DIARRHEA

Diarrhea is one of the most common health complaints. It can range from a mild, temporary condition to a potentially life threatening one.

If you have diarrhea, you will typically experience loose, watery stools and feel the urgent need to have a bowel movement multiple times a day. Diarrhea can be acute or chronic.

Acute diarrhea occurs when the condition lasts for 1 to 2 days. You might experience diarrhea due to a viral or bacterial infection you acquired via something you ate or drank.

Chronic diarrhea refers to having diarrhea on most days for longer than 3 to 4 weeks. Some common causes of chronic diarrhea include:

• irritable bowel syndrome (IBS)
• inflammatory bowel diseases (IBD)
• conditions, such as celiac disease, that affect the absorption of certain nutrients

What causes diarrhea?

Diarrhea may be caused by many things, including:

• A bacterial infection
• A virus
• Trouble digesting certain things (food intolerance)
• Food allergy (such as celiac disease, gluten allergy)
• Parasites that enter the body through food or water
• A reaction to medicines
• An intestinal disease, such as inflammatory bowel disease
• A problem with how your stomach and bowels work (functional bowel disorder), such as irritable bowel syndrome
• A result of surgery on the stomach or gall bladder
• Recent antibiotic use
• Metabolic conditions such as thyroid problems
• Other less common reasons such as damage from radiation treatments or tumors that make too many hormones

Many people get traveler’s diarrhea. This happens when you have food or water that is not safe because of bacteria, parasites, and even food poisoning.

Severe diarrhea may mean you have a serious disease. See your healthcare provider if your symptoms don’t go away or if they keep you from doing your daily activities. It may be hard to find out what is causing your diarrhea.

What are the symptoms of diarrhea?

Each person’s symptoms may vary. Symptoms of diarrhea may include:

• Belly (abdominal) cramps
• Stomach pain
• Swelling (bloating)
• Upset stomach (nausea)
• Urgent need to go to the bathroom
• Fever
• Bloody stools
• Loss of body fluids (dehydration)
• Leaking stool and not being able to control your bowels (incontinence)

Dehydration is a serious side effect of diarrhea. Symptoms include:

• Feeling thirsty
• Not urinating as often
• Having dry skin as well as a dry mouth and nostrils (mucous membranes)
• Feeling very tired
• Feeling that you may pass out or faint (lightheaded)
• Headaches
• Fast heart rate
• Sunken fontanelle (soft spot) on baby’s head

Diarrhea symptoms may look like other health problems.  Bloody diarrhea is always a concern. Always see your doctor to be sure. Be sure to tell the doctor about any bleeding, fever, or vomiting.

How is diarrhea diagnosed?

To see if you have diarrhea, your healthcare provider will give you a physical exam and ask about your past health. You may also have lab tests to check your blood and urine.

Other tests may include:

• Stool studies including culture and other tests. This test checks for any abnormal bacteria in your digestive tract that may cause diarrhea and other problems. To do this, a small stool sample is taken and sent to a lab.
• Sigmoidoscopy. This test lets your healthcare provider check the inside of part of your large intestine. It helps to tell what is causing diarrhea. A short, flexible, lighted tube (sigmoidoscope) is put into your intestine through the rectum. This tube blows air into your intestine to make it swell. This makes it easier to see inside. A biopsy can be taken if needed.
• Colonoscopy. This test looks at the full length of your large intestine. It can help check for any abnormal growths, tissue that is red or swollen, sores (ulcers), or bleeding. A long, flexible, lighted tube (colonoscope) is put into your rectum up into the colon. This tube lets your healthcare provider see the lining of your colon and take out a tissue sample (biopsy) to test it. He or she can also treat some problems that may be found.
• Imaging tests. These tests can see if there are any problems with the way your organs are formed (structural abnormalities).

• Fasting tests. These tests show if you are unable to digest certain foods (food intolerance). They can also tell if certain foods bring on an immune system reaction (food allergy).
• Blood tests. These can look for metabolic problems like thyroid disease, anemia (low blood count), evidence of low vitamin levels suggesting poor absorption, and celiac disease, among other things.

How is diarrhea treated?

Your healthcare provider will make a care plan for you based on:

• Your age, overall health, and past health
• How serious your case is
• How well you handle certain medicines, treatments, or therapies
• If your condition is expected to get worse
• What you would like to do

In most cases you will need to replace the fluids you have lost.

You may also need a medicine that fights infection (antibiotic) if a bacterial infection is causing your diarrhea.

Complications of diarrhea

If your diarrhea is not treated you are at risk for dehydration. Severe dehydration can lead to organ damage, shock, and fainting (loss of consciousness) or coma.

Can diarrhea be prevented?

Having good personal habits can keep you from getting diarrhea caused by bacteria or a virus. It is important to:

• Wash your hands often
• Use alcohol based sanitizers
• Eat foods that have been cleaned and cooked in a safe way
• Not take any foods or liquids that may have been infected with a bacteria or virus

When you are traveling, make sure anything you eat and drink is safe. This is even more important if you travel to developing countries.

Travel safety tips for water and other liquids include:

• Not drinking tap water or using it to brush your teeth
• Not using ice made from tap water
• Not drinking milk or milk items that have not gone through a process to kill certain bacteria (pasteurization)

Travel safety tips for food include:

• Not eating any fresh or raw fruits and vegetables unless you wash and peel them yourself
• Making sure all meat and fish have been cooked to at least medium doneness
• Not eating raw or rare-cooked meat or fish
• Making sure meat and shellfish such as shrimp, crab, and scallops, are hot when served
• Not eating food from street vendors or food trucks

Living with diarrhea

In most cases diarrhea is a short-term problem. Often it only lasts for a few days. Be sure to take plenty of liquids when you’re having a bout of diarrhea.

Some health problems can make diarrhea last longer or keep coming back. These include inflammatory bowel disease and irritable bowel syndrome. If another health problem is causing your diarrhea, follow your healthcare provider’s advice for treating that problem.

When should I call my healthcare provider?

Call your healthcare provider if:

• You have diarrhea more often
• You have a greater amount of diarrhea
• You have symptoms of dehydration. You may feel thirsty, tired, or dizzy. You may also have less urine, or a dry mouth.
• You have diarrhea with rectal bleeding or black and tarry stools, a fever, or are vomiting

Key points about diarrhea

• Diarrhea is when your stools are loose and watery.
• You may also need to go to the bathroom more often.
• Short-term (acute) diarrhea lasts 1 or 2 days.
• Long-term (chronic) diarrhea lasts several weeks.
• Diarrhea symptoms may include belly cramps and an urgent need to go to the bathroom.
• Loss of fluids (dehydration) is one of the more serious side effects.
• Treatment usually involves replacing lost fluids.
• You may need an infection-fighting medicine (antibiotic) if a bacterial infection is the cause.

Next steps

Tips to help you get the most from a visit to your health care provider:

• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.