What is the connection between migraine headaches and diarrhea. How can you identify and manage these symptoms effectively. What are the risk factors and potential treatments for migraine-related gastrointestinal issues.

The Relationship Between Migraine Headaches and Gastrointestinal Symptoms

Migraine headaches are often accompanied by a range of symptoms, including gastrointestinal disturbances such as diarrhea. While the exact mechanism behind this connection remains unclear, research suggests a potential link between migraines and various gastrointestinal disorders. Understanding this relationship can help individuals better manage their symptoms and seek appropriate treatment.

Common Gastrointestinal Disorders Associated with Migraines

• Irritable bowel syndrome (IBS)
• Inflammatory bowel disease (IBD)
• Celiac disease

These conditions share some common features with migraine headaches, including inflammation and altered gut-brain communication. The presence of generalized inflammation may contribute to both migraine symptoms and gastrointestinal disturbances.

Understanding Migraine Headaches: Causes and Triggers

Migraine headaches are characterized by intense, throbbing pain, often localized to one side of the head. While the exact cause remains unknown, experts believe that temporary changes in brain chemicals, nerves, and blood vessels play a significant role. Identifying and managing triggers is crucial for effective migraine prevention and treatment.

Common Migraine Triggers

• Fatigue and sleep disturbances
• Stress and anxiety
• Hunger and dehydration
• Hormonal fluctuations, particularly in women
• Sensory stimulation (e.g., loud noises, bright lights)
• Certain foods and food additives
• Caffeinated beverages

Are all migraine triggers equally impactful for everyone? No, migraine triggers can vary significantly from person to person. What triggers a migraine in one individual may have no effect on another. This variability underscores the importance of maintaining a personal migraine diary to identify and manage individual triggers effectively.

Recognizing Migraine Symptoms: Beyond the Headache

While severe head pain is the hallmark of migraine headaches, these episodes often involve a constellation of symptoms that can significantly impact daily life. Understanding the full range of migraine symptoms can help individuals recognize the onset of an attack and seek appropriate treatment promptly.

Common Migraine Symptoms

1. Intense, throbbing head pain (often unilateral)
2. Sensitivity to light, sound, and smells
3. Nausea and vomiting
4. Neck pain or stiffness
5. Visual disturbances (aura)
6. Numbness or tingling sensations
7. Difficulty concentrating
8. Mood changes (anxiety, irritability, depression)
9. Fatigue and insomnia

Can migraine symptoms vary between attacks? Yes, migraine symptoms can differ from one episode to another, even in the same individual. Some attacks may be preceded by an aura, while others may not. The severity and duration of symptoms can also fluctuate, making each migraine experience unique.

Diagnosing Migraine Headaches with Gastrointestinal Symptoms

Accurately diagnosing migraine headaches, particularly when accompanied by gastrointestinal symptoms like diarrhea, requires a comprehensive approach. Healthcare providers typically rely on a combination of medical history, symptom evaluation, and targeted diagnostic tests to rule out other potential causes and confirm the diagnosis.

Diagnostic Approaches for Migraine and Gastrointestinal Symptoms

• Detailed medical history and symptom assessment
• Food allergy and intolerance testing
• Stool tests to rule out infections or other GI disorders
• Blood tests to check for underlying conditions
• Fasting tests to identify potential food-related triggers
• Hydrogen breath tests to assess carbohydrate malabsorption
• Endoscopy to examine the digestive tract (if necessary)
• Imaging studies (e.g., CT scan) to rule out structural brain abnormalities

Is a specific test required to diagnose migraines? No, there is no single definitive test for diagnosing migraines. The diagnosis is primarily based on the patient’s reported symptoms, medical history, and the exclusion of other potential causes. However, additional tests may be conducted to rule out other conditions and ensure an accurate diagnosis.

Treatment Options for Migraine Headaches and Associated Diarrhea

Managing migraine headaches with concurrent gastrointestinal symptoms often requires a multifaceted approach. Treatment strategies may include a combination of lifestyle modifications, trigger avoidance, and targeted medications to address both neurological and digestive symptoms.

Lifestyle Modifications and Non-Pharmacological Approaches

1. Keeping a detailed food and symptom diary
2. Identifying and avoiding personal migraine triggers
3. Implementing stress management techniques (e.g., meditation, yoga)
4. Maintaining regular sleep patterns
5. Staying hydrated and eating regular, balanced meals
6. Engaging in regular physical activity
7. Practicing relaxation techniques and biofeedback therapy

Pharmacological Treatments for Migraines

• FDA-approved migraine-specific medications:
  • Erenumab
  • Lasmiditan
  • Ubrogepant
• Antidepressants (e.g., amitriptyline, nortriptyline)
• Anti-epileptic medications
• Over-the-counter pain relievers (used judiciously)

Managing Diarrhea Associated with Migraines

• Over-the-counter antidiarrheal medications (e.g., loperamide, bismuth subsalicylate)
• Proper hydration and electrolyte replacement
• Dietary modifications to reduce gastrointestinal irritation
• Probiotics to support gut health

Can all migraine medications be used to treat associated diarrhea? No, migraine medications are specifically designed to target neurological symptoms and may not directly address gastrointestinal issues. It’s essential to work with a healthcare provider to develop a comprehensive treatment plan that addresses both migraine and diarrhea symptoms effectively.

Preventing Migraine Headaches: Strategies for Long-Term Management

While complete prevention of migraine headaches may not be possible for all individuals, implementing certain strategies can help reduce the frequency and severity of attacks. A proactive approach to migraine management can significantly improve quality of life and minimize the impact of associated symptoms like diarrhea.

Key Prevention Strategies

1. Consistent trigger identification and avoidance
2. Regular stress management and relaxation practices
3. Maintaining a consistent sleep schedule
4. Adopting a balanced, migraine-friendly diet
5. Regular exercise and physical activity
6. Proper hydration and nutrition
7. Consistent use of prescribed preventive medications
8. Regular follow-ups with healthcare providers

Is it possible to completely eliminate migraine triggers? While complete elimination of all triggers may be challenging, identifying and managing key triggers can significantly reduce migraine frequency and severity. The goal is to minimize exposure to known triggers while developing coping strategies for unavoidable ones.

Risk Factors for Migraine Headaches and Associated Gastrointestinal Symptoms

Understanding the risk factors associated with migraine headaches and related gastrointestinal symptoms can help individuals and healthcare providers develop targeted prevention and management strategies. While some risk factors are beyond an individual’s control, awareness can lead to more effective monitoring and early intervention.

Common Risk Factors for Migraines

• Gender (more common in women)
• Family history of migraines
• Age (onset typically occurs before age 40)
• Hormonal changes (e.g., menstruation, pregnancy, menopause)
• Certain medical conditions (e.g., depression, anxiety, sleep disorders)
• History of head or neck trauma
• Obesity
• Excessive caffeine or alcohol consumption

Risk Factors for Gastrointestinal Symptoms in Migraine Sufferers

• Pre-existing gastrointestinal disorders (e.g., IBS, IBD)
• Food intolerances or allergies
• Stress and anxiety
• Certain medications (including some migraine treatments)
• Irregular eating habits
• Dehydration

Do all migraine sufferers experience gastrointestinal symptoms? No, not all individuals with migraines will experience gastrointestinal symptoms like diarrhea. The presence and severity of these symptoms can vary widely among migraine sufferers, underscoring the importance of personalized assessment and treatment approaches.

The Impact of Migraine Headaches and Diarrhea on Quality of Life

Migraine headaches, particularly when accompanied by gastrointestinal symptoms like diarrhea, can significantly impact an individual’s quality of life. Understanding these effects is crucial for developing comprehensive management strategies and providing appropriate support to those affected by these conditions.

Areas of Life Impacted by Migraines and Associated Symptoms

1. Work productivity and absenteeism
2. Social relationships and activities
3. Family life and responsibilities
4. Mental health and emotional well-being
5. Physical health and overall energy levels
6. Sleep quality and patterns
7. Ability to engage in hobbies and leisure activities
8. Financial burden due to medical expenses and lost work time

How can individuals minimize the impact of migraines on their daily lives? Developing a comprehensive management plan that includes trigger avoidance, stress reduction techniques, and appropriate medical treatment can help reduce the frequency and severity of migraine attacks. Additionally, open communication with family, friends, and employers about the condition can foster understanding and support, making it easier to navigate challenging episodes.

Emerging Research and Future Directions in Migraine and Gastrointestinal Symptom Management

As our understanding of the complex relationship between migraine headaches and gastrointestinal symptoms continues to evolve, researchers are exploring new avenues for diagnosis, treatment, and prevention. These advancements hold promise for improving the lives of individuals affected by these often debilitating conditions.

Areas of Ongoing Research and Development

• Genetic markers for migraine susceptibility
• Role of the gut microbiome in migraine pathophysiology
• Novel pharmacological targets for migraine prevention and treatment
• Advanced neuroimaging techniques for migraine diagnosis and monitoring
• Personalized medicine approaches based on individual genetic and environmental factors
• Non-invasive neuromodulation techniques for migraine management
• Comprehensive gut-brain axis interventions for managing migraines and gastrointestinal symptoms

What potential breakthroughs can we expect in migraine treatment in the coming years? While it’s difficult to predict specific breakthroughs, ongoing research in areas such as personalized medicine, neuromodulation, and gut-brain interactions shows promise for developing more targeted and effective treatments. These advancements may lead to improved quality of life for individuals suffering from migraines and associated gastrointestinal symptoms.

As research continues to unravel the complex relationship between migraine headaches and gastrointestinal symptoms like diarrhea, individuals affected by these conditions can look forward to more tailored and effective management strategies. By staying informed about the latest developments and working closely with healthcare providers, those experiencing migraines and associated symptoms can take proactive steps towards better health and improved quality of life.

Link, treatment, and risk factors.

Migraine headaches can cause extreme discomfort and pain, along with a range of other symptoms. Some people may experience nausea and diarrhea during a migraine episode.

This article discusses the link between migraine headaches and diarrhea, as well as the possible risk factors that could lead to such symptoms. We also outline the potential treatment options for migraine headaches and diarrhea.

Share on PinterestManaging stress levels may help treat migraine headaches and diarrhea.

Migraine headaches may occur alongside a range of other symptoms, including diarrhea. People who experience diarrhea will pass loose, watery stools at least three times per day.

It is unclear why migraine headaches might lead to diarrhea. According to a 2014 review, some studies show a link between migraine headaches and gastrointestinal (GI) disorders. Examples include:

• irritable bowel syndrome
• inflammatory bowel disease
• celiac disease

According to the review, generalized inflammation is one possible factor that could explain the occurrence of both a migraine headache and diarrhea.

A migraine headache is an intense pulsing or throbbing pain in the head. An “aura,” which is a visual or auditory disturbance, often precedes these headaches.

The exact cause of migraine headaches remains unclear. However, experts believe that they may be due to temporary changes in chemicals, nerves, and blood vessels within the brain.

Some people find that certain factors can trigger a migraine episode. Some potential triggers include:

• tiredness
• stress
• hunger
• mild dehydration
• hormonal changes in women
• strong stimulation of the senses, such as loud noises or flashing lights
• certain foods or food additives
• certain beverages, such as those containing caffeine

The main symptom of a migraine headache is severe pain on one side of the head. Other symptoms may include:

• sensitivity to light, smell, or sound
• neck pain or stiffness
• nausea
• vomiting
• anxiety
• irritability
• depressed mood
• insomnia
• fatigue
• difficulty concentrating
• visual disturbances
• numbness or tingling in different parts of the body

To diagnose a migraine headache with diarrhea, a doctor will take a person’s medical history and ask about their symptoms. This may involve questions about how often the headaches or watery stools occur, and whether there are any obvious triggers for these symptoms.

To investigate potential triggers, a doctor may test a person for food allergies or intolerances.

The following tests may also help to determine the cause of the diarrhea:

• stool tests
• blood tests
• fasting tests
• hydrogen breath tests
• endoscopy

There are no specific tests to confirm a diagnosis of a migraine headache. However, a doctor may order a medical imaging test, such as a CT head scan. This will help to check for any potential causes within the brain.

Although there is currently no cure for migraine headaches, it is possible to manage the symptoms.

Some potential options for treating or preventing a migraine headache and diarrhea include:

Keeping a food diary

People who suspect that certain foods or beverages trigger their migraines and diarrhea episodes should keep a food diary. People can use this to record the foods they eat throughout the day, along with any symptoms they experience. Identifying and avoiding possible triggers will reduce the risk of future migraine episodes.

Managing stress levels

Some people find stress management techniques can help to prevent and treat migraine headaches. These could include:

• exercise
• yoga
• relaxation techniques
• biofeedback therapy

Biofeedback therapy involves using visual or auditory feedback about the body’s internal state to gain control over involuntary body functions

Taking medications for migraine

Some drugs that the Food and Drug Administration (FDA) have approved for treating migraine headaches include:

• erenumab
• lasmiditan
• ubrogepant
• amitriptyline
• nortriptyline

A doctor may also recommend drugs typically used to treat epilepsy or depression. Sometimes, doctors may prescribe tricyclic antidepressants to prevent migraines.

Taking medications for diarrhea

Many over-the-counter (OTC) medications are available for treating diarrhea. Examples include loperamide and bismuth subsalicylate. However, people who experience bloody stools or fever should avoid these medications.

The following tips may help to reduce the frequency of migraine headaches:

• identifying migraine triggers and avoiding them where possible
• managing stress levels
• taking any medications as prescribed

If a person experiences migraine episodes often, they may benefit from taking medication every day. When deciding which medications to take, it is important to consider the potential side-effects. People can discuss the options with their doctors.

Certain factors can increase the risk of migraine headaches and diarrhea.

Risk factors for migraine

The potential triggers listed above are the main risk factors for migraine.

However, estrogen may also trigger migraine headaches. This may explain why such headaches are three times more common in women than in men. Migraine episodes can become less common after menopause, when estrogen levels decline, according to the National Institutes of Health (NIH).

Risk factors for diarrhea

The following factors may increase the risk of diarrhea:

• not washing the hands after using the toilet or before preparing food
• eating food that is out of date
• drinking tap water in certain countries while abroad

Symptoms of a migraine headache and diarrhea generally go away on their own or with appropriate home treatment. However, people should see a doctor if they experience the following:

• diarrhea lasting more than 2 days
• diarrhea that involves passing more than six or more loose stools within 24 hours
• migraine episodes that increase in frequency or severity

People should also see a doctor if any of the following symptoms accompany the migraine and diarrhea episode:

• dehydration
• fever
• difficulty breathing
• blurred vision
• weakness and dizziness
• confusion
• severe nausea or vomiting
• severe rectal pain or stomach pain
• stools containing blood, or a black, tarry substance

Migraine headaches typically involve severe pain on one side of the head. The exact cause of migraine headaches remains unclear. Some potential triggers include tiredness, stress, and dietary sensitivities.

Several other symptoms, including diarrhea, may accompany a migraine headache. Some researchers have proposed that generalized inflammation may help explain the link between the two conditions.

Some potential treatments for migraine headaches and diarrhea include keeping a food diary, managing stress, and taking medications. Using these treatments regularly may help to prevent future episodes.

Read this article in Spanish.

Link, treatment, and risk factors.

Migraine headaches can cause extreme discomfort and pain, along with a range of other symptoms. Some people may experience nausea and diarrhea during a migraine episode.

This article discusses the link between migraine headaches and diarrhea, as well as the possible risk factors that could lead to such symptoms. We also outline the potential treatment options for migraine headaches and diarrhea.

Share on PinterestManaging stress levels may help treat migraine headaches and diarrhea.

Migraine headaches may occur alongside a range of other symptoms, including diarrhea. People who experience diarrhea will pass loose, watery stools at least three times per day.

It is unclear why migraine headaches might lead to diarrhea. According to a 2014 review, some studies show a link between migraine headaches and gastrointestinal (GI) disorders. Examples include:

• irritable bowel syndrome
• inflammatory bowel disease
• celiac disease

According to the review, generalized inflammation is one possible factor that could explain the occurrence of both a migraine headache and diarrhea.

A migraine headache is an intense pulsing or throbbing pain in the head. An “aura,” which is a visual or auditory disturbance, often precedes these headaches.

The exact cause of migraine headaches remains unclear. However, experts believe that they may be due to temporary changes in chemicals, nerves, and blood vessels within the brain.

Some people find that certain factors can trigger a migraine episode. Some potential triggers include:

• tiredness
• stress
• hunger
• mild dehydration
• hormonal changes in women
• strong stimulation of the senses, such as loud noises or flashing lights
• certain foods or food additives
• certain beverages, such as those containing caffeine

The main symptom of a migraine headache is severe pain on one side of the head. Other symptoms may include:

• sensitivity to light, smell, or sound
• neck pain or stiffness
• nausea
• vomiting
• anxiety
• irritability
• depressed mood
• insomnia
• fatigue
• difficulty concentrating
• visual disturbances
• numbness or tingling in different parts of the body

To diagnose a migraine headache with diarrhea, a doctor will take a person’s medical history and ask about their symptoms. This may involve questions about how often the headaches or watery stools occur, and whether there are any obvious triggers for these symptoms.

To investigate potential triggers, a doctor may test a person for food allergies or intolerances.

The following tests may also help to determine the cause of the diarrhea:

• stool tests
• blood tests
• fasting tests
• hydrogen breath tests
• endoscopy

There are no specific tests to confirm a diagnosis of a migraine headache. However, a doctor may order a medical imaging test, such as a CT head scan. This will help to check for any potential causes within the brain.

Although there is currently no cure for migraine headaches, it is possible to manage the symptoms.

Some potential options for treating or preventing a migraine headache and diarrhea include:

Keeping a food diary

People who suspect that certain foods or beverages trigger their migraines and diarrhea episodes should keep a food diary. People can use this to record the foods they eat throughout the day, along with any symptoms they experience. Identifying and avoiding possible triggers will reduce the risk of future migraine episodes.

Managing stress levels

Some people find stress management techniques can help to prevent and treat migraine headaches. These could include:

• exercise
• yoga
• relaxation techniques
• biofeedback therapy

Biofeedback therapy involves using visual or auditory feedback about the body’s internal state to gain control over involuntary body functions

Taking medications for migraine

Some drugs that the Food and Drug Administration (FDA) have approved for treating migraine headaches include:

• erenumab
• lasmiditan
• ubrogepant
• amitriptyline
• nortriptyline

A doctor may also recommend drugs typically used to treat epilepsy or depression. Sometimes, doctors may prescribe tricyclic antidepressants to prevent migraines.

Taking medications for diarrhea

Many over-the-counter (OTC) medications are available for treating diarrhea. Examples include loperamide and bismuth subsalicylate. However, people who experience bloody stools or fever should avoid these medications.

The following tips may help to reduce the frequency of migraine headaches:

• identifying migraine triggers and avoiding them where possible
• managing stress levels
• taking any medications as prescribed

If a person experiences migraine episodes often, they may benefit from taking medication every day. When deciding which medications to take, it is important to consider the potential side-effects. People can discuss the options with their doctors.

Certain factors can increase the risk of migraine headaches and diarrhea.

Risk factors for migraine

The potential triggers listed above are the main risk factors for migraine.

However, estrogen may also trigger migraine headaches. This may explain why such headaches are three times more common in women than in men. Migraine episodes can become less common after menopause, when estrogen levels decline, according to the National Institutes of Health (NIH).

Risk factors for diarrhea

The following factors may increase the risk of diarrhea:

• not washing the hands after using the toilet or before preparing food
• eating food that is out of date
• drinking tap water in certain countries while abroad

Symptoms of a migraine headache and diarrhea generally go away on their own or with appropriate home treatment. However, people should see a doctor if they experience the following:

• diarrhea lasting more than 2 days
• diarrhea that involves passing more than six or more loose stools within 24 hours
• migraine episodes that increase in frequency or severity

People should also see a doctor if any of the following symptoms accompany the migraine and diarrhea episode:

• dehydration
• fever
• difficulty breathing
• blurred vision
• weakness and dizziness
• confusion
• severe nausea or vomiting
• severe rectal pain or stomach pain
• stools containing blood, or a black, tarry substance

Migraine headaches typically involve severe pain on one side of the head. The exact cause of migraine headaches remains unclear. Some potential triggers include tiredness, stress, and dietary sensitivities.

Several other symptoms, including diarrhea, may accompany a migraine headache. Some researchers have proposed that generalized inflammation may help explain the link between the two conditions.

Some potential treatments for migraine headaches and diarrhea include keeping a food diary, managing stress, and taking medications. Using these treatments regularly may help to prevent future episodes.

Read this article in Spanish.

Watery diarrhea – causes, diagnosis and treatment

Watery diarrhea is repeated (up to 15-20 times a day) defecation, 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 intestinal pathologies, enzyme deficiency. To establish the causes of diarrhea, ultrasound, x-rays, endoscopy, and 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 is usually accompanied by secretory type watery diarrhea. Bacteria are able to secrete a specific enterotoxin that affects the epithelial cells of the mucosa and causes the accumulation of adenylate cyclase and cAMP in them. This contributes to an increased release of ions into the intestinal lumen with subsequent entry into the intestine along the concentration gradient of a large amount of liquid. The condition is exacerbated by concomitant inflammatory lesions of the gastrointestinal tract. The following intestinal infections lead to diarrhea with water:

• Cholera . This infectious disease manifests as diarrhea, which quickly loses its fecal character and odor, becoming watery. A few 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, waterborne 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. A greenish frothy stool (“swamp mud”) is 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. Botulism is characterized by eye manifestations: double vision, flickering of “flies” before the eyes, blurred vision. In severe cases, paresis, paralysis of mimic muscles with asymmetry of the face are observed.
• Campylobacteriosis . The disease begins acutely with a rise in temperature to 38 ° C or more, pain in the muscles and joints. Multiple diarrhea immediately joins with the release of liquid, fetid feces, in which streaks of mucus and blood are detected. Patients often complain of abdominal cramps, while nausea and vomiting occur in only a quarter of patients with campylobacteriosis.

Viral infections

Dyspeptic disorders, in particular watery diarrhea, are considered the main manifestations of most viral intestinal lesions. Viruses, when they enter the gastrointestinal tract, multiply inside the epithelial cells, causing their death and desquamation from the surface of the mucosa, which leads to impaired 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 that occur 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 stools are fecal in nature, in severe cases, the leading one is profuse diarrhea with the discharge of a cloudy, fetid, yellow-green liquid. Diarrhea is combined with cramping pains 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 stools, vomiting, abdominal pain. Multiple defecation 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 influenza . With this type of influenza infection, gastrointestinal symptoms 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 the 2nd-3rd day of illness.
• Marburg hemorrhagic fever. The disease manifests itself acutely with the onset 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 3rd-4th day of hemorrhagic fever. Pathognomonic signs are maculopapular rash, uterine, nasal and gastrointestinal bleeding that appear on days 5-6 of illness.
• HIV infection . AIDS is characterized by abundant watery stools without pathological inclusions, due to 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 subfebrile fever, increased sweating at night. Most patients lose more than 10% of body weight.

Protozoal and helminthic invasions

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

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

Noncommunicable bowel diseases

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

• Enteritis . Watery diarrhea is a symptom of non-infectious inflammation of the small intestine, which is allergic, drug-induced, or autoimmune in nature. The appearance of liquid, fetid feces is mainly caused by malabsorption and maldigestion syndromes. The chair is observed up to 10-15 times during the day, accompanied by flatulence, rumbling in the abdomen, decreased appetite, nausea, significant weight loss.
• Enteropathy . Chronic watery diarrhea is manifested in non-inflammatory intestinal pathologies. A change in the consistency of stool masses can be caused by both fermentopathy and a violation of the motility of the gastrointestinal tract (for example, a hypomotor variant of diabetic enteropathy). The pain syndrome is weakly expressed, digestive disorders that contribute to weight loss and protein-energy malnutrition predominate.
• Acute colitis . For colitis, spasms in the left iliac region, painful urge to defecate, the presence of pathological impurities of mucus, blood in the feces are typical. 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 noted 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 an 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 disturbed. The condition is aggravated by the addition of the secretory mechanism of diarrhea associated with cAMP activation.

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 pain in the epigastrium, sour belching. In children, defecation with water becomes a consequence of galactosemia – intolerance to milk due to a congenital lack of an enzyme. The symptom appears immediately after the start of breastfeeding, accompanied by malnutrition, jaundice, inhibition of reflexes.

Examination

Watery diarrhea always indicates problems 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 using laboratory and instrumental methods is necessary to detect morphological changes and determine the cause of diarrhea. The most valuable in terms of diagnostics are:

• Radiography . With the help of a survey radiography of the abdominal cavity, the condition of the gastrointestinal tract of the patient is quickly assessed. For a detailed study of the internal 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 A 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 allows you to identify signs of the inflammatory process. Sonography is also performed to assess the condition of the pancreas.
• Fecal analysis . To study the processes of digestion, absorption of food, a microscopic examination of feces with pH measurement is carried out. Watery diarrhea is often caused by infectious processes, so 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 those of a viral nature. The study is not sufficiently informative in the first few days from the onset of the disease, when the concentration of antibodies in the blood has not yet increased.

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 wall 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 modification required. With an acute disorder, a starvation diet is indicated with the gradual introduction of rice dishes, foods containing pectins, salted soups, broths, dietary protein foods (veal, turkey, chicken, hard-boiled eggs). With watery diarrhea, a significant amount of fluid is lost, therefore, when 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 frequency of watery diarrhea until the exact cause of stool problems is determined. In no case should you take medications that inhibit intestinal motility, 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.

Appendix 1. Terms and definitions

Acute watery diarrhea (ATD)

Acute watery diarrhea is a condition characterized by three or more loose or watery (not bloody) stools in a 24 hour period.

Suspected case of cholera

In an area where a cholera outbreak has not yet been declared: Any person 2 years of age or older who has acute watery diarrhea and is severely dehydrated or dies from acute watery diarrhea.

In an area where a cholera outbreak has been reported: any person who has or dies of acute watery diarrhea.

Confirmed cholera case

Suspected case with V. cholerae serogroup O1 or O139 on culture or polymerase chain reaction (PCR) testing. In countries where cholera was never known or eradicated, it has been demonstrated that subgroups V. cholerae O1 and O139 are toxigenic.

Cholera alert

A cholera alert (suspected cholera outbreak) is defined as the detection of at least one of the following events:

acute watery diarrhea and severe dehydration or die from acute watery diarrhea 1 week apart;

b) one death from severe acute watery diarrhea in a person over 5 years of age;

c) One case of acute watery diarrhea with a positive rapid diagnostic test (RDT) for cholera in a designated area (including areas at risk of the current outbreak) that has not yet detected a confirmed case of cholera.