Diarrhea is one of the most common reasons for people to seek medical advice; it can range from a mild, temporary condition, to one that can be life-threatening.
Globally, there are an estimated 2 billion cases of diarrheal disease each year, and 1.9 million children under the age of 5, mostly in developing countries, die from diarrhea.
Diarrhea is characterized by loose, watery stools or a frequent need to have a bowel movement. It usually lasts a few days and often disappears without any treatment. Diarrhea can be acute or chronic.
Acute diarrhea occurs when the condition lasts for one to two days. You might experience diarrhea as a result of a viral or bacterial infection. Other times, it could be due to food poisoning. There’s even a condition known as traveler’s diarrhea, which happens when you have diarrhea after being exposed to bacteria or parasites while on vacation in a developing nation. Acute diarrhea is fairly common.
Causes of diarrhea
Most cases of diarrhea are caused by an infection in the gastrointestinal tract. The microbes responsiblefor this infection include:
- Parasitic organisms
The most commonly identified causes of acute diarrhea in the United States are the bacteria Salmonella, Campylobacter, Shigella, and Shiga-toxin-producing Escherichia coli.
Some cases of chronic diarrhea are called “functional” because a clear cause cannot be found. In the developed world, irritable bowel syndrome (IBS) is the most common cause of functional diarrhea.
IBS is a complex of symptoms. There is cramping abdominal pain and altered bowel habits – diarrhea, constipation, or both.
Inflammatory bowel disease (IBD) is another cause of chronic diarrhea. It is a term used to describe either ulcerative colitis or Crohn’s disease. There is often blood in the stool in both conditions.
Other major causes of chronic diarrhea include:
- Microscopic colitis usually affects older adults. The persistent diarrhea is often during the night.
- Malabsorptive and maldigestive diarrhea the first is caused by impaired nutrient absorption, the second by impaired digestive function. Celiac disease is one example.
- Chronic infections a history of travel or antibiotic use can be clues to chronic diarrhea; various bacteria and parasites can be the cause.
- Drug-induced diarrhea the obvious cause is laxatives, but a list of other drugs can also lead to diarrhea including antibiotics.
- Endocrine causes sometimes hormones are the cause, for example, in conditions including Addison disease and carcinoid tumors.
- Cancer causes neoplastic diarrhea is associated with a number of gut cancers.
You may experience diarrhea as a result of a number of conditions or circumstances. Potential causes of diarrhea include:
- a food intolerance, such as lactose intolerance
- a food allergy
- an adverse reaction to a medication
- a viral infection
- a bacterial infection
- an intestinal disease
- a parasitic infection
- gallbladder or stomach surgery
Symptoms of diarrhea?
There are many different symptoms of diarrhea. You may experience only one of these or any combination of all of them. The symptoms depend on the cause. It’s common to feel one or more of the following:
- abdominal pain
- a fever
- bloody stools
- a frequent urge to evacuate your bowels
- a large volume of stools
Diarrhea in babies and young children
Diarrhea is a serious condition in very young people. It can cause severe dehydration in an infant in just one day.
Call your child’s doctor or seek emergency care if you see symptoms of dehydration, such as:
- decreased urination
- dry mouth
- a headache
- a lack of tears when crying
- dry skin
- sunken eyes
- sunken fontanel
Treatments for diarrhea
Correcting dehydration is the priority of diarrhea treatment.
Mild cases of acute diarrhea may resolve without treatment. Persistent or chronic diarrhea will be diagnosed and treated in addition to the symptoms of diarrhea.
For all cases of diarrhea, the first important step in treatment is to rehydrate:
- Fluids can be replaced by simply drinking more fluids, or they can be received intravenously in severe cases. Children and older people are more vulnerable to dehydration.
- Oral rehydration solution/salts (ORS) – this is water that contains salt and glucose. It is absorbed by the small intestine to replace the water and electrolytes lost in the stool. In developing countries, ORS costs just a few cents; the World Health Organization (WHO) says ORS can safely and effectively treat over 90 percent of non-severe diarrhea cases).
- Oral rehydration products are available commercially – for example Oralyte and Rehydralyte. Zinc supplementation may reduce the severity and duration of diarrhea in children.
- OTC antidiarrheal medicines are also available:
- Loperamide (Imodium, for example) is an antimotility drug that reduces stool passage.
- Bismuth subsalicylate (for example, Pepto-Bismol) reduces diarrheal stool output in adults and children and may be a safer alternative to loperamide. This drug can also be used to prevent traveler’s diarrhea.
There is some concern that antidiarrheal medications could prolong bacterial infection by reducing the removal of pathogens via stools.
Antibiotics are only used to treat diarrhea caused by a bacterial infection. If the cause is a certain medication, switching to another drug might be possible.
Be Sure to Stay Hydrated
Your body can lose a lot of fluids and salts when you have diarrhea, making dehydration a major concern. Frequent loose and watery stools can quickly lead to fluid loss. Here are some easy ways to stay hydrated:
Select sports drinks
“Sports drinks make sense and are available in a wide variety of flavors,” Dr. Bickston says. Sports drink work because of their sugar and salt content, both allow water to be more easily absorbed, and even more so when taken together. People can make their own sports drinks by adding a teaspoon of salt to a quart of apple juice, Bickston says. “That little amount of salt will help the body absorb fluids but isn’t enough to make the apple juice taste bad.” Bickston recommends keeping your drinks at room temperature because a warm drink will sit better with you than a cold one.
Stick to clear liquids
Some other good choices for treating diarrhea include clear broth and water (unless you are traveling out of the country).
Avoid drinks that can worsen symptoms
Caffeinated, alcoholic, and sugary drinks can worsen dehydration. Milk and other dairy products can make your symptoms feel worse because diarrhea can cause temporary lactose-intolerance.
Try Eating a Bland Diet
When dealing with a brief bout of diarrhea, you want to keep your diet bland. You may find it best to only have clear liquids for the first 24 hours. Then, you can slowly add bland foods to your diet. Some bland foods include bananas, rice, applesauce, and toast — otherwise known as the BRAT diet. Crackers and mashed potatoes (minus the butter) are also safe.
Fried and greasy foods are usually not well-tolerated in people who have diarrhea. You should also consider limiting high-fiber foods like bran as well as fruits and vegetables that can increase bloating. Foods to avoid include:
- artificial sweeteners (found in chewing gum, diet soft drinks and sugar substitutes)
- ice cream
- green leafy vegetables
Try Some Over-the-Counter Medications
In most cases, over-the-counter medications can be helpful in stopping an occasional bout of diarrhea — especially traveler’s diarrhea (ingesting contaminated food or water while abroad). Over-the-counter medications include loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol, Kaopectate). “These are reasonable to use on occasion and have the great advantage of not requiring a doctor’s prescription,” Bickston says. However, they should not be used for more than two days.
Probiotics are sources of “good” bacteria that work in your intestinal tract to create a healthy gut environment. They’re essentially live microorganisms that exist in certain foods, including:
- aged soft cheeses
- beet kvass
- cottage cheese
- dark chocolate
- green olives
- sourdough bread