any OTC medication that you feel works the fastest/most effectively? — A.J.

ANSWER: Nearly everyone has occasional bouts of diarrhea. Most of the time, these are self-limiting and don’t require treatment. However, the traditional BRAT diet — bananas, (white) rice, (peeled) apples and (white) toast — is an effective diet change to help the gut. In more severe cases, I recommend a clear liquid diet for 24 hours to allow the gut to heal, being sure to get in enough fluid, sugar and sodium. Chicken or vegetable broth and apple juice are traditional for this, but scientifically formulated oral rehydration solutions are available.

When medication is called for, loperamide 2 mg (Imodium) is my first choice. This should not be used in the presence of bloody diarrhea or fever: Please see your doctor in those situations.

I occasionally see someone take so much loperamide that they become constipated, and then reach for a medication to help with that. Don’t get caught in that vicious cycle. Go easy on the loperamide (i.e., one or two tablets to start, then at most one more after each loose bowel movement, never to exceed eight tablets a day, and never exceeding two days of treatment).

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