Oranges, grapefruits, lemons, and other citrus fruits are chock-full of essential nutrients such as vitamin C, flavonoids, and fiber (which help protect against inflammation, heart disease, and cancer) — making them a great snack or addition to your diet.
But in some people, these fruits can also cause digestive issues, including diarrhea. Here are three reasons why citrus fruits (including juice) may cause or worsen diarrhea.
1. Foodborne Illnesses
Sometimes fruits and vegetables carry harmful bacteria, such as salmonella, E. coli, and listeria, that can cause foodborne illnesses. It’s important to wash or scrub all produce carefully under running water before eating, cutting, or cooking it — even if you don’t plan to eat the peel.
Orange and grapefruit juices can also cause diarrhea if they are unpasteurized. Pasteurization is a process where food is briefly heated to destroy bacteria and other pathogens. Without pasteurization, juice can contain harmful bacteria that may cause gastrointestinal problems.
Fortunately, most packaged juices sold in the United States are pasteurized. However, some packaged juices sold at health food markets, farmers markets, and juice bars have not been pasteurized. These products are required to carry a warning label informing consumers of the potential risks. If you are unsure whether a packaged juice has been pasteurized, don’t hesitate to ask.
Fresh-squeezed juices are not pasteurized.
Diarrhea is a common symptom of foodborne illnesses, along with abdominal pain, fever, vomiting, headaches, and body aches. These symptoms may last as long as 7 to 10 days.
2. Citrus Allergies or Intolerances
Citrus fruits may cause oral allergy syndrome, which is most often caused by a cross-reaction to an allergy you already have to tree, grass, or other pollen. Symptoms include itching, tingling, and minor swelling of the tongue, mouth, lips, and throat. Symptoms of oral allergy syndrome usually go away on their own, within 30 minutes, once you stop eating the trigger food.
A true citrus fruit allergy is extremely rare. If you have a citrus fruit allergy, abdominal symptoms such as pain, nausea, and vomiting are possible, along with hives and other symptoms. This is more serious than oral allergy syndrome. A true citrus fruit allergy has a risk of anaphylaxis, a life-threatening condition that requires immediate medical attention in a hospital emergency room and a prompt dose of epinephrine.
Symptoms of anaphylaxis include:
Hives
Chest tightening or trouble breathing
Stomach pain with nausea, vomiting, or diarrhea
Swollen tongue and difficulty swallowing
Headache, sweating, or dizziness
Racing or weak pulse
If you have any of these symptoms, call 911 or go to the nearest emergency room.
Keep in mind that true citrus allergies are not common. If you suspect an allergy, speak with your doctor, who can help make the correct diagnosis and start you on any necessary treatments.
3. Digestive Disorders
If you have a bowel disorder, such as irritable bowel syndrome (IBS), Crohn’s disease, or fructose malabsorption, drinking citrus juices may cause diarrhea.
Citrus fruits, including oranges and grapefruits, are often noted for triggering IBS symptoms, along with dairy products, wheat, beans, cabbage, and carbonated drinks. Symptoms of IBS include:
Cramping and belly pain
Bloating and gas
Diarrhea, constipation, or both
Feeling of incomplete bowel movements
Stool that contains mucus
Crohn’s disease is a more serious digestive condition marked by swelling and inflammation of the digestive tract. Symptoms include:
Diarrhea
Fever
Fatigue
Abdominal pain and cramping
Blood in the stool
Mouth sores
Weight loss
With fructose malabsorption, your body is unable to absorb a sugar called fructose found in fresh fruits like oranges and grapefruits. Diarrhea is a common symptom, in addition to bloating, gas, and stomach pain.
When to See a Doctor
Luckily, most cases of diarrhea are short-lived and only last a few days. This is also known as acute diarrhea, and it usually goes away on its own.
If it lasts longer than four weeks, it’s considered chronic diarrhea and should be evaluated by a doctor. Chronic diarrhea may be a sign of an underlying health issue, such as a food intolerance, allergy, or a condition that affects your digestive system, such as IBS or celiac disease.
The Takeaway
Citrus fruits can trigger diarrhea in some individuals, due to allergies or digestive disorders, or when consumed as unpasteurized juice, which may harbor harmful bacteria.
For those who suspect that they have an allergy to citrus fruit, it’s important to seek medical advice to get an accurate diagnosis.
While citrus fruits are nutritious, if you have a condition like IBS or fructose malabsorption, citrus fruits may worsen your symptoms.
If you experience persistent or chronic diarrhea, see your doctor to determine the cause and start any necessary treatments.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
Nekrich A. The Powerful Health Benefits of Citrus Fruits. University of Washington. May 23, 2022.
Julie Cunningham has been a registered dietitian for more than 25 years. She is a certified diabetes care and education specialist (CDCES) and an international board-certified lactation consultant. She has served as the president of the Foothills Chapter of the North Carolina Dietetics Association (NCDA) and has been a member of the executive board of the NCDA.
Ms. Cunningham received a bachelor's degree from Appalachian State University in North Carolina. She subsequently completed a master's degree in public health nutrition at the University of North Carolina at Chapel Hill.
Ms. Cunningham has worked in women's and children's health, cardiology, and diabetes. She is the author of 30 Days to Tame Type 2 Diabetes, and she has also written for Abbott Nutrition News, Edgepark Medical Health Insights, diaTribe, Babylist, and others.
A resident of beautiful western North Carolina, Cunningham is an avid reader who enjoys yoga, travel, and all things chocolate.
