Diarrhea is more than three loose, liquid stools in a single day. It depletes the body of fluids and electrolytes. Diarrhea can be:
Acute—Occurring suddenly and lasting brieflyChronic—Long-termRecurring—Coming and going
If the body loses too much fluid, it can become
dehydrated. Dehydration is especially dangerous for babies, young children, and elderly people.
Causes may include:
Food intolerance, such as
lactose intolerance
Medicines, including:
AntibioticsMagnesium-containing antacidsHigh blood pressure medicationsQuinineChemotherapyLaxativesIrritable bowel syndrome, which is episodes of diarrhea often alternate with periods of
constipationInjury to the bowel after radiation treatments for cancer
Malabsorption syndromes, such as:
Celiac diseaseTropical sprueShort bowel syndromeWhipple's diseaseIntestinal lymphangiectasiaDiseases of the pancreas and/or gallbladder
Inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease
Chronic diseases, such as:
Liver diseaseDiabetesHyperthyroidismAddison's diseasePellagraSclerodermaAmyloidosis
Acquired Immune Deficiency Syndrome (AIDS)Colon cancerIntestinal surgery
Infections, including food poisoning, such as:
Bacterial:
Campylobacter, Clostridium difficile, Salmonella, Shigella,
and
Escherichia coli
Viral:
rotavirus,
Norwalk virus,
cytomegalovirus,
herpes simplex virus, and viral hepatitis
Parasitic:
Giardia lamblia,
Entamoeba histolytica,
Cryptosporidium,
tapeworm,
roundworm, flukes
Fungal:
Candida—yeast
Risk factors include:
Traveling
to a developing country where the water and food supply may be contaminatedHaving a severely weakened immune system, such as with AIDS or after an organ transplantTaking certain medicines
Symptoms may include:
Frequent, loose, liquid stoolsAbdominal pain, crampingUrgent need to defecateBlood and/or mucus in stoolFeverDehydrationNausea, vomitingMuscle aches and painsWeight lossMalnutrition
Call your doctor if you:
Have diarrhea that lasts longer than three daysAre not able to eat or drink to stay hydratedHave a fever
Call your doctor if your young child:
Has diarrhea lasting longer than a dayHas pus in stoolIs dehydrated—no wet diapers in three hours, dry mouth, crying without tears, skin that stays up after being pinchedIs sleepy or irritableHas a fever
Call for medical help or go to the emergency room right away if you or your child has:
Severe abdominal pain and crampingBloody or black stool
The doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor may insert a gloved finger into your rectum to examine it. This is called a digital rectal exam.
To determine the cause of your diarrhea, the doctor will ask questions, such as:
Does anyone else in your family have diarrhea?What kinds of food have you eaten recently?Do you drink well water?Do your children attend daycare?Have you traveled recently?Do you use laxatives?What medicines do you take?Do you have any symptoms other than diarrhea, such as fever, rash, or aching joints?What is your sexual history?Have you ever had abdominal surgery?
Tests may include:
Your bodily fluids, tissues, and waste products may be tested. This can be done with: Laboratory analysis of a stool sampleBlood testsBiopsyYou may need to have your rectum and colon examined. This can be done with: Flexible sigmoidoscopyColonoscopyYou may need to have images taken of your colon. This can be done with:
Upper Gastrointestinal (GI) SeriesBarium enemaYou may need to have fasting or food elimination tests. Treating the underlying condition may help to relieve the diarrhea.
General recommendations for treating diarrhea include:
Plain water will not replace the electrolytes lost through diarrhea. For adults and children, look for age-specific oral rehydration solutions. Avoid fruit juices and soda. For young children, continue with breastfeeding or formula feeding.
Doctors differ in their approach to treating diarrhea. For example, your doctor may recommend that you:
Drink only clear fluids during severe phases of diarrhea.Avoid certain foods, such as: very spicy foods, fatty foods, greasy foods, high-fiber foods, dairy products in large amounts, and caffeinated drinks.Eat certain foods, such as: complex carbohydrates like pasta and rice, yogurt, fruits and vegetables, and lean meatsAsk your doctor which dietary guidelines you should follow. As your diarrhea subsides, your usual healthy foods can be reintroduced.
Use a hot water bottle or heating pad on your abdomen to relieve cramps and pain.
Your doctor may recommend medicines, such as:
Antidiarrheal medicineAntibiotics—May be needed if a bacterial infection is causing diarrhea
Probiotics, such as
Lactobacillus casei,
Enterococcus faecium, and
Saccharomyces boulardii—May be beneficial in some casesZinc
supplementation—May be advised in some casesChildren should not be given medicine unless specifically recommended by the doctor.
Diarrhea can cause severe dehydration. You may need to be hospitalized. Fluids will be delivered through an IV.
To reduce your chance of getting diarrhea:
Practice good handwashing.Practice safe food preparation and food storage.If you have diarrhea, do not prepare food for others.
If you are traveling:
Drink bottled water.Use bottled water when brushing your teeth.Avoid drinks that contain ice.Do not eat food purchased from street vendors.Do not eat raw vegetables or fruits. All produce should be peeled and/or cooked.Make sure meats are cooked thoroughly.Eat only pasteurized dairy products.If you eat seafood, make sure it is very hot.
Rotavirus is a common cause of diarrhea in children under five years of age. There is a
vaccine
to prevent rotavirus. The first dose is given at age two months. Make sure your infant has received this vaccine.
Last reviewed September 2012 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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