What is Diarrhea?

Everyone has experienced the loose, watery and sometimes painful stools of diarrhea at some time. Usually diarrhea lasts only a couple of days and is no cause for concern. Whenever it lasts for weeks, it can point to a serious condition that requires medical attention.

Diarrhea can be characterized as
Acute—usually lasts one or two days
Chronic—lasting two weeks or more

Common symptoms associated with diarrhea include:

• Loose stools
• Watery stools
• Abdominal cramps
• Abdominal pain
• An urgent need to have bowel movement
• Fever
• Nausea

More serious symptoms that indicate you need to see a doctor are:

• Bloody or black stools
• Oily stools
• Severe abdominal or rectal pain
• Dehydration
• Diarrhea that lasts more than 48 hours

The most common causes for diarrhea are:

• Viral infections—The most common cause of diarrhea, often called a “bug” or the “stomach flu.”
• Bacterial infections and parasites—Contaminated food or water can cause diarrhea. Salmonella and E. coli are well known foodborne bacterial infections. Travelers in developing countries sometimes pick up bacterial infections or parasites from poorly processed food and water, which is termed travelers diarrhea.
• Food allergies or intolerances—Food intolerances are common. The most frequent offenders we find in our practice are:
  • Milk and milk products. Milk products contain a sugar called lactose. While our bodies make an enzyme that helps break down lactose, some people do not have much of this enzyme, and diarrhea can result.
  • Artificial sweeteners. Some patients have no difficulty with them, but for many sweeteners can be a problem. Frequent offenders are sucralose, the sweetener found in Splenda; and the sugar alcohols of sorbitol, mannitol, and xylitol that are found in a number of chewing gums and diet foods.
  • Fructose is found naturally in fruit, vegetables and honey. It is often added in concentrated form to drinks and processed foods in the form of high fructose corn syrup. Intolerance for this sugar may be experienced as cramps, bloating, gas or diarrhea.

• Alcohol is known to cause diarrhea for many people.
• Other common food intolerances and allergies include coffee, soy, nuts cereal, wheat, eggs and seafood and certain vegetables .

• Medications—A number of medications can cause diarrhea. antibiotics, acid inhibitors in the proton pump class, metformin, cancer drugs and antacids containing magnesium are some of the most common.
• Digestive tract conditions—In some cases, when diarrhea symptoms do not go away after a short time, there could be a larger problem in the digestive tract. Your doctor will assess your symptoms and diagnose whether conditions such as Celiac disease, Crohn’s disease, irritable bowel syndrome, or ulcerative colitis could be causing your diarrhea.

When your diarrhea becomes serious as characterized by bloody, black or oily stools, severe abdominal pain, dehydration or lasting more than a few days, you should call our office. Your doctor can diagnose the cause of chronic diarrhea by:

• taking a medical history
• performing a physical exam
• performing diagnostic tests

Treatment for diarrhea depends on the cause and the length of time you have experienced symtoms.

ACUTE DIARRHEA

• Drink non-caffeinated fluids to avoids dehydration
• The use of anti-diarrheal medications is reasonable in the absence of fever or bloody stool. Over the counter medications such as Bismuth subsalicylate (Pepto-Bismol, Kaopectate) and loperamide (Imodium) are readily available.
• Reintroduce foods slowly to help your gut recover. Clear liquids such as broth and sports drinks are a good start. When those are tolerated, follow a BRAT diet, which stands for bananas, rice, applesauce and toast.
• Take a warm bath to relieve soreness in the rectal area. You may wish to use a barrier cream such as A&D ointment.

CHRONIC DIARRHEA  requires medical evaluation. Your doctor can best advise you on a treatment plan once a diagnosis is made.

Most diarrhea illnesses are self limiting.  Occasionally, serious and treatable conditions present with diarrhea. These conditions may be complicated by the following:

• Disturbance in electrolytes such as sodium and potassium
• Dehydration and resulting kidney injury
• Overwhelming infection
• Blood loss