What are the key symptoms of diarrhea. How can you differentiate between normal bowel movements and diarrhea. What are the common causes of diarrhea. How can diarrhea be effectively managed at home. When should you seek medical attention for diarrhea.

Understanding Diarrhea: Definition and Symptoms

Diarrhea is a common gastrointestinal condition characterized by the passage of loose or watery stools more frequently than usual. To understand if you have diarrhea, it’s essential to know the typical symptoms and how they differ from normal bowel movements.

What Defines Diarrhea?

Diarrhea is typically defined as having three or more loose or liquid stools per day, or more frequent bowel movements than what’s normal for an individual. The Bristol Stool Chart, a medical tool used to classify feces, can help identify diarrhea:

• Type 5: Soft blobs with clear-cut edges (passed easily)
• Type 6: Fluffy pieces with ragged edges, a mushy stool
• Type 7: Watery, no solid pieces, entirely liquid

Types 5, 6, and 7 on this chart may indicate diarrhea, depending on the frequency and your normal bowel habits.

Common Symptoms of Diarrhea

Aside from loose or watery stools, diarrhea may be accompanied by other symptoms:

• Abdominal cramps or pain
• Bloating
• Nausea
• Urgency to have a bowel movement
• Fever (in cases of infection)
• Dehydration (if severe or prolonged)

Causes of Diarrhea: From Common to Complex

Diarrhea can occur due to various reasons, ranging from simple dietary changes to more serious medical conditions. Understanding the potential causes can help in determining the appropriate treatment and management strategies.

Common Causes of Diarrhea

1. Viral infections (e.g., norovirus, rotavirus)
2. Bacterial infections (e.g., E. coli, Salmonella)
3. Parasitic infections
4. Food intolerances or allergies
5. Medications (e.g., antibiotics, laxatives)
6. Stress or anxiety

Less Common Causes

• Inflammatory bowel diseases (Crohn’s disease, ulcerative colitis)
• Celiac disease
• Irritable bowel syndrome (IBS)
• Cancer or cancer treatments
• Malabsorption disorders

In some cases, diarrhea may be a symptom of an underlying condition. Can chronic diarrhea indicate a more serious health issue. Yes, persistent diarrhea lasting more than a few days could be a sign of a chronic condition and should be evaluated by a healthcare professional.

Hydration: The Cornerstone of Diarrhea Management

One of the most crucial aspects of managing diarrhea is maintaining proper hydration. Diarrhea can lead to significant fluid loss, potentially resulting in dehydration if not addressed promptly.

Why is Hydration Important During Diarrhea?

During episodes of diarrhea, the body loses not only water but also essential electrolytes. This loss can lead to:

• Fatigue and weakness
• Dizziness
• Dry mouth and skin
• Decreased urine output
• In severe cases, electrolyte imbalances and organ dysfunction

Effective Hydration Strategies

To combat dehydration, consider the following strategies:

1. Drink plenty of fluids throughout the day
2. Opt for a variety of beverages to replace lost electrolytes
3. Sip fluids slowly to prevent nausea
4. Consider oral rehydration solutions for severe cases

Which fluids are best for rehydration during diarrhea. Water is essential, but including beverages like clear broths, diluted fruit juices, and electrolyte-rich drinks can help replace lost minerals more effectively.

Dietary Modifications: Navigating Food Choices During Diarrhea

While managing diarrhea, making informed dietary choices can significantly impact your recovery and comfort. Understanding which foods to avoid and which to include can help alleviate symptoms and support your digestive system.

Foods to Avoid During Diarrhea

Certain foods and beverages can exacerbate diarrhea symptoms. It’s advisable to avoid:

• Dairy products (except for yogurt with live cultures)
• Fatty, greasy, or fried foods
• Spicy foods
• Caffeine and alcohol
• High-fiber foods
• Artificial sweeteners

The BRAT Diet: A Gentle Approach

The BRAT diet (Bananas, Rice, Applesauce, Toast) is often recommended for mild cases of diarrhea. These foods are:

• Easy to digest
• Low in fiber
• Help firm up stools
• Provide some nutrients

While the BRAT diet can be helpful in the short term, it’s important to reintroduce a varied diet as symptoms improve to ensure adequate nutrition.

Gradually Reintroducing Foods

As diarrhea subsides, slowly reintroduce a wider variety of foods. Start with easily digestible options and progress to your normal diet over several days. Pay attention to how your body responds to different foods and adjust accordingly.

The Role of Probiotics in Diarrhea Management

Probiotics, often referred to as “good bacteria,” can play a significant role in managing diarrhea and supporting overall gut health. These beneficial microorganisms can help restore balance to the digestive system, potentially reducing the duration and severity of diarrhea.

How Do Probiotics Help with Diarrhea?

Probiotics can assist in diarrhea management through several mechanisms:

• Competing with harmful bacteria for resources
• Producing substances that inhibit pathogen growth
• Enhancing the gut’s protective barrier
• Modulating the immune response

Choosing the Right Probiotic

Not all probiotics are created equal. When selecting a probiotic for diarrhea, consider:

1. Specific strains: Some strains, like Lactobacillus rhamnosus GG and Saccharomyces boulardii, have shown particular efficacy in managing diarrhea
2. Colony-forming units (CFUs): Look for products with adequate CFUs, typically in the billions
3. Quality and storage: Choose reputable brands and follow storage instructions

Can probiotics be taken alongside other diarrhea treatments. Yes, probiotics are generally safe to use in conjunction with other treatments, but it’s always best to consult with a healthcare provider, especially if you have a compromised immune system.

When to Seek Medical Attention for Diarrhea

While most cases of diarrhea resolve on their own with proper home care, there are instances where medical attention is necessary. Recognizing the signs that indicate a need for professional evaluation is crucial for preventing complications.

Warning Signs Requiring Medical Attention

Seek medical care if you experience any of the following:

• Diarrhea lasting more than 3 days
• Severe abdominal or rectal pain
• Bloody or black stools
• High fever (above 102°F or 39°C)
• Signs of severe dehydration (extreme thirst, dry mouth, little to no urine output, severe weakness)
• Symptoms of shock (rapid heartbeat, cold and clammy skin, confusion)

Diagnostic Procedures for Persistent Diarrhea

If you seek medical attention for diarrhea, your healthcare provider may perform several tests to determine the cause:

1. Stool sample analysis to check for parasites, bacteria, or viruses
2. Blood tests to assess electrolyte levels and check for signs of infection
3. Colonoscopy or endoscopy in cases of chronic diarrhea to examine the intestines
4. Imaging studies like CT scans or ultrasounds if structural issues are suspected

How long should you wait before seeking medical attention for diarrhea. While mild cases often resolve within a few days, persistent diarrhea lasting more than 3 days, or accompanied by severe symptoms, warrants medical evaluation.

Prevention Strategies: Minimizing the Risk of Diarrhea

While not all cases of diarrhea can be prevented, adopting certain habits and practices can significantly reduce your risk of developing this condition. Understanding and implementing these preventive measures can help maintain digestive health and overall well-being.

Hygiene Practices

Proper hygiene is crucial in preventing many causes of diarrhea, especially those related to infections. Key practices include:

• Washing hands thoroughly with soap and water, especially before eating and after using the bathroom
• Using hand sanitizer when soap and water are unavailable
• Avoiding touching your face with unwashed hands
• Properly cleaning and disinfecting surfaces, especially in the kitchen and bathroom

Food Safety Measures

Many cases of diarrhea are caused by foodborne illnesses. To reduce this risk:

1. Wash fruits and vegetables thoroughly before consumption
2. Cook meats to appropriate temperatures
3. Avoid raw or unpasteurized dairy products
4. Store food at proper temperatures
5. Be cautious with street food and unfamiliar water sources when traveling

Lifestyle Considerations

Certain lifestyle factors can influence your susceptibility to diarrhea:

• Manage stress through relaxation techniques or exercise
• Maintain a balanced diet rich in fiber and probiotics
• Stay hydrated with clean water
• Exercise regularly to support overall health and immune function

Can dietary supplements help prevent diarrhea. While some supplements, like probiotics, may support digestive health, it’s important to consult with a healthcare provider before starting any supplement regimen, as individual needs vary.

Long-Term Management of Chronic Diarrhea

For individuals experiencing chronic or recurrent diarrhea, long-term management strategies are essential. Chronic diarrhea, defined as loose stools lasting for four weeks or more, often requires a comprehensive approach that addresses underlying causes and focuses on symptom management.

Identifying Underlying Causes

The first step in managing chronic diarrhea is identifying its root cause. This may involve:

• Comprehensive medical history review
• Physical examination
• Specialized tests (e.g., stool analysis, blood tests, endoscopy)
• Consultation with gastroenterology specialists

Tailored Treatment Plans

Once the cause is identified, treatment plans are tailored to the individual. These may include:

1. Dietary modifications (e.g., eliminating trigger foods, following a low-FODMAP diet)
2. Medications to address specific conditions (e.g., anti-inflammatory drugs for IBD, antibiotics for bacterial overgrowth)
3. Probiotics or prebiotics to support gut health
4. Stress management techniques
5. Regular follow-ups to monitor progress and adjust treatment as needed

Lifestyle Adjustments

Managing chronic diarrhea often requires long-term lifestyle adjustments:

• Maintaining a food and symptom diary to identify triggers
• Developing strategies for managing symptoms in social and work settings
• Ensuring adequate hydration and nutrition
• Exploring complementary therapies like acupuncture or herbal remedies (under medical supervision)

How can individuals with chronic diarrhea maintain a good quality of life. While managing chronic diarrhea can be challenging, working closely with healthcare providers, making necessary lifestyle adjustments, and staying informed about one’s condition can significantly improve quality of life and symptom control.

In conclusion, understanding diarrhea—its symptoms, causes, and management strategies—is crucial for effective treatment and prevention. Whether dealing with an acute bout or managing a chronic condition, proper hydration, dietary adjustments, and timely medical intervention when necessary are key components of care. By implementing preventive measures and staying attuned to your body’s signals, you can minimize the impact of diarrhea on your daily life and overall health. Remember, while most cases of diarrhea resolve on their own, persistent or severe symptoms should always be evaluated by a healthcare professional to ensure appropriate treatment and prevent complications.

NHS Scotland North

Diarrhoea can lead to dehydration and weight loss if left untreated.

What is diarrhoea?

Diarrhoea is the passage of three or more loose or liquid stools a day or more than your normal. The Bristol Stool Chart is a recognised pictorial diagram used in healthcare that you can use to classify your stools. Type 5, type 6 and type 7 may indicate diarrhoea.

Why might I be having diarrhoea?

There are many reasons why you may have diarrhoea. The management and treatment of it usually depends on the cause. It is therefore useful to know the reason for your diarrhoea.

Diarrhoea can occur due to the cancer itself or as a result of damage or irritation to the digestive tract caused by some cancer treatments. Other reasons include;

• Side effects of medication i.e. antibiotics, laxatives
• Constipation overflow
• Infection
• Malabsorption

You may be asked to provide a stool sample to check for any infection.

How can I manage Diarrhoea?

In addition to medication, changes to what you eat and drink can help.

Keep yourself hydrated

Although you may not feel like eating it is important that you do continue to eat and drink to keep yourself nourished and hydrated. Your body will lose a lot of water and salts if you have diarrhoea and you may be at risk of becoming dehydrated.

It can help to include drinks other than water to replace the salts. Tea, coffee, milk, water, fruit juice, soda, diluting juice, beef stock all count towards your body’s fluid intake. 

Sip fluid throughout the day and if you are going out take a drink with you.

Avoid known Irritants

These are food and drinks that are known to irritate the digestive tract. These can make your symptoms worse.

Keep a food and symptom diary

This can help to identify food and drinks that are troublesome for you. You may wish to avoid these foods to see if this helps. If you don’t notice an improvement with avoiding certain food and drinks try reintroducing these back in to your diet. It is important to have a varied diet to make sure you get everything you need. Avoiding certain food and drinks long-term unnecessarily is not recommended.

You can find details on a balanced diet here.

What about fibre?

As part of a healthy balanced diet the general population is encouraged to eat 30g fibre per day. This can be difficult to achieve particularly if you have a poor appetite.

If you are adding fibre to your diet do it gradually introducing 1-2 changes every few days. This will help your bowel adjust and avoid bloating and excess gas.

For more information on how to include fibre in your diet visit The British Dietetic Association or British Nutrition Foundation.

Some people find reducing the fibre content of their diet when they have symptoms of diarrhoea can help. As a starting point see below for examples of higher and lower fibre containing foods.

Higher fibre alternative	Lower fibre alternative
Seeded or wholemeal bread or bread products, pitta, wraps	White bread, white roll, white pitta bread, white wrap, crumpet, pancake
Oatcakes, Ryvita, flapjack	Cream crackers, breadsticks, rice cakes
Bran flakes, porridge oats, muesli, wholegrain cereal	Refined breakfast cereals i.e. corn or rice based cereal
Brown rice	White rice, basmati rice, noodles
Wholemeal pasta, quinoa	White pasta
Baked potato or boiled potato (with skin)	Mashed or boiled potato or baked potato (without skin)
Nuts, seeds	Ground nuts
Lentils, kidney beans, yellow-split peas, baked beans, chickpeas	Skinned chicken, white fish, hard-boiled egg, scrambled egg
Fruit Juice (with pulp/with bits)	Fruit Juice (without pulp/without bits), diluting juice
Dried apricots, raisins, prunes	Peeled, skinless or tinned fruit i. e. apple, peach, pear
Orange, satsuma, apple (with skin), pear (with skin), kiwi fruit with seeds, watermelon, pineapple	Skinless or tinned fruit i.e. apple, peach, pear, ripe galia melon, banana. Avoid orange piths.
Peas, sweetcorn, raw vegetables i.e. carrot and salad vegetables including cucumber, lettuce, tomato	Well-cooked fruit and vegetables i.e. carrot, broccoli or grated vegetables

What about fat?

A diet high in fat can contribute to diarrhoea. It may be worth considering reducing your intake or avoiding the following obvious sources of high-fat foods in the short-term:

• Batter
• Pastries
• Fried foods i.e. bacon, egg, sausages
• Take-aways

Pancreatic exocrine insufficiency (PEI) can lead to malabsorption of fat and result in diarrhoea. There are effective treatments for this if this is the reason for your diarrhoea. Please discuss this with a healthcare professional for more information.

Following a ‘low-fat’ diet without medical reason is not recommended when you have cancer. This can accelerate weight loss and mean that you miss out on vital nutrients. Click here for more information on a healthy balanced diet.

What about lactose?

Chemotherapy damages healthy gut cells. Lactose intolerance can occur as a result of chemotherapy treatment. This normally resolves when you stop chemotherapy treatment.

Following a lactose free diet during your treatment can help. If you choose to follow a lactose-free diet for the duration of your treatment please read the advice here to make sure you are taking in enough calcium.

If you are having radiotherapy treatment, the evidence does not support following a lactose-free diet unless you have been diagnosed with lactose intolerance.

What about probiotics?

Taking probiotics is not recommended for someone with cancer.

Cancer and cancer treatment can reduce your ability to fight infection. Probiotics contain live bacteria and so consuming probiotics with having a weakened immune system can increase your risk of developing an infection.

Probiotics have in some cases been found to limit the length of time you have diarrhoea for and there is evidence to support their use in those with irritable bowel syndrome however taking probiotics is not recommended for someone with cancer. To find out more about probiotics check out the British Dietetic Association fact sheet on Probiotics.

What if I have had radiotherapy to my pelvic area?

If you have diarrhoea as a result of radiotherapy treatment the evidence no longer suggests that restricting your fibre intake will help.

Continue to eat as you usually would do. If you have diarrhoea consider your fluid intake, avoid known irritants and take your medication as prescribed. If your symptoms continue discuss changes to your medication with your healthcare team.  An antispasmodic medication could help.                                          

If your symptoms continue consider asking for a referral to a dietitian.

What if I have diarrhoea related to immunotherapy?

If you have diarrhoea as a result of immunotherapy treatment you are recommended to follow the advice above. This includes;

• Keep yourself hydrated
• Avoid food and drinks that are known to irritate the gut (irritants)
• Discuss uncontrolled symptoms and medication with your healthcare team

If your diarrhoea is associated with colitis your healthcare team will manage this. You may also benefit from a referral to a dietitian.

What if I have a stoma?

The information on this page is not suitable for you if you have a stoma. Speak to your healthcare team if you are looking for advice specific to eating and drinking with a stoma.

What about medication?

Continue to take any medication as prescribed, even if you think these are contributing to your loose stools, for example, antibiotics.

Anti-diarrhoeal medication can help your symptoms. Speak to your healthcare team if you do not have medication to help your symptoms, to discuss changes to current medications or if your symptoms persist despite medication.

What You Should Know When Your Child Has Diarrhea| Banner

When your children are little, there are lots of unexpected and somewhat gross things you’ll have to tackle. Things like spit-up, snotty noses and yes, diarrhea. No one likes to have diarrhea, but it can be especially worrisome when it happens to your baby or child. As a parent, you want to help them feel better and keep them healthy.

Here’s what to know about the possible causes of your child’s diarrhea and what to do (and NOT to do) to help them feel better.

Is it loose stools or diarrhea?

As adults, it’s a little more obvious when we have diarrhea, but it can be hard to tell the difference between diarrhea and normal stools in children.

“Stools (or bowel movements) are considered to be diarrhea when they are not only looser than usual but also occur more frequently,” said Alyson Boone, CPNP-PC, a certified pediatric nurse practitioner in primary care with Banner Children’s. “Diarrhea can vary from loose to watery stools.”

What causes diarrhea in children?

Your child’s diarrhea may last one to two days and go away. If diarrhea lasts more than two days, they could have a more serious problem.

“Diarrhea can be acute (usually with illness) or chronic due to a health problem like irritable bowel syndrome or an intestinal disease, malabsorption (where the body is not able to properly absorb nutrients) or other autoimmune issues,” Boone said. “I would not be worried about it if it is a one-time loose stool. ”

Causes of diarrhea in children may include but are not limited to:

• An illness (viral and bacterial)
• Stress
• Trouble digesting food (food intolerance, such as lactose intolerance)
• Intestinal disease (ulcerative colitis, celiac disease or Crohn’s disease)
• A food allergy
• Excessive juice intake (usually more common in toddlers)
• A problem with how the stomach and bowels work (functional bowel disorder)
• Side effects from taking an antibiotic and medication
• Traveler’s diarrhea (visiting some foreign countries)

What are the symptoms of diarrhea in children?

Depending on its cause and each child, symptoms may occur a bit differently. If your child has diarrhea, they may have large, runny, frequent or watery poop. The color of their poop also might vary from shades of brown and green.

Other symptoms that can accompany diarrhea are stomach pain and cramping, an urgency to go, upset stomach, nausea and vomiting.

“In addition to diarrhea, I would encourage parents to watch for a set pattern, whether it occurs after eating/drinking certain foods or activity/stress, or for additional symptoms of an illness including fever, vomiting, fatigue or dehydration,” Boone said.

Acute diarrhea can often be treated at home. However, diarrhea is concerning if: 

• Blood is present, including both bright red or black tarry appearing stools (regardless of how long diarrhea has been present or how many stools in a day).
• It results in decreased urine production, dry mouth and no tears when your child cries (a sign of dehydration).
• Or it lasts longer than one to two weeks.

How is diarrhea treated?

Treating your child’s diarrhea will depend on many factors, including their symptoms, age, general health and severity, but at this age range hydration is very important.

“One of the most important things to remember with any illness (including diarrhea) is hydration,” Boone said. “If your child doesn’t want to eat but is willing to drink that is the best thing.”

But not all drinks are created equal. Pedialyte is formulated with the proper fluid and electrolytes to help with hydration. You should avoid giving your child drinks like Gatorade and fruit juices as the sugar content can often make diarrhea worse.

“With diarrhea, you can also become temporarily lactose intolerant so I usually recommend avoiding dairy products (including milk and cheese),”  Boone said.

Avoid products like Imodium (unless you know it is not infectious as it could make it worse) and if you choose to use Pepto Bismol, make sure it’s the pediatric version.

Boone also encourages giving your child food, but a bland diet, avoiding spices, greasiness, sugar and lactose/dairy. Starchy and soft foods are digested best. These foods include cereals, grains, crackers, rice, bananas and pasta.

For breastfed babies, Boone said to keep breastfeeding. “This is always best for diarrhea,” said Boone. If your baby is formula-fed, keep feeding them baby formula, unless it seems to be making them gassy or bloated. In this case, you should contact their provider to see if it should be avoided.

When should I reach out to my child’s health care provider?

Contact your child’s provider if your child has diarrhea and:

• The diarrhea lasts more than a few days.
• Blood is present in the diarrhea.
• They have an uncontrolled high fever (meaning it doesn’t go below 102 degrees even with treatment or is consistently over 103 when the treatment wears off).
• They haven’t had a wet diaper in at least eight hours or gone pee less than three to four times in a day.

Does my child need electrolytes?

Electrolyte solutions are very helpful for moderate to severe diarrhea but may not be required with mild diarrhea.

“These fluids have the right balance of water, sugar and salts,” Boone said.

Diarrhea dos and don’ts:

Do wash your hands often. Always wash your hands after changing diapers or your child’s hands after using the toilet. This is important in keeping the family safe, especially if diarrhea is related to a virus.

Do get your child to drink. Dehydration can occur quickly in young children. Ensure they are staying well hydrated.

Don’t give them sugary drinks. Gatorade, Kool-Aid and sodas contain too much sugar and not a lot of salt. Give them water and sugar-free fluids.

Do protect against diaper rash. Your baby’s skin can become irritated by diarrhea. Wash the area after each stool and protect it with a layer of petroleum jelly or ointment. Changing the diaper quickly after stools helps as well.

Don’t drink and eat certain things when you travel. If you’ll be visiting certain countries, especially those in developing nations, travel safety tips include:

• Not giving them or brushing their teeth with tap water.
• Not using ice made from tap water.
• Not drinking unpasteurized milk and juices.
• Not eating raw fruits and vegetables, unless they’ve been washed AND peeled by you.
• Not eating from street vendors or food trucks.

Takeaway

At some point in childhood, your little one will experience diarrhea or loose, watery stools. It can be caused by several things, including bacterial and viral infections.

Dehydration is a major concern at these ages, so make sure you’re helping your child replace lost fluids by drinking plenty of water.

If you have questions or concerns, contact your child’s provider right away.

Related articles:

• What Your Poop Is Telling You
• Is It Time to See an Expert for Your Child’s Tummy Trouble?
• Drink Up! Hydration Tips to Ensure Your Child Drinks Enough Water
• Baby Got Gas? Signs Your Baby Has Gas and Tips to Treat It

Children’s Health
Gastroenterology
Parenting

Chronic diarrhea in an adult.

With what it can be connected, stress or food?

Author, editor and medical expert – Zavgorodnyaya Ekaterina Aleksandrovna.

Editor and medical expert – Harutyunyan Mariam Harutyunovna.

Number of views: 667 887

Date last updated: 05/31/2023

Average reading time: 5 minutes

Contents:

Nutrition
Stress
Diseases of the pancreas and gallbladder
Treatment of chronic diarrhea
How to eat with chronic diarrhea as an adult?

Almost every person knows firsthand what diarrhea is. For some, diarrhea becomes permanent. If symptoms persist for more than 4 weeks, this indicates chronic diarrhoea. ² . With it, the stool becomes frequent, more than 3 times a day, but, more importantly, its consistency changes – poorly formed or completely liquid feces are excreted ² . Living with chronic diarrhea is extremely uncomfortable – it is impossible to be far from the toilet. The urge to defecate can come at the most inopportune moment, such as on the road, at an important meeting, or during a performance in the theater.

Why does diarrhea become permanent? What can be done to restore stool regularity? We’ll tell you in the article.

Nutrition

What we eat can become our medicine or “provoker” of digestive problems. For example, you decided to lose weight or radically change your diet and most likely made up your menu so that half of the diet was vegetables and fruits. But how does this change the work of your intestines? If you eat a lot of plant foods, the coarse fiber in its composition mechanically irritates the intestinal wall. Food moves faster, which causes a change in stool – it becomes more frequent and less hard ^1.9 .

Chronic diarrhea can also be caused or aggravated ¹ :

• fatty and fried foods ¹ ;
• coarse fiber, which is abundant in fruits and vegetables ¹ ;
• dairy products ¹ ;
• caffeinated drinks such as tea, coffee, cocoa ^{2. 9} .

Stress

Anxiety, poor sleep and chronic overwork do not pass without a trace – both the nervous system and different parts of the gastrointestinal tract react to overload ^1.3 . During strong emotional experiences, peristalsis intensifies – wavy contractions of the intestinal wall ¹⁰ . This mechanism underlies irritable bowel syndrome (IBS) ¹⁰ , which presents with chronic diarrhea and abdominal pain. The latter usually resolves after defecation ⁴ .

Diseases of the pancreas and gallbladder

Normally, the pancreas produces enzymes that are involved in the digestion of food in the small intestine. When overeating or against the background of long-term chronic inflammation, the death of gland cells occurs. As a result, the number of enzymes is sharply reduced, the absorption of nutrients is disturbed, and the person notes chronic diarrhea ⁴ .

Another possible cause of loose stools is an excess of bile acids. They are part of the bile and are involved in the breakdown of fats ² . If bile acids accumulate in large quantities in the small intestine ⁵ , chronic diarrhea may occur. For example, this problem often worries people who have had their gallbladder removed ⁵ . Due to the continuous release of bile into the intestines, the movement of its contents is accelerated ¹ .

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Treatment of chronic diarrhea

If you are experiencing chronic diarrhea, it is best not to delay your visit to the doctor. He will clarify the diagnosis and prescribe the necessary treatment. Self-medication is unacceptable, because simply eliminating the symptoms, you do not affect the cause of diarrhea. For example, chronic diarrhea may be a manifestation of an overactive thyroid or diabetes mellitus ² , as well as a side effect of medications ¹ .

Did you know that…

More than 700 drugs can cause chronic diarrhea as a side effect ¹ .

Depending on the cause and severity of chronic diarrhea, the doctor may prescribe drugs of different groups, for example ³ :

• anti-inflammatory drugs;
• antibiotics;
• digestive enzymes;
• probiotics containing bacteria;
• antidiarrheals.

Imodium ^® Express ⁸ can be used as a remedy for symptoms of chronic diarrhea. Its active ingredient, loperamide, acts on special receptors in the intestinal wall and, as a result, weakens intestinal motility;

Imodium ^® Express does not need to be taken with water – lyophilisate tablets dissolve on the tongue within seconds ⁸ .

How should adults eat with chronic diarrhea?

Changing your diet, diet, amount of food and fluids you drink can reduce the symptoms of chronic diarrhea and improve your well-being ⁷ . It is important that your diet remains complete and varied at the same time – this way you unload the intestines and speed up its recovery ⁶ . And in order to normalize the stool, try to eat little and more often ⁷ .

These recommendations may not work equally well for everyone, so it is important to always consult your doctor before making dietary changes ⁷ .

Causes and treatments for chronic diarrhea

The information in this article is for reference only and does not replace professional medical advice. For diagnosis and treatment, contact a qualified specialist.

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List of sources:

1. Schiller LR, Pardi DS, Sellin JH. Chronic Diarrhea: Diagnosis and Management. Clin Gastroenterol Hepatol. 2017 – URL: https://pubmed.ncbi.nlm.nih.gov/27496381/ Open link in new window
2. Arasaradnam RP et al. Guidelines for the investigation of chronic diarrhoea in adults: British Society of Gastroenterology, 3rd edition Gut 2018; 67:1380-1399.
3. Sarsenbayeva A. S., Lazebnik L. B. Diarrhea in adults. Clinical guidelines. Project. Experimental and clinical gastroenterology. 2020;178(6): 4–41.
4. Descoteaux-Friday GJ, Shrimanker I. Chronic Diarrhea. [Updated 2020 Nov 17]. In: StatPearls Publishing; 2021 Jan- URL: https://www.ncbi.nlm.nih.gov/books/NBK544337/ Open link in new window (Accessed: 09.12.2022, access mode – free).
5. Burgers K, Lindberg B, Bevis ZJ. Chronic Diarrhea in Adults: Evaluation and Differential Diagnosis. Am Fam Physician. 2020 Apr 15;101(8):472-480. – URL: https://pubmed.ncbi.nlm.nih.gov/32293842/ Open link in new window
6. LaRocque R et al. Approach to the adult with acute diarrhea in resource-rich settings // Uptodate: Professional Version 2020. – URL: https://www.uptodate.com/contents/approach-to-the-adult-with-acute-diarrhea-in -resource-rich-settings#h34 Open link in new window (Accessed: 09.12.2022, access mode – free).
7. Bonci L. Diet Strategies for Managing Chronic Diarrhea. International Foundation for Gastrointestinal Disorders, 2020.
8. Instructions for use of Imodium ^® Express//Reg.number N016140/01// GRLS RF. – URL: http://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=fdbc42af-4580-4ecd-93d8-2e9a965c707a&t= Open link in new window (date of access: 12/09/2022, access mode – free).
9. Bychkova T.S. Physiology of nutrition: a textbook for higher professional education / T.S. Bychkova, E.N. Artemov. – Eagle: FGBOU VPO “State University – UNPK”, 2013. – 163 p.
10. Gubergrits N.B., Belyaeva N.V., Agibalov A.N. IBS: effective treatment regardless of the change of scenery. Gastroenterology: abstract of the doctor, 2013. 41-45.

Diarrhea (Diarrhea) – Directory of diseases

Diarrhea (diarrhea, indigestion) is a digestive disorder in which bowel movements occur more than 2 times a day, while the stool is liquid. Diarrhea can be acute (comes on suddenly and resolves within 1-2 weeks) or chronic (lasting more than 2 weeks).

General

Diarrhea is often accompanied by abdominal cramps, vomiting, or high fever.

With diarrhea of ​​the small intestine, they are disturbed by: a rare stool, but large in volume, watery, with food debris. There is usually no pain in the abdomen.

Colon diarrhea is characterized by small, frequent stools that may contain blood, pus, and mucus. Often accompanied by abdominal pain.

Who gets diarrhea and how?

There are 2 types of diarrhea:

• When food passes too quickly through the intestines due to increased peristalsis (wave-like contraction of the walls).
• If water absorption in the large intestine is impaired or inflammatory fluid is secreted into the intestinal lumen, causing intestinal contents to liquefy.

There are 4 types of diarrhea:

• Exudative diarrhea is diagnosed in inflammatory bowel diseases (ulcerative colitis), in ischemic bowel disease. Manifestations: vomiting, pain syndrome, accelerated peristalsis and rapid evacuation of intestinal contents, impaired absorption of water from the intestines and digestive function, often with the development of fermentation and gas formation (flatulence). Exudative diarrhea also develops with bacterial acute intestinal infections, in which case they are called invasive. In this case, the bacteria damage the epithelium and can penetrate into the bloodstream with the development of sepsis (blood poisoning). Symptoms: vomiting, abdominal pain, fever, loose stools, often with blood and pus.
• Secretory diarrhea is caused by some laxatives and certain bacteria. In this case, only the small intestine is affected without the development of an inflammatory process, and the stool becomes liquid, plentiful, watery and without blood or pus. The disease begins with the appearance of frequent loose stools with a slight increase in body temperature, then vomiting occurs and dehydration quickly sets in.
• Osmotic (osmolar) diarrhea occurs when there is a deficiency of digestive enzymes (congenital enteropathy, chronic pancreatitis), removal of part of the small intestine, taking certain laxatives. In osmotic diarrhea, stools are copious and often contain large amounts of semi-digested food. Osmotic diarrhea can also be caused by viruses (most often rotaviruses). Rotavirus diarrhea is more common in children in the autumn-winter period.
• Hyper- and hypokinetic diarrhea. Hyperkinetic develops when intestinal motility is accelerated, for example, during stress during exams or with irritable bowel syndrome (“bear disease”). The chair is liquid or mushy, frequent, but its daily amount is normal and does not exceed 200-300 g. Hypokinetic diarrhea occurs less frequently. It is associated with excessive bacterial contamination of the small intestine.

Causes of diarrhea:

• Drinking unboiled contaminated water.
• Viral, bacterial or parasitic infection of the intestine.
• Intestinal infections: dysentery, salmonellosis, etc.
• Dysbacteriosis.
• Improper diet (for example, too much spicy or coarse plant foods).
• Inadequate diet.
• Food allergy.
• Food intolerance (eg lactose)
• Acute poisoning.
• Metabolic disorders.
• Chronic diseases of the digestive system (gastritis, colitis, enteritis, pancreatitis, hepatitis, etc.).
• Lack of vitamins K, F, B2 (riboflavin) and niacin.
• Emotional disorders.
• Stress.
• Changes in food, water and climate that occur during long-distance travel – “travelers’ diarrhea”. All known enteric pathogens can be causative agents.
• Drug use: antibiotics, some vitamin preparations, iron preparations, blood pressure lowering drugs, antidepressants.
• Parasites in the human body.
• Malabsorption syndrome.

When do you need to see a doctor?

• Diarrhea lasts more than 3-4 days.
• Blood streaks or mucus in the stool.
• Severe abdominal pain is a sign of acute surgical pathology.
• The temperature rises sharply.
• Tar-like (black) stools that occur when bleeding from the upper gastrointestinal tract.
• For severe dehydration.

How do I know if I have diarrhea?

If the diarrhea is very strong, then the urge to defecate practically follows each other. Also concerned about abdominal pain, flatulence, nausea and vomiting. The appetite disappears, the person loses weight.

Large stools are diagnosed with osmotic diarrhea. Profuse watery stools occur with secretory diarrhea. In this case, steatorrhea (fatty feces sticking to the walls of the toilet) is possible. Loose stools of small volume with mucus and blood – with exudative diarrhea. With hyper- and hypokinetic diarrhea, liquid or mushy stools of small volume are observed.

Stool testing, including stool testing for parasites, is required to determine the cause of diarrhea. For chronic diarrhea, bowel x-rays, endoscopy, and biopsy may be required.

What can diarrhea cause?

In acute diarrhea, the body loses significant amounts of water and minerals, which can lead to dehydration. Children and the elderly are most susceptible to dehydration.

Signs of dehydration: dry skin and oral mucosa, intense thirst, rapid breathing and pulse, infrequent urination, weakness, dizziness, sunken eyes. May intensify if, against the background of diarrhea, a temperature appears (for example, with intestinal infections) or vomiting (with poisoning).

This negatively affects blood circulation and the functioning of internal organs, for example, if potassium is lost, the function of the intestines and heart is disturbed. Even death is possible.

Chronic diarrhea may lead to anemia.

Due to the fact that diarrhea disrupts the digestion process, a large amount of undigested nutrients enter the large intestine, which in turn leads to the rapid development of bacteria and intoxication of the body.

How to protect yourself from diarrhea?

Wash your hands with warm water and soap after going to the toilet, changing your baby and before eating.

Wash hands, cutting boards and knives thoroughly after cutting meat. The meat must undergo a complete heat treatment.

Watch the expiration date of the food Do not leave the finished food in the heat for a long time.

Do not drink raw or unpurified water of unknown origin. To purify water, you need to boil it for 15 minutes, add tablets or drops of iodine and chlorine, or use a special filter.

Also, in no case should you eat unwashed fruits and vegetables (it is advisable to wash them only in clean water and very thoroughly, or even better, peel them).

What should I do if I have diarrhea?

The most important thing in the treatment of diarrhea (diarrhea) is to establish the cause of the disease. Your doctor may order tests for this. Treatment depends on the type of diarrhea.

Seek immediate medical attention if diarrhea persists for more than 2 days in children and more than 5 days in adults, or if you experience weight loss, signs of dehydration, severe abdominal cramps or pain, or if you have dark, bloody, or mucous stools.