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Osmotic Diarrhea - An Overview

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Osmotic diarrhea occurs when food is not fully absorbed in the small intestine and exerts an osmotic pressure that draws excessive fluid into the intestine.

Medically reviewed by

Dr. Kaushal Bhavsar

Published At May 18, 2023
Reviewed AtDecember 28, 2023

What Is Osmotic Diarrhea?

Diarrhea is a very common condition. It has many types, so one is osmotic diarrhea. It is a gastrointestinal issue characterized by an increase in watery stools. Acute diarrhea is the onset of three or more loose stools per day that lasts not more than 14 days, while chronic diarrhea is the onset of loose stools that last more than 14 days. Usually, the stools are already composed of a high percentage of water, but osmotic diarrhea includes excessive loss of water with feces. It occurs when the food is not entirely absorbed in the small intestine. This excess water present causes the bowel movements to be loose and watery. Osmotic diarrhea is commonly seen in individuals suffering from malabsorption syndrome and those intolerant to sugar.

What Is the Difference Between Osmotic Diarrhea and Secretory Diarrhea?

Secretory diarrhea is similar to osmotic diarrhea. Secretory diarrhea occurs when the body secretes electrolytes into the intestine, resulting in water build-up. It can be caused because of several factors that include:

  • Viral infections such as viral hepatitis and norovirus.

  • Drugs such as misoprostol.

  • Bacterial infections like E.coli and salmonella.

  • Parasites like Giardia and cryptosporidium.

  • Digestive disorders like ulcerative colitis and celiac disease.

  • Genetic disorders like congenital chloride diarrhea.

What Are the Causes of Osmotic Diarrhea?

Osmotic diarrhea occurs when one eats food that does not get well absorbed but draws water into the intestines. The causes of osmotic diarrhea include:

  • Lactose is found in dairy products.

  • Artificial sweeteners such as saccharine and aspartame.

  • Carbohydrates are found in fruit juices.

  • Side effects of certain antibiotics.

  • The side effects of blood pressure medication.

  • Chemotherapy.

  • Gallbladder removal.

  • High-dose radiation therapy.

  • Laxatives contain magnesium sulfate, sodium phosphate, and magnesium phosphate.

  • Fat malabsorption.

  • Enzyme deficiencies include food allergies, fructose malabsorption, bile acid malabsorption, and bile salt malabsorption.

  • Poor digestion.

  • Chronic ethanol ingestion.

  • Hyperthyroidism.

  • Dumping syndrome.

  • Celiac disease.

  • Loss of pancreatic secretions. This could be because of chronic pancreatitis or cystic fibrosis.

  • Crohn's disease.

  • Pernicious anemia, inability to absorb vitamin B12.

  • Ulcerative colitis.

  • Irritable bowel syndrome.

  • Radiation enteropathy.

What Are the Symptoms of Osmotic Diarrhea?

The main symptom of osmotic diarrhea is loose and watery bowel movements. Other symptoms include:

  • Stomach pain.

  • Nausea.

  • Bloating.

  • Dry lips and skin.

  • Cramping.

  • Blood in the bowel.

  • High fever.

  • Dehydration.

  • Bowel movement with the consistency of tar.

  • Pus in bowel movement.

  • Bowel movement with color.

What Is the Treatment of Osmotic Diarrhea?

Osmotic diarrhea can last for a few days. Usually, it can be treated with simple home remedies that include dietary modifications and other over-the-counter medications like bismuth subsalicylate and loperamide. The health care provider may suggest making a few modifications to the diet and suggest limiting or avoiding the following foods in the diet:

  • Sugar.

  • Artificial sweeteners.

  • Alcohol.

  • Carbonated drinks.

  • Nuts and seeds.

  • Lactose-rich foods.

  • Whole wheat or corn products such as popcorn and muffins.

  • Vegetables that are high in dietary fiber like broccoli and sprouts.

  • Caffeinated drinks like coffee.

  • Legumes such as lentils and beans.

The health care provider may suggest the consumption of the following things in the diet:

  • White rice.

  • Bananas.

  • Cooked vegetables like beets and carrots.

  • Broiled or baked chicken without skin.

  • Boiled potato without skin.

  • Applesauce.

  • Bread products are made from white refined flour, such as pasta and plain white bread.

How to Prevent Osmotic Diarrhea?

The prevention depends upon the underlying cause. The following measures can be taken under consideration for the prevention of osmotic diarrhea:

  • Water - Always try to use boiled and filtered water to prevent diarrhea. Water is the leading cause of viral and bacterial infection.

  • Eat Food Rich in Fiber - Fibrous foods help to enhance and maintain digestive health. These foods include pulses, whole grain cereals, vegetables, millets, and fruits with their seeds and skin. These types of food help to prevent and treat diarrhea.

  • Gluten and Lactose Allergy - It is recommended for people with osmotic diarrhea avoid gluten and lactose if they are sensitive to these products and are advised to consume their alternatives.

  • Food Safety - Avoid eating raw, cold, and stale food while eating out or traveling, as the food can be contaminated with germs at different stages during the processing of food. So it is recommended to have food that is boiled, hot, and properly cooked.

  • Drink Electrolyte-Rich Food - Drink fluids that contain essential electrolytes like glucose, sodium, potassium, etc as the body requires them to make up for the extreme cases of watery diarrhea. One can also have coconut water or Gatorade.

  • Eat Probiotic Foods - It is also recommended to eat probiotic foods like fermented kimchi, salsa, live culture yogurt, and naturally fermented pickles. The gut contains beneficial bacteria that are killed because of the intake of different types of antibiotics. Intake of probiotic foods is a great way to replenish healthy bacterial colonies.

  • Chew Food Properly - If the Food is not chewed correctly, then the undigested large food particles in the intestinal tracts can lead to diarrhea, bloating, constipation, abdominal pain, and also can lead to other digestive problems.

  • Hand Washing - Sanitation affects the transmission of diarrheal diseases. Proper washing of hands using soap and water is essential to prevent the transmission of the condition.

The recommended foods for people suffering from diarrhea include:

  • Bananas.

  • Carrots.

  • Citrus foods.

  • Okra.

  • Boiled potatoes.

  • Applesauce.

  • Beetroots.

  • Dried peas.

  • Cooked chicken.

  • Psyllium Husk.


Osmotic diarrhea lasts only for a few days and is caused by eating certain kinds of foods. It usually goes away on its own when one stops consuming the food responsible for the condition. But if the state lasts for more than a few days and becomes severe, one should visit a health care provider immediately.

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Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)


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