By: Ann K. Avery, MD, Infectious Disease Physician at MetroHealth Medical Center
It’s never fun when your stomach decides to act up. That queasy, crampy feeling that sends you running to the bathroom again and again? Yep, that’s diarrhea. If you’re living with HIV, it’s normal to wonder if the two might be connected. The truth is, HIV diarrhea is a lot less common today than it used to be, and that’s great news.
Let’s take a closer look at what’s really going on, why it happens, and how to feel better fast.
Why HIV diarrhea happens less often today
Years ago, diarrhea was a big issue for people living with HIV. But treatment has come a long way! The medicines that caused the most stomach problems, called protease inhibitors, are used much less now. Newer HIV medications are much easier on your system and have fewer side effects.
Better testing and care also make a difference. Because HIV is often caught earlier these days, people get treatment sooner and avoid infections that can upset the stomach. And with fewer people needing long courses of antibiotics, there are fewer cases of diarrhea linked to them too.
So, if you’re having diarrhea and have HIV, it’s possible they’re related, but it’s not the most likely cause. Lots of things can cause an upset stomach, and most are temporary.
Other reasons you might have diarrhea
Often, the cause has nothing to do with HIV. It might be:
- A virus or bacteria (like food poisoning or “stomach flu”)
- Antibiotics or other medications
- Stress, diet, or dehydration
- Inflammatory bowel diseases like Crohn’s or ulcerative colitis
People who are more likely to be affected by HIV, such as LGBTQ+ folks, people of color, or those with limited access to health care, may also face higher rates of diarrhea from other causes. For example, research from Case Western Reserve University found that gay men are twice as likely to have inflammatory bowel disease, which can cause ongoing stomach issues.
And for people who have receptive anal sex, bowel health is extra important. This type of sex can sometimes lead to anal irritation or hemorrhoids, which may cause pain, bleeding, or changes in bowel movements.
What to do when diarrhea hits 💧
Even though HIV diarrhea is less common today, diarrhea itself can of course still happen. When it does, these simple steps can help:
1. Stay hydrated.
Diarrhea makes your body lose water quickly. Try to drink at least eight glasses of water a day, and consider drinks that replace electrolytes, like Pedialyte or sports drinks.
2. Eat gentle foods.
When your stomach’s upset, skip spicy, greasy, or dairy-heavy meals for a bit. Focus on easy-to-digest foods like rice, bananas, oatmeal, and toast.
3. Add fiber.
Fiber helps keep your digestion on track. Fruits, veggies, beans, and whole grains are all great sources. If you need help reaching your daily goal (about 30 grams), a fiber supplement can fill the gap.
4. Try over-the-counter medicine.
If you’re dealing with short-term diarrhea, products like Pepto-Bismol, Imodium, or Kaopectate can help. Just remember: if things don’t improve after a couple of days, talk to your doctor before taking more.
When to see your doctor 🩺
If diarrhea sticks around for more than a few days, or you notice blood, fever, or pain, it’s time to call your doctor. Your care team can help figure out what your diarrhea is caused by, and they can also help you prevent future flare-ups. Regular checkups and lab tests are great ways to catch any issues early.
Living well with HIV
Here’s the bottom line: with today’s treatments, most people live long, healthy lives without HIV diarrhea. But if you do have diarrhea, it’s nothing to be embarrassed about, and it’s usually easy to manage with the right care.
Taking care of your body, staying on treatment, and keeping up with doctor visits will help you feel your best. It’s all part of living well and staying healthy. 💙