What is diarrhea (diarrhoea)?
Diarrhea--loose, watery stools occurring more than three times in one day--is a common problem that usually lasts a day or two and goes away on its own without any special treatment. However, prolonged diarrhea can be a sign of other problems, including Irritable Bowel Syndrome (IBS).
Diarrhea can cause dehydration, which means the body lacks enough fluid to function properly. Dehydration is particularly dangerous in children and the elderly, and it must be treated promptly to avoid serious health problems.
People of all ages can get diarrhea. The average adult has a bout of diarrhea about four times a year.
What causes diarrhea?
Diarrhea may be caused by a temporary problem, like an infection, or a chronic problem, like an intestinal disorder or disease such as IBS or Crohn's. A few of the more common causes of diarrhea are:
Bacterial infections. Several types of bacteria, consumed through contaminated food or water, can cause diarrhea. Common culprits include Campylobacter, Salmonella, Shigella, and Escherichia coli.
Viral infections. Many viruses cause diarrhea, including rotavirus, Norwalk virus, cytomegalovirus, herpes simplex virus, and viral hepatitis.
Food intolerances. Some people are unable to digest a component of food, such as lactose, the sugar found in milk. For IBS-diarrhea, food intolerances and irritants are a particularly common cause of symptoms, and the proper diet can dramatically help bowel function.
Parasites. Parasites can enter the body through food or water and settle in the digestive system. Parasites that cause diarrhea include Giardia lamblia, Entamoeba histolytica, and Cryptosporidium.
Reaction to medicines, such as antibiotics, blood pressure medications, and antacids containing magnesium.
Intestinal diseases, like inflammatory bowel diseases (Crohn's, ulcerative colitis, diverticulitis) or celiac disease.
Functional bowel disorders, such as Irritable Bowel Syndrome, in which the intestines do not work normally.
Some people develop diarrhea after stomach surgery or removal of the gallbladder. The reason may be a change in how quickly food moves through the digestive system after stomach surgery or an increase in bile in the colon that can occur after gallbladder surgery. A remedy for this type of diarrhea is the prescription drug Questran.
In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes away on its own, an extensive search for the cause is not usually necessary.
People who visit foreign countries are at risk for traveler's diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or, sometimes, parasites. Traveler's diarrhea is a particular problem for people visiting developing countries. Visitors to the United States, Canada, most European countries, Japan, Australia, and New Zealand do not face much risk for traveler's diarrhea.
What are the symptoms of diarrhea?
Diarrhea may be accompanied by cramping abdominal pain, bloating, nausea, or an urgent need to use the bathroom. Depending on the cause, a person may have a fever or bloody stools (though these are NOT typical for IBS).
Diarrhea can be either acute (short-term) or chronic (long-term). The acute form, which lasts less than 3 weeks, is usually related to a bacterial, viral, or parasitic infection. Chronic diarrhea lasts more than 3 weeks and is usually related to functional disorders like irritable bowel syndrome or diseases like celiac disease or inflammatory bowel disease.
Diarrhea in Children
Children can have acute or chronic forms of diarrhea. Causes include bacteria, viruses, parasites, medications, functional disorders, and food sensitivities. Infection with the rotavirus is the most common cause of acute childhood diarrhea. Rotavirus diarrhea usually resolves in 5 to 8 days.
Medications to treat diarrhea in adults can be dangerous to children and should be given only under a doctor's guidance.
Diarrhea can be dangerous in newborns and infants. In small children, severe diarrhea lasting just a day or two can lead to dehydration. Because a child can die from dehydration within a few days, the main treatment for diarrhea in children is rehydration.
Take your child to the doctor if any of the following symptoms appear:
Stools containing blood or pus, or black stools
Temperature above 101.4 degrees Fahrenheit
No improvement after 24 hours
Signs of dehydration
Diarrhea and dehydration?
General signs of dehydration include:
Less frequent urination
Dark colored urine
Signs of dehydration in children include:
Dry mouth and tongue
No tears when crying
No wet diapers for 3 hours or more
Sunken abdomen, eyes, or cheeks
Listlessness or irritability
Skin that does not flatten when pinched and released
If you suspect that you or your child is dehydrated, call the doctor immediately. Severe dehydration may require hospitalization.
When should a doctor be consulted about diarrhea?
Although usually not harmful, diarrhea can become dangerous or signal a more serious problem. You should see the doctor if:
You have diarrhea for more than 3 days.
You have severe pain in the abdomen or rectum.
You have a fever of 102 degrees Fahrenheit or higher.
You see blood in your stool or have black, tarry stools.
You have signs of dehydration.
If your child has diarrhea, do not hesitate to call the doctor for advice. Diarrhea can be dangerous in children if too much fluid is lost and not replaced quickly.
What tests might the doctor do for diarrhea?
Diagnostic tests to find the cause of diarrhea include the following:
Medical history and physical examination. The doctor will need to know about your eating habits and medication use and will examine you for signs of illness.
Stool culture. Lab technicians analyze a sample of stool to check for bacteria, parasites, or other signs of disease or infection.
Blood tests. Blood tests can be helpful in ruling out certain diseases.
Fasting tests. To find out if a specific food intolerance or allergy is causing the diarrhea, the doctor may ask you to avoid lactose or other foods to see whether the diarrhea responds to a change in diet.
Sigmoidoscopy. For this test, the doctor uses a special instrument to look at the inside of the rectum and lower part of the colon.
Colonoscopy. This test is similar to sigmoidoscopy, but the doctor looks at the entire colon.
What is the treatment for diarrhea?
In most cases, replacing lost fluid to prevent dehydration is the only treatment necessary. Medicines that stop diarrhea may be helpful in some cases, but they are not recommended for people whose diarrhea is from a bacterial infection or parasite - stopping the diarrhea traps the organism in the intestines, prolonging the problem. Instead, doctors usually prescribe antibiotics. Viral causes are either treated with medication or left to run their course, depending on the severity and type of the virus.
For IBS diarrhea, dietary changes are the best way to both alleviate and prevent symptoms. Gut-directed hypnosis is also highly effective for IBS diarrhea.
Preventing Dehydration from Diarrhea
Dehydration occurs when the body has lost too much fluid and electrolytes (the salts potassium and sodium). The fluid and electrolytes lost during diarrhea need to be replaced promptly--the body cannot function properly without them. Dehydration is particularly dangerous for children, who can die from it within a matter of days.
Although water is extremely important in preventing dehydration, it does not contain electrolytes. To maintain electrolyte levels, you could have broth or soups, which contain sodium, and fruit juices, soft fruits, or vegetables, which contain potassium.
For children, doctors often recommend a special rehydration solution that contains the nutrients they need. You can buy this solution in the grocery store without a prescription. Examples include Pedialyte, Ceralyte, and Infalyte.
Points to Remember about Diarrhea
Acute diarrhea is a common short-term problem that usually resolves on its own. Chronic long-term diarrhea as a symptom of Irritable Bowel Syndrome responds well to dietary modifications.
Diarrhea is dangerous if a person becomes dehydrated.
Causes include viral, bacterial, or parasitic infections; food intolerance; reactions to medicine; intestinal diseases; and functional bowel disorders.
Treatment involves replacing lost fluids and electrolytes. Depending on the cause of the problem, a person might also need medication to stop the diarrhea or treat an infection. Children may need an oral rehydration solution to replace lost fluids and electrolytes.
Call the doctor if a person with diarrhea has severe pain in the abdomen or rectum, a fever of 102 degrees Fahrenheit or higher, blood in the stool, signs of dehydration, or diarrhea for more than 3 days.
If you feel confident with your doctor's diagnosis that your diarrhea is a symptom of Irritable Bowel Syndrome, learn all you need to know about this disorder with The First Year: IBS, an essential guide to successfully managing the disorder. For quick treatment of IBS diarrhea, begin taking a soluble fiber supplement like Acacia Tummy Fiber and start making dietary changes.
IBS Diarrhea Diet Cheat Sheet
Diarrhea information provided by the National Digestive Diseases Information Clearinghouse, NIH
Learn Diarrhea Trigger Foods
- Safe Foods For Diarrhea
- Soluble Vs. Insoluble Fiber
- 10 Commandments of Eating for IBS
- More for IBS Diarrhea!
Excerpted from Eating for IBS.