Diarrhea

Diarrhea is an illness which is diagnosed and treated by the GI Division of Premier Medical Group.

How is diarrhea defined?

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Diarrhea is defined as loose watery stools, occurring three or more times per day. Acute diarrhea is a common problem that usually lasts one or two days and goes away on its own, but if the diarrhea lasts more than two days, it could be a sign of something more serious. Chronic diarrhea may be recurrent (it may come and go).

Diarrhea is the second most reported illness in the United States. Adults report at least one bout of diarrhea per year while children report at least two bouts. It’s inconvenient and unpleasant, but usually goes away on its own. Diarrhea of any length may cause dehydration and loss of electrolytes.

Everyday things such as food, medication, or stress can cause diarrhea. If you learn what your triggers are for diarrhea, that’s half the battle. Nonetheless, chronic diarrhea can be an indication of an underlying medical condition.

What causes diarrhea?

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The most common cause of diarrhea is eating food that has spoiled, mainly because it was not refrigerated well enough or went bad before the patient ate it.

To avoid bacteria-related diarrhea, cook meat, poultry, and eggs completely. Wash your hands, utensils, and surfaces. Refrigerate leftovers quickly; don’t leave them at room temperature longer than necessary. When dining out, make sure to check online for health department ratings.

Other causes are food intolerance, medications, and stress. These can all lead to diarrhea. Chronic diarrhea could be a sign of something more serious, so it’s important to be seen by your health care provider.

Bacteria are part of everyday life; we have good bacteria and we have bad bacteria. Usually bacteria and humans get along well, but there are some bacteria that wreak havoc on your digestive tract.

Other causes of diarrhea are:

  • Viral Causes: There are some viruses that can lead to diarrhea and vomiting. These strains are very contagious, and can easily be spread from unwashed hand to hand, shared drinks, and utensils. Even if you have no symptoms, you can still spread the virus. If someone you know has diarrhea, avoid sharing utensils and drinks. With viral infections, the diarrhea usually clears up within two to three days;
  • Traveler’s Diarrhea: Many people who travel contract a bout of diarrhea. More common nicknames are, Delhi Belly and Montezuma’s Revenge. This type of diarrhea generally comes from contaminated water or foods, and it can also cause vomiting. Its best when traveling to avoid raw, unpeeled produce and water from faucets. Eat only cooked foods and drink bottled or boiled water. Usually, this form only lasts twelve hours;
  • Medication: Sometimes a course of antibiotics can cause diarrhea, because while the antibiotics are killing the bad bacteria, they also kill the good bacteria. Other medications that can cause diarrhea are cancer drugs, antacids, and blood pressure medications. If you think your medications are causing diarrhea, it’s important to relay this to your doctor;
  • Food Intolerance: This happens when your body cannot digest certain foods. The most common food offenders are dairy products and artificial sweeteners. The bout of diarrhea usually happens within thirty minutes to two hours.
  • Chronic Conditions: When diarrhea lasts more than three days, it could be caused by something more serious. Speak to your doctor to make sure you don’t have, IBS (Irritable Bowel Syndrome), IBS, (Inflammatory Bowel Disease), Celiac Disease, Addison’s Disease, Diabetes, Chronic pancreatitis, or Hyperthyroidism;
  • Gluten sensitive enteropathy/Celiac disease: This is an autoimmune disease of the small intestine that flares up with the consumption of gluten, which is the main component in wheat. This can cause chronic diarrhea, unexplained anemia, chronic fatigue, or unexplained weight loss. It is very important to get an accurate diagnosis for Celiac disease so you can learn to manage it and eat the right foods.

What are the symptoms of diarrhea?

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The most common symptoms of diarrhea are cramping, abdominal pain, nausea, and urgency to go to the bathroom. Some people have a loss of bowel control. If the diarrhea is caused by an infection, it may also cause a fever, chills, or bloody stools.

Diarrhea can also cause dehydration, which can lead to a loss of electrolytes. This is especially dangerous in older adults, children, and people with compromised immune systems. It can lead to more serious health problems such as shock, coma, or organ damage.

The most typical signs of dehydration in adults are:

  • Fatigue
  • Dizziness
  • Dry skin
  • Thirst
  • Infrequent urination
  • Dark-colored urine

The most typical signs of dehydration in young children and infants are:

  • No wet diapers for 3 hours or more
  • High fever
  • Lethargy or irritability
  • Dry mouth and tongue
  • No tears when crying

If you show any of these symptoms, and have reason to suspect you are dehydrated, you should see your doctor immediately. Drinking fluids is essential when you have diarrhea, but water alone does not replace essential electrolytes. Suggested beverages include: fruit juices, sports drinks, caffeine-free soft drinks, and broths. For children, the doctor recommended fluids to prevent dehydration are products such as Pedialyte, Naturalyte, Infalyte.

How is diarrhea diagnosed?

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Typically, acute diarrhea goes away in two to three days, but if it lasts longer than three days and is accompanied by symptoms such as fever and/or bloody stools, your doctor may want perform some diagnostic tests to rule out something more serious.

Diagnostic tests may include:

  • Stool culture: A sample will be sent to a lab for signs of bacteria, infection, or parasites;
  • Blood tests: A blood test can rule out other diseases;
  • Medical history and physical exam;
  • Fasting tests: Avoiding certain foods to see if they trigger the diarrhea is and to see whether the diarrhea reacts to the change in your diet;
  • Colonoscopy or Sigmoidoscopy

What are the types of diarrhea?

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There are five different types of diarrhea:

  • Osmotic diarrhea: This occurs when there is too much water in the bowels, generally a result of Celiac Disease, pancreatic disease, or too many laxatives;
  • Motility-related diarrhea: This occurs when the food you eat moves too fast through the intestines (hypermotility);
  • Secretory diarrhea: This occurs when your stomach releases more fluids than usual and fluids are not absorbed properly;
  • Inflammatory diarrhea: This occurs when the lining of your stomach becomes inflamed as the result of infection. (Viral, bacterial, parasitic, or autoimmune). Also colon cancer and IBS (inflammatory bowel disease) can cause diarrhea;
  • Dysentery: This occurs as the result of bacterial infections such as Salmonella, Shigella and Entamoeba histolyica.

How is diarrhea treated?

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The most important part of treating diarrhea is to avoid getting dehydrated. It’s important to replace fluids and loss of electrolytes. Some non-prescription medicines used for the treatment of diarrhea include Imodium (loperamide), Kaopectate, and Pepto-Bismol. If the diarrhea lasts longer than three days, and there are bloody stools, it’s recommended that you see your doctor. He or she may need to prescribe antibiotics, but antibiotics can only help a bacterial infection, not viral diarrhea. You should not use these over-the-counter medications for infants or children without the advice of your pediatrician.

Drinking fluids that contain sugar, sodium, and potassium is crucial to keep from getting dehydrated. Examples of such drinks include sports drinks, prepared rehydration solutions, chicken or beef broth, colas, or bottled and flavored mineral water.

If you are also vomiting, take very small quantities of liquid every 15 minutes. When you are able to hold down liquids, eat soft, bland foods before resuming your regular diet.

There are some doctors who prefer that you do not use the over-the-counter medicines, because it slows the process of passing the bacteria or virus out of your system. As with anything that compromises your health, you should always check with your doctor before taking any medicines, including over-the-counter ones.

Diarrhea Diet

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  • BRAT: The standby diet most doctors refer to is simply, “BRAT,” for bananas, rice, apples (not apple juice), and tea
  • Avoid caffeine, greasy and high fiber foods, and very sweet foods as these can aggravate diarrhea
  • Avoid dairy products
  • Do eat: plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken (without the skin)
  • Yogurt with live bacteria may help

Frequently Asked Questions

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Can stress cause diarrhea?

Yes, stress can cause diarrhea, but if the diarrhea continues, it’s important to see your doctor to make certain it’s not from something more serious.

What do I need to tell my doctor about my diarrhea?

The more information you can provide the doctor, the easier it will be to get an accurate diagnosis. Make sure to write down:

  • Is the diarrhea continuous, or does it stop and start again?
  • How long have you had diarrhea?
  • Is your stool bloody?
  • Do some foods make it worse?
  • Recent travel history
  • Current medications

When should I see a doctor?

Adults should see a doctor if they have any of the following symptoms:

  • Fever over 102 degrees
  • Dehydration
  • Diarrhea for more than two days
  • Bloody stools, or stools that have pus

Will using probiotics help my diarrhea?

Experts suggest that probiotics can reduce the duration of infectious diarrhea by half a day to about two days. Probiotics, which consist of beneficial microbes, may help treat some kinds of diarrhea. The most well-known form of probiotics is yogurt. Bacteria introduced into milk creates yogurt. The same bacteria may help keep intestines healthy. There are many forms of bacteria that have health benefits, but only certain strains help diarrhea. Check with your doctor for suggestions on which type of probiotics may be best for you.