Diarrhea and Gastroenteritis (Stomach Flu) in Children and Adults

Every year, millions of Americans come down with the “stomach flu,” or viral gastroenteritis. It can cause diarrhea, vomiting, cramps, fever, and headache. It’s also highly contagious. What treatments will make life with the stomach flu a little less awful? More importantly, how can you avoid getting it in the first place? Here are some answers.

What Is the Stomach Flu?

The stomach flu is not a single disease. Instead, it’s just a nickname for viral gastroenteritis, which is itself caused by a number of nasty viruses, such as noroviruses, rotaviruses, and adenoviruses.

These viruses target the digestive tract and cause inflammation of the stomach and intestines. The most awful symptoms — diarrhea, vomiting, and cramps — are actually your body’s defense mechanisms. Your body is trying to drive the virus out.

Stomach flu can develop at any time of the year, but it’s most common in the fall and winter in the U. S. Although unpleasant, stomach flu is rarely serious. Symptoms usually last for 1 to 3 days and sometimes longer. The greatest risk — especially in babies and older people — comes from dehydration. Untreated, dehydration can be dangerous.

Despite the name, stomach flu has nothing to do with the “true” flu, influenza. Influenza causes body ache and fever. It almost never causes diarrhea or vomiting in adults. Rarely, it can trigger vomiting in children.

Treating Gastroenteritis (Stomach Flu)

There is no cure for the stomach flu. Antibiotics don’t help, because it’s caused by viruses, not bacteria. For the most part, you just have to wait it out. In the meantime, there are some things you can do to make yourself more comfortable and prevent complications.

• Drink more. It’s important to increase fluid intake when you are vomiting or have diarrhea. Adults should aim to get one cup of fluid every hour. Children need 1 ounce of fluid every 30 to 60 minutes. Drink slowly, since too much at once could worsen vomiting. If your child tends to gulp, give them a frozen popsicle instead.
• Drink wisely. When you have diarrhea, drinking more water may not be enough. You’re losing important minerals and electrolytes that water can’t supply. Instead, ask your doctor about giving your sick child an oral rehydration solution such as CeraLyte, Infalyte, Naturalyte, Pedialyte, and generic brands. (If your baby is still nursing or using formula, keep feeding them as usual.) Adults can use oral rehydration solutions or diluted juices, diluted sports drinks, clear broth, or decaffeinated tea. Sugary, carbonated, caffeinated, or alcoholic drinks can make diarrhea worse, so be sure to dilute sugary beverages if you drink them.
• Don’t eat only bland foods. The old advice was to stick with a liquid diet for a few days and then to add in bland foods, such as the BRAT diet of bananas, rice, applesauce, and toast. That’s fine for the first day or so of stomach flu. However, doctors say that you should return to your normal diet as soon as you feel up to it. BRAT foods aren’t bad. They just don’t provide the fat and protein that you need. Sticking with them too long could actually slow your recovery.
• Get the right nutrients. Look for foods with potassium (such as potatoes, bananas, and fruit juices), salt (such as pretzels and soup), and yogurt with active bacterial cultures. Even a little fat could help, because it slows down digestion and may reduce diarrhea. If you feel up to it, add a pat of butter or some lean meat to your next meal.
• Use over-the-counter medications. They’re not necessary, but some people find relief in medications for diarrhea and vomiting. Just use them with care, and read and follow the label instructions. Never give a medication for diarrhea or vomiting to a child unless a pediatrician says that you should.
• Rest. Give your body time to recover.

Protecting Yourself from Gastroenteritis (Stomach Flu)

The viruses that cause gastroenteritis come from contact with an infected person’s stool. You may get it if a person with the virus didn’t wash their hands after using the bathroom and then touched the escalator at the mall — the same escalator you touched before eating lunch. Stomach flu viruses are tough, too. Some can live on surfaces such as counters for months.

It’s important to take steps to protect yourself and your family. Here’s some advice.

• Wash your hands. According to experts, this is still the best way to stop a stomach virus. One review of studies found that good hand-washing technique cut the rate of diarrhea by 40%. Make sure to use soap and water and do it thoroughly — wash your hands for as long as it takes to recite the alphabet. Always wash your hands after using the bathroom, before eating, and after changing a diaper.
• Use hand sanitizer. If you’re not near a sink to wash your hands, use an alcohol-based hand sanitizer. Be aware that hand sanitizer may not be as effective as hand washing at preventing the stomach flu.
• Wipe down surfaces. If a family member has the stomach flu, wash off high-traffic areas — such as the bathroom, door knobs, phones, and TV remotes — with a diluted bleach solution. If it’s possible, keep healthy people out of the bathroom the sick person is using.
• Make sure your kids get their vaccines.Vaccines for rotavirus can protect children from some types of stomach flu. Kids usually get the vaccines before they are age 2.

When to See a Doctor

Most people don’t need to see the doctor when they have the stomach flu. But it’s a good idea to get medical attention if you or your child has stomach flu and:

• Is under 3 months old
• Is over 3 months old and has been vomiting for more than 12 hours or the diarrhea hasn’t gotten better after two days
• Is an adult and the diarrhea hasn’t gotten a little better after two days
• Has other symptoms, such as high fever or blood or pus in the stool

In rare cases, people with stomach flu need to be hospitalized, usually because of dehydration. In adults, dehydration can cause extreme thirst, decreased urination, dark urine, dry skin, fatigue, and dizziness. In babies and young children, dehydration can cause:

• Crying without tears
• Going three hours or more without a wet diaper
• Fever
• Dry tongue and mouth
• Extreme crankiness
• Sunken fontanel, the soft spot on the top of a baby’s head
• Sunken cheeks or eyes

Anyone with signs of dehydration needs medical help right away.

Loperamide Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Before taking loperamide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: stomach/abdominal pain without diarrhea, bowel obstruction (e. g., ileus, megacolon, abdominal distention).

Antibiotics may rarely cause a severe intestinal condition due to a bacteria called C. difficile. Symptoms include: diarrhea that doesn’t stop, abdominal or stomach pain/cramping, or blood/mucus in your stool. This condition may occur during treatment or weeks to months after treatment has stopped. This medication may make this condition worse. Do not use this anti-diarrhea product, especially after recent antibiotic use, if you have the above symptoms without talking with your doctor first.

This medication should not be used without seeing your doctor first if you have certain medical conditions. These symptoms/conditions may require other treatment before you can use this medication safely. Before using this medication, tell your doctor or pharmacist your medical history, especially of: black/tarry stool, blood/mucus in your stool, high fever, HIV infection/AIDS, liver problems, certain stomach/intestinal infections (e.g., Salmonella, Shigella), certain type of bowel disease (acute ulcerative colitis).

Loperamide may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using loperamide, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using loperamide safely.

This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Liquid forms of this product may contain sugar and/or alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease. Ask your doctor or pharmacist about using this product safely.

Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above).

Children may be more sensitive to the effects of this drug, especially drowsiness. Children are also at a higher risk for dehydration. See also Warning and How to Use sections.

During pregnancy, this medication should be used only if clearly needed. Discuss the risks and benefits with your doctor.

This drug passes into breast milk but is unlikely to have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Symptoms, Causes, Diagnosis, Treatment, Prevention

Diverticulosis is when pockets called diverticula form in the walls of your digestive tract.

The inner layer of your intestine pushes through weak spots in the outer lining. This pressure makes them bulge out, making little pouches. Most often it happens in your colon, the lower part of your large intestine.

Is It the Same As Diverticulitis?

No. Diverticulitis happens if one or more of the pockets gets inflamed or infected. This can cause severe pain in your belly. Diverticulosis often brings no symptoms at all.

Who’s at Risk?

Diverticulosis is common in people over age 60. It doesn’t happen often to those younger than 30. Experts think the pouches show more with age. Men might get it more than women.

Research shows the condition might be genetic. That means you’re more likely to get it if your parents or any of your brothers or sisters have it.

What Causes It?

Doctors aren’t sure. Some think muscle spasms or strain (like when you have a bowel movement) make pressure build in your colon and push against the lining.

In the past, most experts thought not eating enough fiber — which is found in many fruits and vegetables, grains, and beans — led to diverticulosis. But recent studies haven’t shown a clear link between the condition and eating fiber.

Your doctor will ask about your eating habits and health history before suggesting you tweak your diet.

What Are the Symptoms?

Most people who have diverticulosis don’t show any signs. Those who do might have:

A doctor likely will suggest some ways to relieve your symptoms, like taking a mild pain reliever, while they pinpoints the cause. Conditions such as irritable bowel syndrome and peptic ulcers can cause similar symptoms, so they’ll want to rule them out.

How Is It Diagnosed?

Most doctors don’t notice cases of diverticulosis until they screen for other conditions. For instance, the pouches might show up in a colonoscopy, or an X-ray.

Your doctor might take these steps to know for sure:

Gather your medical history. They’ll ask you about your diet, general health, meds you take, and how often you have bowel movements.

Do a physical exam. This may include a digital rectal exam. With a lubricated gloved finger, they’ll gently check your anus for bleeding, pain, or other signs.

Perform tests. These might include:

• A CT scanmakes images of your digestive tract
• A colonoscopy looks in your rectum and colon
• A blood sample shows if you have signs like anemia or inflammation
• A lower GI series uses X-rays to get a better look at your large intestine

What’s the Treatment?

The main goal is keep the pockets from causing problems. Your doctor might prescribe treatments that include:

High-fiber diet or fiber supplements. This will depend on how much your doctor thinks fiber (or the lack of it) might play into your condition. Fiber-rich foods reduce gas and pain in your stomach.

They might suggest a fiber product like Citrucel or Metamucil. They come in pill, powder or wafer forms. You’ll take it with lots of water.

Meds that help ease symptoms. These might include mesalazine.

Probiotics. Research is still being done on how probiotics — live bacteria that live in your stomach and intestines — can help fight diverticulosis symptoms. Yogurt and supplements are good sources.

It’s important to check with your doctor before taking supplements of any kind.

What About Nuts and Seeds?

In the past, doctors thought you had to avoid certain foods if you had diverticulosis. These included nuts, seeds like sunflower and sesame, and even little seeds in fruits and vegetables such as cucumbers and strawberries. But recent research shows these foods don’t harm people with diverticulosis.

Can I Prevent Diverticulosis?

This condition is much more common now than it was 100 years ago. Many doctors believe our modern diet – which features lots of refined carbs and keeps you from getting enough fiber – plays the biggest role in whether you get it.

Other possible risk factors include:

Possible Complications

Having diverticulosis doesn’t mean you’ll have more problems, but they can happen. For example:

Sacs can get infected, and even burst. This is diverticulitis. It’s treated with rest, fluids, and antibiotics.

The infection can spread and an abscess can form. A specialist will need to drain the pus.

A perforation (a hole along the stomach wall) can occur. It’s rare, but life-threatening and requires immediate surgery.

You can get a diverticular hemorrhage. This is rare. It happens when your arteries wear through the intestinal wall. It causes massive bleeding and requires hospitalization and blood transfusions.

Anti-diarrheal Medicines: OTC Relief for Diarrhea

Diarrhea is when you have frequent and liquid bowel movements. Many things can cause it, including:

• Viruses.
• Bacteria and parasites.
• Medicines such as antibiotics.
• Lactose intolerance.
• Fructose or artificial sweeteners.
• Digestive disorders such as celiac disease or irritable bowel syndrome.

It is a common condition that most of the time doesn’t require treatment. It usually lasts only a couple of days, whether you treat it or not. But medicine can help you feel better. It especially helps if you also have cramping or stomach pain.

What types of OTC medicines treat diarrhea?

You can buy over-the-counter (OTC) medicines without a prescription from your doctor. Some OTC medicines can help you feel better if you have diarrhea. These are called antidiarrheal medicines. Antidiarrheal medicines include:

• Loperamide (1 brand name: Imodium).
• Bismuth subsalicylate (2 brand names: Kaopectate, Pepto-Bismol).

Bismuth subsalicylate can also be used for an upset stomach.

Path to Improved Wellness

How do OTC antidiarrheal medicines work?

Loperamide slows down how fast things move through your intestines (bowels). This allows more fluid to be absorbed into your body. This helps you have less diarrhea and more formed stools.

Bismuth subsalicylate balances the way fluid moves through your intestines. It reduces inflammation. It keeps bacteria and viruses that cause diarrhea from growing in the stomach and intestines.

How do I safely take OTC antidiarrheal medicines?

Before you take an OTC antidiarrheal medicine, read the directions on the drug facts label. This will tell you how much medicine to take and how often to take it. If you have any questions, call your family doctor or pharmacist. Keep a record of which OTC medicines you are using and when you take them. If you need to go to the doctor, take this list with you.

Follow these tips to make sure you are taking the right amount of medicine:

• Take only the amount recommended on the medicine’s label. Don’t assume that more medicine will work better or quicker. Taking more than the recommended amount can be dangerous.
• If you take prescription medicine, ask your doctor if it’s okay to take OTC antidiarrheal medicine.
• Don’t use more than one OTC antidiarrheal medicine at a time unless your doctor says it’s okay. They may have similar active ingredients. These could add up to be too much medicine.

How can I safely store OTC antidiarrheal medicines?

Store all medicines up and away, out of reach and sight of young children. Keep medicines in a cool, dry place. This will help prevent them from becoming less effective. Do not store medicines in bathrooms or bathroom cabinets. They are often hot and humid.

Things to Consider

Healthy adults usually don’t experience side effects from antidiarrheal medicines. But side effects may be a concern if you are older or have health problems. Call your doctor if you notice any side effects.

Loperamide side effects may include:

• Abdominal pain.
• Constipation.
• Dizziness.
• Nausea or vomiting.

Bismuth subsalicylate side effects may include:

• Constipation.
• Blackened stools and/or tongue.
• Ringing sound in the ear (called tinnitus).

Who shouldn’t take OTC antidiarrheal medicines?

Don’t take antidiarrheal medicines if bacteria or parasites are causing your diarrhea. If you have a “stomach bug,” your body needs to get rid of the bacteria or parasite that is causing the diarrhea. Stopping the diarrhea in this case can actually make your condition worse. Talk to your family doctor if you think you have a bacterial or parasitic infection.

Don’t give loperamide to children 2 years of age or younger unless your doctor says it’s okay. Check with your doctor before using loperamide for older children, as well.

You shouldn’t take loperamide if you have a fever. Don’t use it if you’ve ever had a rash or an allergic reaction after taking it. Don’t take loperamide if you have bloody or black stools. These may be signs of a more serious problem, such as a bacterial infection.

Some people are allergic to aspirin or other salicylate medicines. They should not take bismuth subsalicylate. Don’t give bismuth subsalicylate to children 12 years of age or younger. Don’t give it to children or teenagers who may have the flu or chickenpox. This increases their risk for Reye syndrome. This is a serious illness that can lead to death.

Can OTC antidiarrheal medicines cause problems with other medicines I take?

Taking certain medicines with antidiarrheal medicines can increase your risk for side effects. Bismuth subsalicylate also may affect some medicines, causing them not to work as well. Ask your doctor before taking loperamide or bismuth subsalicylate if you also take:

• Antibiotics.
• Antiviral medicines for human immunodeficiency virus (HIV).
• Prescription pain medicines.
• Blood-thinning medicines.
• Medicines for gout.
• Medicines for arthritis.
• Medicines for diabetes.

Also ask your doctor before taking bismuth subsalicylate if you take pain relievers or cold medicines. These medicines may contain aspirin, which is a salicylate. You may get too much salicylate if you take more than one of these medicines at a time.

When should I call my doctor?

Talk to your doctor before taking an antidiarrheal medicine if:

• Your diarrhea lasts longer than 2 days.
• You have a fever.
• You have mucus or blood in your stools.
• You have a history of liver disease.
• You are taking prescription medicine.

Questions to Ask Your Doctor

• What is causing my diarrhea?
• How long will it last if I don’t treat it?
• Will taking an OTC antidiarrheal medicine shorten the length of time the diarrhea lasts?
• What can I be doing to treat my diarrhea in addition to taking OTC medicines?
• Will antidiarrheal medicines make me constipated?
• What side effects should I watch out for if I take antidiarrheal medicine?

Resources

International Foundation for Gastrointestinal Disorders: Antidiarrheal Agents

Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Diarrhea and Cancer Treatment – Side Effects

Drink plenty of fluids, to prevent dehydration. It may also help to avoid certain foods, such as dairy products. Talk with your doctor to learn what medicine to take.

Credit: iStock

What Is Diarrhea?

Diarrhea means having bowel movements that are soft, loose, or watery more often than normal. If diarrhea is severe or lasts a long time, the body does not absorb enough water and nutrients. This can cause you to become dehydrated or malnourished.

What Causes Diarrhea?

Cancer treatments, or the cancer itself, may cause diarrhea or make it worse. Some medicines, infections, and stress can also cause diarrhea. Tell your health care team if you have diarrhea.

What Are the Dangers of Diarrhea?

Diarrhea that leads to dehydration (the loss of too much fluid from the body) and low levels of salt and potassium (important minerals needed by the body) can be life threatening. Call your health care team if you feel dizzy or lightheaded, have dark yellow urine or are not urinating, or have a fever of 100.5 °F (38 °C) or higher.

Ways to Manage Diarrhea

You may be advised to take steps to prevent complications from diarrhea:

• Drink plenty of fluid each day. Most people need to drink 8 to 12 cups of fluid each day. Ask your doctor or nurse how much fluid you should drink each day. For severe diarrhea, only clear liquids or IV (intravenous) fluids may be advised for a short period.
• Eat small meals that are easy on your stomach. Eat six to eight small meals throughout the day, instead of three large meals. Foods high in potassium and sodium (minerals you lose when you have diarrhea) are good food choices, for most people. Limit or avoid foods and drinks that can make your diarrhea worse.
• Check before taking medicine. Check with your doctor or nurse before taking medicine for diarrhea. Your doctor will prescribe the correct medicine for you.
• Keep your anal area clean and dry. Try using warm water and wipes to stay clean. It may help to take warm, shallow baths. These are called sitz baths.

Questions to Ask Your Health Care Team about Diarrhea

Prepare for your visit by making a list of questions to ask. Consider adding these questions to your list:

• What is causing the diarrhea?
• What symptoms should I call you about?
• How much liquid should I drink each day?
• Can I speak to a registered dietitian to learn more about foods and drinks that are best for me?
• What medicine or other steps can I take to prevent diarrhea and to decrease rectal pain?

Listen to tips on how to manage diarrhea caused by your cancer treatments such as radiation therapy.
(Type: MP3 | Time: 2:55 | Size: 2.7MB)
View Transcript

Chronic Diarrhea Treatments | Stanford Health Care

Treatments for Chronic Diarrhea

Once we determine the cause of your diarrhea, we work with you to develop a personalized treatment plan. If you are not comfortable taking a lot of medications, we may recommend alternative therapies, such as herbal supplements. If your treatment includes medical nutrition therapy, we take time to understand your food preferences before recommending changes to your diet.

Chronic diarrhea treatments may include:

• Anti-diarrheal medicine: Medicines to slow movement in your intestines or make your bowel movements less watery
• Antibiotics: If your chronic diarrhea is due to a bacterial infection, you will need antibiotics to get rid of it.
• Fiber supplements: You may need a fiber supplement to add bulk to your stool (bulk forming laxative). This can help make your stool less watery.
• Medical nutrition therapy: Working with experts from Nutrition Services who specialize in gastrointestinal disorders, we help you find foods that are less likely to cause diarrhea. This may include avoiding fatty foods and too much fruit.
• Oral rehydration therapy: Drinking a rehydration solution can help you replace lost minerals and body fluids, if your diarrhea causes dehydration.
• Pain management: Offering innovative approaches, experts at Stanford Health Care’s GI Pain Clinic address the source of your pain. Your treatment may include medications, stress management, or alternative therapies, such as acupuncture.
• Total parenteral nutrition: Getting all the nutrition you need from special fluids you receive through a catheter (thin, spaghetti-like tube) in your vein. Total parenteral nutrition can help you if your intestines need time to heal or your stomach has lost its ability to absorb nutrients from food taken by mouth.
• Tube feeding: Helping you get adequate nutrition when your body is not getting enough nutrients from food by mouth, tube feeding works by delivering specially formulated liquid nutrition directly to your stomach through a special tube, also known as a percutaneous endoscopic gastrostomy (PEG) tube.

Diarrhea and Diet – Gastrointestinal Society

What is diarrhea?

Diarrhea is defined as the frequent passage of watery, loose stools, accompanied by an excessive loss of fluid and electrolytes. Another standard definition of diarrhea is passing more than three liquid bowel movements daily, or more than one litre of stool from an ileostomy or colostomy per day. Diarrhea occurs because the contents of the gastrointestinal tract are moving too rapidly, causing less fluid and nutrients to be absorbed.

What causes diarrhea?

Diarrhea is classified into four categories: osmotic, secretory, exudative, or rapid intestinal transit diarrhea.

Osmotic diarrhea is caused by the presence of solutes in the gastrointestinal tract that are poorly absorbed and produce an osmotic effect. The osmotic effect is the movement of water from low solute concentration to high solute concentration. The causes of osmotic diarrhea may be lactose intolerance, fat malabsorption, dumping syndrome after gastric surgery, or certain medications (i.e. hypertonic or sorbitol-containing liquid medications).

Secretory diarrhea occurs when there is an over secretion of water and salts in the intestine, which is caused by bacterial toxins (Clostridium difficile, E. coli, etc.), caffeine, viruses, or increased bile acids following an ileal resection.

Exudative diarrhea is associated with damage to the intestinal mucosa, leading to the release or oozing of mucus, blood, and plasma proteins from cells as result of inflammation or injury. This increases the fluid content of feces and is present in ulcerative colitis, Crohn’s disease, or radiation enteritis.

Finally, rapid intestinal transit diarrhea is defined as an increase in propulsive activity in the colon. When the colon contracts more intensely than normal, food is passed more quickly through the digestive system and less water is absorbed back into the body, making the stool too watery. Causes of this type of diarrhea are irritable bowel syndrome, surgical bypass, gastric and intestinal resections, antibiotics, or stress.

How can diarrhea be prevented?

Prevention of diarrhea depends on the underlying cause. If medications are causing a person to experience diarrhea, an alternative form (i.e. tablet instead of sorbitol-containing liquid) or type of medication should be explored, especially when diarrhea is chronic. Some people who are malnourished or on bowel rest, may experience diarrhea for the first few days when starting to eat again because the bowel wall’s ability to function decreases when it is not used and resumes normal function slowly. Consult your physician to determine the underlying cause and treatment for your diarrhea, especially if there is any associated pain, blood, or distension.

Dietary Recommendations for Diarrhea:

• Drink 8-10 cups of fluid per day, like water, broth, half-strength juice, weak tea, or electrolyte replacement drinks.
• Eat small frequent meals slowly during the day.
• Try sources of soluble fibre to help firm up stool.
• Limit fried or fatty foods since these can worsen diarrhea.
• Some high fibre foods may contribute to diarrhea.
• Foods with lots of sugar may worsen diarrhea, such as regular pop, candy, large quantities of juice, and chocolate milk.
• Some people may become temporarily lactose intolerant when experiencing diarrhea (so can benefit from lower lactose choices, such as cheese, yoghurt, Lactaid® milk or Lactaid® pills).
• Consult your physician to determine if an anti-diarrheal medication is suitable for you.

The following foods may be better tolerated:

Foods to limit:

Mary Flesher, Clinical Dietitian

First published in the

Inside Tract® newsletter issue 139 – September/October 2003

Image: Tharakorn | bigstockphoto.com

90,000 Watery diarrhea – causes, diagnosis and treatment

Watery diarrhea is a multiple (up to 15-20 times a day) bowel movement, which is accompanied by the release of loose loose stools. Usually the symptom is combined with other dyspeptic disorders: vomiting, cramps, abdominal pain. Diarrhea with water is most often associated with intestinal infections, but can be observed with non-infectious bowel pathologies, enzyme deficiency. To establish the causes of diarrhea, ultrasound, radiography, endoscopy, laboratory tests are used.To stop diarrhea, adsorbents, enveloping and astringent preparations are used.

Causes of watery diarrhea

Water bowel movements often indicate infectious or non-infectious intestinal diseases. Sometimes pregnant women complain about the appearance of liquid unformed feces, which is caused by gestational changes in the digestive and endocrine systems. In children, watery stools can be a sign of a toxic form of dyspepsia or the initial stage of colitis.Diarrhea with water with dyspeptic disorders, weakness, hemorrhages is characteristic of alimentary-toxic aleukia. Profuse diarrhea occurs in 90% of patients with toxic shock.

Bacterial infections

Ingestion of pathogenic intestinal microflora, as a rule, is accompanied by secretory watery diarrhea. Bacteria are able to secrete a specific enterotoxin that affects the epithelial cells of the mucous membrane and causes the accumulation of adenylate cyclase, cAMP.This contributes to an increased release of ions into the intestinal lumen, followed by a large amount of fluid entering the intestine along the concentration gradient. The condition is aggravated by concomitant inflammatory lesions of the gastrointestinal tract. The following intestinal infections lead to diarrhea with water:

• Cholera . This infectious disease manifests itself with diarrhea, which quickly loses fecal character and odor, becoming watery. Several hours later, repeated vomiting joins, which aggravates the condition, provoking severe dehydration.A distinctive feature is the complete absence of abdominal pain or moderate discomfort, detected in no more than 30% of patients.
• Escherichiosis . Watery diarrhea often develops when infected with enterotoxigenic strains of the microbe, when the disease proceeds as a mild variant of cholera. In young children, water-borne diarrhea is usually caused by enteropathogenic strains. Diarrhea is combined with vomiting, pain in the epigastrium, along the intestines. An increase in body temperature to subfebrile numbers is possible.General condition of patients of moderate severity.
• Salmonellosis . Dyspeptic disorders are the main manifestations of the gastrointestinal form of infection. The first symptoms of salmonellosis are general intoxication and headache, after a few hours there are severe cramping pains in the intestines, profuse bowel movements, first with the release of unformed feces, and then water with food particles, mucus. Greenish frothy stools (“swamp mud”) are characteristic.
• Botulism .With the gastroenterological variant of the infection, dyspeptic symptoms come to the fore: watery diarrhea, repeated vomiting, spastic abdominal pain. Patients complain of dry mouth, sensation of a lump in the throat. For botulism, eye manifestations are characteristic: double vision, flashing “flies” before the eyes, blurred vision. In severe cases, there are paresis, paralysis of facial muscles with facial asymmetry.
• Campylobacteriosis . The disease begins acutely with a rise in temperature to 38 ° C or more, pain in muscles and joints.Multiple diarrhea immediately joins with the release of liquid fetid feces, in which streaks of mucus and blood are revealed. Patients often complain of abdominal cramps, while nausea and vomiting occur in only a quarter of campylobacteriosis patients.

Viral infections

Dyspeptic disorders, in particular watery diarrhea, are considered the main manifestations of most viral intestinal lesions. When viruses enter the gastrointestinal tract, they multiply inside the epithelial cells, causing their death and desquamation from the mucosal surface, which leads to disruption of parietal digestion, diarrhea.Pathogens also slow down the processes of reabsorption of water from the intestinal lumen, which causes profuse diarrhea. The most common viral diseases with intestinal damage:

• Rotavirus gastroenteritis . Watery stools are the main manifestation of rotavirus infection. With a mild variant, the frequency of defecation is up to 10 times per day, the bowel movements are fecal in nature, with a severe course, profuse diarrhea with the discharge of a cloudy, fetid yellow-green fluid is the leading one.Diarrhea is combined with cramping pain in the umbilical region, subfebrile fever.
• Norovirus infection . Norovirus is characterized by simultaneous damage to the respiratory and digestive systems. The disease begins with a sore throat, nasal congestion, then dyspepsia joins – watery feces, vomiting, abdominal pain. Repeated bowel movements with the release of a large volume of fluid becomes a prerequisite for severe dehydration, which is manifested by dry skin, mucous membranes, decreased blood pressure, oliguria.
• Hong Kong Flu . With this type of influenza infection, symptoms from the gastrointestinal tract are combined with signs of damage to the respiratory system, general intoxication of the body. Along with headache, high fever, repeated diarrhea with water, moderate pain in the abdomen, nausea, and lack of appetite are noted. Respiratory manifestations (dry cough, sore throat, nasal congestion) occur on day 2-3 of the illness.
• Hemorrhagic fever Marburg. The disease manifests itself acutely with the appearance of headache, myalgia, conjunctivitis, erosions on the oral mucosa. Dyspeptic disorders in the form of watery diarrhea, vomiting, severe pain in the abdominal cavity develop on the 3-4th day of hemorrhagic fever. Pathognomonic signs – maculopapular rash, uterine, nose and gastrointestinal bleeding, appearing on 5-6 days of illness.
• HIV infection . AIDS is characterized by abundant watery stools without pathological inclusions, caused by digestive disorders and the addition of a secondary infection against the background of severe immunodeficiency.In addition to loose stools, other nonspecific symptoms are determined – prolonged low-grade fever, increased sweating at night. Most patients lose more than 10% of their body weight.

Protozoal and helminthic invasions

Helminths and protozoa have a direct pathogenic effect on the enterocytes of the mucous membrane, causing severe disturbances in the digestion and absorption of food components. Severe malabsorption syndrome in combination with increased secretion of water and electrolytes into the intestinal cavity provokes profuse diarrhea.With insufficient replacement of fluid losses, dehydration syndrome of varying severity develops. Watery diarrhea is noted with invasions such as:

• Cryptosporidiosis . Protozoa parasitize in the lumen of the small intestine, potentiating malabsorption and inhibition of the activity of digestive enzymes, as a result of which a watery stool with a fetid odor appears. Diarrhea is accompanied by severe abdominal cramps, nausea, and vomiting. The disease more often affects people with immunodeficiencies.In such cases, there is a long course (up to 4 months) with severe dehydration.
• Strongyloidosis . Intestinal manifestations are noted in the second phase of the disease, after 2-3 weeks from the onset of the first symptoms – urticaria, rashes and arthralgia. The development of diarrhea is associated with inflammatory lesions of the small intestinal mucosa, the formation of hemorrhages, erosions. In addition to diarrhea, the appearance of pain in the epigastric region, nausea, and vomiting is typical. Sometimes there is jaundice of the skin, pain in the right hypochondrium.

Non-communicable bowel diseases

Watery diarrhea often complicates the course of organic diseases of the digestive tract, especially in the initial stages. The increase in the volume of feces is due to both disturbances in the processes of parietal and cavity digestion, and the effect of various inflammatory mediators. Diarrhea is associated with disorders of intestinal motility in a hyperkinetic or hypokinetic type. With a change in the frequency and consistency of stools, the following non-infectious pathologies of the gastrointestinal tract occur:

• Enteritis .Watery diarrhea is a symptom of non-infectious inflammation of the small intestine that is allergic, medicinal, or autoimmune. The appearance of thin, fetid feces is mainly caused by the syndromes of malabsorption and maldigestion. The chair is observed up to 10-15 times during the day, accompanied by flatulence, rumbling in the abdomen, decreased appetite, nausea, significant loss of body weight.
• Enteropathy . Chronic watery diarrhea occurs with non-inflammatory intestinal pathologies.A change in the consistency of feces can be caused by both fermentopathies and impaired gastrointestinal motility (for example, a hypomotor variant of diabetic enteropathy). The pain syndrome is poorly expressed, digestive disorders predominate, contributing to weight loss, protein-energy deficiency.
• Acute colitis . Colitis is characterized by spasms in the left iliac region, painful urge to defecate, the presence of pathological impurities of mucus, blood in the stool.The stool at first has a fecal character, a fetid odor, as the disease progresses, it becomes watery. The frequency of bowel movements reaches 25 times a day. Similar changes are observed in pseudomembranous colitis with exudative enteropathy.

Enzyme deficiency

In the absence of enzymes in the initial sections of the small intestine, the appearance of profuse diarrhea with water is associated with the osmotic mechanism. The presence of a large number of undigested large molecules, especially disaccharides and peptones, is a prerequisite for an increase in pressure in the intestinal lumen, the release of fluid and sodium ions.Diarrhea occurs with fibrosis of the pancreas and a decrease in its exocrine function by 80-90%, as a result of which the digestion of all types of food is impaired. The condition is aggravated by the addition of a secretory mechanism of diarrhea associated with the activation of cAMP.

Watery stools are possible with gastrinoma, Zollinger-Ellison syndrome. Increased secretion of gastrin and hydrochloric acid leads to the destruction of digestive enzymes, an increase in the osmolarity of the chyme. Diarrhea is combined with intense epigastric pain, sour belching.In children, water excretion is a consequence of galactosemia – milk intolerance due to a congenital absence of an enzyme. The symptom appears immediately after the start of breastfeeding, accompanied by malnutrition, jaundice, suppression of reflexes.

Survey

Watery diarrhea always indicates a problem with the digestive system. Examination of patients with complaints of watery diarrhea is carried out by a gastroenterologist or infectious disease specialist. To verify the clinical diagnosis, a comprehensive examination of the gastrointestinal tract is necessary using laboratory and instrumental methods to detect morphological changes and establish the cause of diarrhea.The most valuable in terms of diagnostics are:

• Radiography . With the help of plain radiography of the abdominal cavity, the condition of the patient’s gastrointestinal tract is quickly assessed. For a detailed study of the inner surface of the digestive tract, oral contrasting with barium sulfate is used. The method is quite informative in detecting non-infectious processes that cause watery stools.
• Ultrasound examination The non-invasive examination method is used as a screening diagnosis to exclude severe organic diseases of the digestive system, neoplasms.Ultrasound of the abdominal cavity can reveal signs of an inflammatory process. Sonography is also done to assess the condition of the pancreas.
• Stool analysis . To study the processes of digestion, absorption of food, a microscopic examination of feces with measurement of pH is carried out. Watery diarrhea is often caused by infectious processes, therefore, all patients undergo bacteriological culture of feces, analysis for helminth eggs. To exclude ulcerative-destructive processes, the Gregersen reaction is shown.
• Serological tests . The search for antimicrobial antibodies or specific antigens in the blood is the most accurate way to identify various infectious diseases, especially of a viral nature. The study is not informative enough in the first few days from the onset of the disease, when the concentration of antibodies has not yet increased in the blood.

As an additional general clinical method, a biochemical blood test is used to help determine the degree of malabsorption and protein deficiency.If specific lesions of the gastrointestinal tract are suspected, endoscopic examination with biopsy is recommended. To assess the exocrine function of the pancreas, a blood test for amylase, lipase is sometimes prescribed.

Adsorbents are used to reduce the frequency of watery diarrhea

Symptomatic therapy

Diet correction required. In case of an acute disorder, a starvation diet is shown with the gradual introduction of rice dishes, products containing pectins, salted soups, broths, dietary protein foods (veal, turkey, chicken, hard-boiled eggs).With diarrhea, a significant amount of fluid is lost in water, therefore, if the patient is in a satisfactory condition, it is important to provide plenty of fluids to prevent severe dehydration.

Adsorbents, astringents and coating agents are used to reduce the incidence of watery diarrhea until the exact cause of stool disturbances is established. In no case should you take medications that inhibit intestinal peristalsis, as this can increase intoxication and lead to a deterioration in the patient’s condition.Antibacterial agents and antidiarrheal drugs are selected only by a doctor, taking into account the results of the examination, the sensitivity of pathogenic microorganisms.

90,000 how to recognize, what to do, what to give a baby for diarrhea?

Mom very quickly learns to recognize what exactly causes her baby to cry: whether it is hunger, a wet diaper or discomfort in the tummy. But if in the first two cases the problem is easy to solve, then, unfortunately, it is much more difficult to determine the root cause of abdominal discomfort.

Often, young mothers lose peace and sleep, blame themselves for hypothermia of the crumbs, non-compliance with the diet and, as a result, spoiled milk, and also find thousands of other probable reasons. We warn parents against premature conclusions and offer to sort out this delicate issue.

Signs of diarrhea in an infant

How do you know if your baby’s digestion is normal or needs to be corrected? How many times a day should babies have bowel movements and what is the acceptable stool consistency? Let’s figure it out.

The following factors may indicate a stool disorder in a child of the first year of life:

• watery stools with greens . Liquid gray-green feces, often mixed with mucus, are typical for children in the first week and a half of life and should not cause concern for parents. The baby’s body is in a transitional period, when the intestine adapts to dairy food and acquires its own microflora.
  Hardness of feces should not be expected for at least the next three months.Breast milk has a laxative effect, causing soft stools that resemble fermented baked milk or liquid porridge in consistency. The normal color of feces in the first months of life is yellow or mustard. The presence of a milk protein smell is noticeable.
  Thus, loose stools by themselves are not a symptom of diarrhea, but should alert in conjunction with a pungent smell of feces, bloating and cramps in the tummy;
• Frequent and abundant stools . Stool frequency is also a very conditional sign.The average rate at this time is considered to be “big hikes” from four to eight times a day. However, the baby can stain diapers and literally after every “snack”, that is, up to 12 times daily.
  At the same time, even an excessively liquid bowel movement eight times a day may indicate problems, if, for example, the baby has been pooping four or less times a day, while having a good appetite and healthy sleep;
• weakness, anxiety, crying . The slightest change in the child’s mood and behavior will not hide from the sensitive mother’s attention.If an active and smiling baby has become lethargic, refuses habitual games and sleeps more than usual, this is a reason to be wary. Physical weakness against the background of frequent urge to use the toilet can signal a lack of beneficial bacteria in the microflora, which help to digest food and assimilate nutrients.
  Indigestion is quite painful even for adults. And for kids, this is a test at all. Painful sensations in the abdomen can cause moods, prolonged crying, night awakenings.Even in the absence of other symptoms, if this continues for more than one day, you need to see a doctor;
• Blood, mucus or foam in stool . Bloody, frothy impurities and mucus in the stool can seriously alarm mothers. In this case, foam in loose stools can occur due to improper attachment to the chest, which is not so difficult to eliminate. Foaming is possible if the baby receives only foremilk, that is, he is not admitted to the “food source” for long enough, or the mother alternates breasts too often.When feeding is established, bubbles and foam in the feces are no longer detected.
  Mucus in moderate doses should also not cause parental concern. It is another matter if orange or green flakes are present in the mucus. So often salmonellosis or coli-infection – Escherichia coli is manifested.
  Diarrhea with bright scarlet blood splashes is dangerous. It may indicate intestinal colitis, which causes inflammatory-dystrophic changes in the intestines, or dysentery, an acute intestinal infection;
• temperature rise .A high temperature in combination with loose stools can be a symptom of non-infectious diarrhea: this is how the body reacts, for example, to teething, which is also indicated by swollen gums and profuse salivation. In this case, you just need to help the baby to get distracted and endure two or three painful days, after which the first teeth will appear. But infectious diarrhea requires immediate medical attention.

As you can see, the symptoms of diarrhea in infants are sometimes a variant of the norm, but they can also indicate conditions that are dangerous to health.When you can cope on your own, and when you definitely need to see a doctor, how to treat diarrhea in a child, depends on the root cause of the stool disorder.

Why does a child have diarrhea: possible causes

Diarrhea in a baby can be caused by various reasons. Diarrhea can be manifested by flu or sore throat – a serious test for the fragile immunity of the baby. It is possible to assume acute respiratory infections if there is a cough, nasal congestion, redness and swelling of the nasopharyngeal organs. The surest solution is to call a pediatrician at home.If the parents also notice a rash, it is worth calling a doctor immediately: perhaps the baby has caught scarlet fever, measles or rubella.

Diarrhea can also indicate an intestinal infection or food poisoning, for example, if the child has eaten expired or allergic foods. An upset stool of a newborn can also be provoked by the use of “unwanted” foods by a nursing mother, such as mushrooms, sausage, soda, citrus fruits.

Diarrhea, coupled with an increase in temperature, is found in serious surgical problems: peritonitis, appendicitis, volvulus.Often, pathologies of the gastrointestinal tract are also accompanied by vomiting.

One of the most common causes of loose stools in a baby is dysbiosis – a violation of the amount and composition of the beneficial intestinal microflora. Nine out of ten babies under the age of one year face this phenomenon, the WHO does not even classify it as a disease. More often and longer diarrhea against the background of dysbiosis occurs in weakened, premature babies.

The causes of dysbiosis and, as a consequence, diarrhea in infants can be as follows:

• late attachment to the breast .Even a half-hour delay between childbirth and the first feeding can adversely affect the health of the baby. Colostrum is rich in components that stimulate the development and growth of bifidobacteria, and their deficiency can manifest as diarrhea in a newborn. For the mother, the consequences are also unpleasant: it is fraught with a decrease or even disappearance of milk, a longer and more painful period of postpartum rehabilitation;
• artificial feeding . High-quality and carefully selected milk formula is a worthy alternative to mother’s milk, but it cannot fully replace it.Together with the mother’s milk, the baby receives immune protection, which helps his intestines to suppress the growth of pathogenic bacteria and increase the number of beneficial microorganisms;
• Inadequate or improper nutrition . A balanced diet and a regulated diet are the basis for proper physical development, well-being and mood of the baby;
• lactose intolerance . The children’s body’s rejection of milk protein, one of the foundations of nutrition for babies under one year old, is a big problem.By assimilating lactose, the body receives the “building blocks” necessary for the growth and development of cells. And loose stools are even the lesser of the evils caused by lactose intolerance;
• Diseases causing malabsorption in the intestine . Maldigestion (improper digestion) syndrome can be caused by various causes. The most obvious are inflammatory or chronic diseases of the gastrointestinal tract: stomach, pancreas, small intestine. Among them: gastroduodenitis, peptic ulcer disease, ulcerative colitis.But malabsorption of nutrients can also be caused by malfunctions of other organs and systems, such as the liver or cardiovascular system. Only medical diagnostics and test results can indicate the root cause of health problems;
• allergic diseases . Food allergies and atopic dermatitis also often lead to loose stools. Unfortunately, allergies are a scourge of the modern world, and a rare person has not encountered the manifestations of this autoimmune disease.Diarrhea is one of the attempts of a small organism to resist allergens, to physically get rid of them. Unfortunately, this does not always turn out to be an effective measure in the fight against the disease – rather, on the contrary. Due to insufficient supply of nutrients, the body quickly depletes energy reserves and weakens. If you suspect an allergy, you need to contact a pediatrician as soon as possible and consult an allergist;
• acute infectious diseases . A child can also react to intestinal infections, flu and other gastrointestinal diseases with loose stools.This is a self-cleaning mechanism, the release of pathogenic microbes from the body. However, the efforts of a fragile infant organism, as a rule, are not enough, medical assistance is needed;
• Long-term use of antibiotics and other drugs weakens the immune system and destroys the healthy microflora involved in the breakdown and assimilation of food. Antibiotics are equally ruthless against pathogenic and beneficial bacteria. After completing the course of treatment, the number of “correct” microorganisms must be urgently restored.

Why a child has diarrhea in a specific, individual case, can only be answered by a doctor – pediatrician, infectious disease specialist, allergist or other narrow specialist.

What to do when a child has diarrhea

The main advice for mothers: do not be afraid to tell the doctor about the problem, even if friends and relatives insist that this is normal and will soon go away on its own. Diarrhea that lasts for several days can be a symptom of a serious medical condition that needs to be diagnosed and treated as soon as possible.

What can you give a baby for diarrhea? Do not self-medicate: the child’s body is too fragile, and experiments are unacceptable. You can give probiotics on your own, but before taking them, you should still consult with a pediatrician.

Below are general guidelines for parents who are dealing with loose stools in toddlers. So, if the baby has diarrhea, you need to:

• change diapers more often . Diarrhea irritates the delicate skin of babies, and the longer it comes into contact with the stool, the greater the baby’s discomfort.In addition, even the most breathable diaper creates a greenhouse effect, and bacteria develop in the warmth that attack the skin and the genitourinary system of the crumbs. This causes inflammation and infection, such as cystitis;
• Give plenty of fluids . If the baby has loose stools, there is a large loss of water, the body becomes dehydrated. Lack of fluid, which serves as the basis of life, leads to the failure of many important processes. It is necessary to avoid dehydration and give the child more water than usual.Additional water intake is also useful because toxins and bacteria will be washed out of the digestive tract along with it, which will accelerate recovery;
• Harvest complementary foods . If the child has just begun to get used to new food and this coincided with an attack of diarrhea, then complementary foods should be abandoned. Diarrhea can be a reaction to inappropriate food. And even if it’s not about her, during the fight against the disease it is better to return to proven and more familiar food for the baby;
• Give rice water .This tip is suitable for parents whose baby is over nine months old. Rice broth is a proven remedy for centuries for improving digestion and strengthening stool. Rice not only does not cause food allergies, but can also help fight it: it binds and removes toxins and allergens from the body;
• use probiotics . To restore normal intestinal microflora, it will be useful for a child to drink probiotics. Since the composition of the intestinal microflora is diverse, it is better to give the child a combined complex of bifidobacteria and lactobacilli.It will be useful for nursing mothers themselves to drink a course of probiotics, which with milk will enter the infant’s digestive system.

The presence of probiotic microorganisms is the norm for the human intestinal microflora: they suppress the growth of harmful bacteria, participate in digestion processes and increase the body’s resistance to infectious threats.

Digestion is one of the most important functions of the body. And the slightest failures in it on the principle of falling dominoes can lead to a whole series of unpleasant consequences.Children’s diarrhea is, first of all, a protective reaction of the body and a signal about violations that may not reveal themselves in another way. It is important to pay close attention to this signal and respond to it in time.

Diarrhea in Coronavirus Infection – Enterol

Does COVID-19 have diarrhea?

In addition to loss of smell, fever and cough, in about half of cases, there are gastrointestinal manifestations of COVID-19: diarrhea, nausea, vomiting and abdominal discomfort [1 p. 1408].The most common of these is diarrhea (loose stools ≥ 3 times a day) [1 page 1409]. According to the data available today, diarrhea with COVID-19 occurs on average in 8% of cases (from 2% to 24%), and these symptoms occur more often in women [1 p. 1409; 2 page 3].

Can covid start with diarrhea? On what day does diarrhea appear with COVID-19?

The study showed that in patients with mild coronavirus infection and diarrhea in 20% of cases, it was the first manifestation of the disease [2 page 3].In the rest, these stool disorders develop in the first 10 days after the onset of respiratory symptoms [2 p. 3]. They can last from 1 day to 2 weeks, on average – 5 days, and usually pass before the 13th day of illness [2 p. 9; 3]. Fever and diarrhea with COVID-19 are also not uncommon: fever was observed in 62% of patients with gastrointestinal symptoms [3].

Could COVID-19 diarrhea be a predictor?

One small study found that patients who had symptoms from the digestive system for the first manifestations of coronavirus infection had a more severe course of the disease and required a longer hospital stay [1 page 1409].However, this conclusion was made on the basis of an analysis of a very small sample of only 50 patients. The World Gastroenterological Organization does not consider gastrointestinal symptoms to be the main factors that can predict the prognosis of the disease [4].

The mechanism of development of diarrhea in COVID-19

Any virus can cause disease only by penetrating into the cell. For the coronavirus, these “gates” are ACE2 receptors [1 page 1407]. Most of them are in the respiratory tract and gastrointestinal tract, and therefore, these are the most susceptible to the effects of coronavirus infection [1 page 1407].In the intestine, these receptors are responsible for the exchange of amino acids and the regulation of the microbiota – the community of microorganisms that inhabit our digestive tract [1 page 1409]. Binding of SARS-CoV-2 to ACE2 receptors can cause imbalance of these microbes – dysbiosis, which in turn can cause the development of diarrhea [1 page 1409]. Conversely, the intestinal microbiota affects the number of ACE2 receptors and thereby determines the body’s susceptibility to infection and the severity of its course [2 p. 11]. Therefore, a diet rich in plant foods and fiber, as a guarantee of “healthy” intestinal microflora, is especially important during a pandemic.

How to treat diarrhea with coronavirus infection?

Vomiting and diarrhea in COVID-19 are usually mild and tend to go away on their own, therefore supportive and symptomatic therapy is usually sufficient [2 page 11]. Treatment of any viral diarrhea primarily consists in replenishing the loss of fluid and salts, for which you can use special rehydration mixtures that are sold in pharmacies. There is still no specific antiviral treatment for SARS-CoV-2 infection, and antibiotics are not only unable to affect the virus, but can also cause dysbiosis and diarrhea [2, page 19].These drugs should be taken exclusively as directed by your healthcare professional if you suspect a secondary bacterial infection.

Given the important role of the gut microbiota in the formation of the immune response and the development of stool disorders in coronavirus infection, probiotics can be a rational therapeutic intervention [2, p. 19]. Enterol, as an effective remedy for viral intestinal infections, can also have a positive effect on coronavirus diarrhea due to the elimination of dysbiosis and the enhancement of nonspecific immune defense.

Diarrhea is the most common gastrointestinal manifestation of SARS-CoV-2 infection. An imbalance in the intestinal microbiota plays a significant role in its development. Based on this, the use of probiotics may be justified in patients with coronavirus diarrhea.

References

1. Troisi J, Venutolo G, Pujolassos Tanyà M, Delli Carri M, Landolfi A, Fasano A. COVID-19 and the gastrointestinal tract: Source of infection or merely a target of the inflammatory process following SARS-CoV-2 infection? World J Gastroenterol 2021; 27 (14): 1406-1418 [doi: 10.3748 / wjg.v27.i14.1406]

2. Kariyawasam JC, Jayarajah U, Riza R, Abeysuriya V, Seneviratne SL. Gastrointestinal manifestations in COVID-19. Trans R Soc Trop Med Hyg. 2021 Mar 16: trab042. doi: 10.1093 / trstmh / trab042. Epub ahead of print. PMID: 33728439; PMCID: PMC7989191.
3. Han C, Duan C, Zhang S, et al. Digestive symptoms in COVID-19 patients with mild disease severity: clinical presentation, stool viral RNA testing, and outcomes. Am J Gastroenterol. 2020; 115 (6): 916-23
4. Jean-Christophe Saurin, COVID-19 Situation in the World and Particular Role of the WGO VOL.25, ISSUE 2 MARCH 2021

Enterol 119 06/07/21

Diarrhea: treatment, causes, symptoms – ProMedicina Ufa

Diarrhea (diarrhea) – frequent, frequent loose stools. Diarrhea is usually accompanied by pain, rumbling in the abdomen, and flatulence. Diarrhea is a symptom of many infectious diseases and inflammatory bowel processes, dysbiosis, neurogenic disorders. Therefore, the diagnosis and treatment of the underlying disease plays an important role in the prevention of complications.The loss of large amounts of fluid in sudden diarrhea leads to a water-salt imbalance and can cause heart and kidney failure.

Causes and symptoms of the disease

There are acute and chronic forms of diarrhea. Acute diarrhea is associated with intestinal infection and has a viral, bacterial and parasitic nature lasting up to 4 weeks. Chronic diarrhea is associated with diseases of the digestive system and lasts more than 4 weeks.

Acute diarrhea is transmitted by the fecal-oral route, through the consumption of food and water contaminated with microorganisms.The causative agents of diarrhea are: bacteria (E. coli, salmonella, dysentery bacteria, cholera vibrio), viruses (rotaviruses, adenoviruses, enteroviruses) and protozoa (lamblia, dysentery amoeba).

Acute intestinal infection caused by Escherichia coli proceeds with moderate phenomena of general intoxication: chills, weakness, decreased appetite, fever up to 38 C, paroxysmal pain in the lower abdomen, false urge to defecate, loose stools up to 10 times a day.Symptoms last no more than a week.

Diarrhea caused by salmonella, dysentery bacteria is severe. Frequent watery stools up to 10-30 times a day, mixed with blood and pus. Abdominal pain, false urge to defecate. During and after defecation, tenesmus occurs – a pulling nature of pain in the rectal area, the temperature rises to 40 C. Due to dehydration of the body, tachycardia occurs, a decrease in blood pressure, dry skin, and weakness.

Diarrhea caused by parasitic pathogens (amoeba, lamblia) develops gradually and manifests itself as bloody diarrhea, constant abdominal pain.

Diagnostics

To make a diagnosis, it is necessary to conduct a bacteriological examination of feces, an analysis of feces for eggs of worms, an analysis of feces for occult blood, a study of feces for dysbiosis.

Coprocytogram – will help to identify the inflammatory process in the intestine, and the degree of food digestion. A general blood test is necessary to determine the signs of acute or chronic inflammation, the presence of anemia. In chronic diarrhea, colonoscopy is performed, sigmoidoscopy – to exclude pathology of the colon.

To assess the motor function of the intestine, to identify organic changes in the intestine, an X-ray examination is performed, and the doctor may also prescribe an ultrasound of the abdominal cavity and small pelvis.

Treatment

Diet is essential for treating diarrheal syndrome. The food is fractional, all dishes are steamed or boiled, spicy, salty, fried, smoked food, alcoholic beverages, canned food, carbonated drinks, coffee, chocolate are excluded. It is recommended to take slimy soups, rice porridge, crackers, baked potatoes, boiled eggs.

For diarrhea, they take enveloping agents, adsorbents that adsorb and remove viruses, pathogenic bacteria, toxins, intestinal gases from the body.

90,000 Protocols for the diagnosis and treatment of irritable bowel syndrome (IBS) in RB

Irritable bowel syndrome (hereinafter – IBS) – functional disorder
intestines, in which abdominal pain is combined with defecation disorders and
intestinal transit.

Normal stool – in healthy adults with mixed
diet, stool frequency ranges from 3 times a day to 3 times a week, stool weight –
100-250 g / day, the stool has a shaped consistency.

Irritable bowel syndrome according to ICD-10 is classified as:

• K58.0 irritable bowel syndrome with diarrhea;
• K58.9 irritable bowel syndrome without diarrhea.

The clinical criteria for IBS are:

• pain and / or discomfort in the abdomen; reduction of pain and
  discomfort after bowel movements; no night pain;
• diarrhea without blood, mainly in the morning after breakfast, sometimes with
  an admixture of mucus and undigested food residues; imperative urge to defecate;
  no diarrhea at night;
• constipation (stool less than 3 times a week, dense), the need for intensive
  straining during bowel movements, a feeling of incomplete emptying of the intestines;
  fragmented stools with mucus production;
• alternating diarrhea and constipation;

90,015 swelling;

• absence of “symptoms of anxiety”: diarrhea at night, blood in the stool, decreased
  body weight, fever, anemia, laboratory signs of inflammation.

The diagnosis of Irritable Bowel Syndrome is established when the patient’s symptoms match all
the following criteria are used to classify IBS:

The severity of IBS is determined by assessing the severity
the dominant manifestation in the patient (diarrhea, constipation, abdominal pain).

The goal of treating irritable bowel syndrome in a patient is:

There is no indication for hospitalization of a patient with IBS.In some cases, hospitalization is allowed for examination
patient, which is impossible on an outpatient basis

Monitoring the effectiveness of patient treatment is carried out clinically
relief of complaints.

Patients with IBS belong to the dispensary observation group D (II).

Diarrhea in a dog, what to do and what to treat at home

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