You have been asked by one of the clinic nurse practitioners that you work with to give a recommendation for the treatment of acute diarrhea. The patient, JW, is a 27-year- old female, is not pregnant, and has no known allergies to medications or foods. She has not been diagnosed with any chronic diseases and thus does not take prescription medications. JW attended a picnic with her classmates and has had frequent, watery stools. She estimates she has had at least four stools within the past 24 hours Several other people had the same symptoms. What do you recommend that JW do to treat her symptoms of diarrhea?

A. Loperamide 2 mg tablets - She should take 4 mg x 1 dose by mouth then 2 mg for each loose stool, do not exceed 8 mg/day, duration of use 48 hours: Loperamide is appropriate for acute, non-bloody diarrhea in otherwise healthy adults. It reduces intestinal motility, helping decrease stool frequency and improve comfort. B. Bismuth subsalicylate liquid or tablets - She should take 525 mg every 30–60 minutes up to 4200 mg/day, duration of use 48 hours: Bismuth subsalicylate is effective for mild to moderate acute diarrhea and has antimicrobial and anti-secretory effects. It is particularly useful in cases of suspected infectious diarrhea from food exposure, such as a picnic setting, making it appropriate C. A or B: Both loperamide and bismuth subsalicylate are appropriate first-line OTC treatments for acute diarrhea in a healthy adult without contraindications. Either can be selected based on patient preference, symptom severity, and tolerance, making this the best overall answer. D. There are no appropriate recommendations for JW's diarrhea given in the options listed: JW’s presentation is consistent with uncomplicated acute diarrhea likely due to foodborne illness. She has no contraindications, so OTC options like loperamide or bismuth subsalicylate are appropriate and recommended.