Definition:
Diarrhea is an increase in the frequency of bowel movements, an increase in the looseness of stool or both. Diarrhea is caused by increased secretion of fluid into the intestine, reduced absorption of fluid from the intestine or rapid passage of stool through the intestine.
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Signs and symptoms
- Severe abdominal or rectal pain.
- Blood in your stool.
- Black, tarry stools.
- Fever.
- Signs of dehydration
Causes of diarrhea
Diagnosis
Most cases of diarrhoea get better within a week and you may not need to visit your GP.
The information below explains what will happen if you need to see your GP.
To identify what is causing your diarrhoea, your GP may ask you questions, such as:
Your GP may ask you for a stool sample so it can be analysed for signs of an infection if you have:
Blood tests
Your GP may suggest you have some blood tests if they suspect your diarrhoea is being caused by an underlying health condition.
For example, your blood can be tested for signs of inflammation, which may suggest inflammatory bowel disease.
Read more about the possible causes of diarrhoea.
Rectal examination
Your GP may recommend a digital rectal examination (DRE) if you have unexplained persistent diarrhoea, particularly if you're over 50.
During a DRE, your GP will insert a gloved finger into your bottom to feel for any abnormalities. It can be useful for diagnosing conditions that affect your rectum and bowel.
Further investigations
If you have persistent diarrhoea and your GP is unable to find the cause, they may refer you to your local hospital for further investigation.
You may have:
The information below explains what will happen if you need to see your GP.
To identify what is causing your diarrhoea, your GP may ask you questions, such as:
- what your stools are like – for example, if they are very watery or contain blood
- how often you need to go to the toilet
- whether you have other symptoms, such as a high temperature (fever)
- whether you have been in contact with anyone else who has diarrhoea, or recently travelled abroad – this may mean you have picked up an infection
- whether you have recently eaten out anywhere – this may mean you have food poisoning
- whether you're taking medication and if it has recently changed
- whether you have been stressed or anxious recently
Your GP may ask you for a stool sample so it can be analysed for signs of an infection if you have:
- persistent diarrhoea that has lasted more than two weeks
- blood or pus in your stools
- symptoms that affect your whole body, such as a fever ordehydration
- a weakened immune system – for example, because you have HIV
- recently travelled abroad
- recently been in hospital or been taking antibiotics
Blood tests
Your GP may suggest you have some blood tests if they suspect your diarrhoea is being caused by an underlying health condition.
For example, your blood can be tested for signs of inflammation, which may suggest inflammatory bowel disease.
Read more about the possible causes of diarrhoea.
Rectal examination
Your GP may recommend a digital rectal examination (DRE) if you have unexplained persistent diarrhoea, particularly if you're over 50.
During a DRE, your GP will insert a gloved finger into your bottom to feel for any abnormalities. It can be useful for diagnosing conditions that affect your rectum and bowel.
Further investigations
If you have persistent diarrhoea and your GP is unable to find the cause, they may refer you to your local hospital for further investigation.
You may have:
- a sigmoidoscopy – an instrument called a sigmoidoscope (a thin, flexible tube with a small camera and light on one end) is inserted into your bottom and up into your bowel
- a colonoscopy – a similar procedure that uses a larger tube called a colonoscope to examine your entire bowel
Treatment for diarrhea
1. Be Sure to Stay Hydrated
Your body can lose a lot of fluids and salts when you have diarrhea, making dehydration a major concern. Frequent loose and watery stools can quickly lead to fluid loss. Here are some easy ways to stay hydrated:
2. Try Eating a Bland Diet
When dealing with a brief bout of diarrhea, you want to keep your diet bland. You may find it best to only have clear liquids for the first 24 hours. Then, you can slowly add bland foods to your diet. Some bland foods include bananas, rice, applesauce, and toast — otherwise known as the BRAT diet. Crackers and mashed potatoes (minus the butter) are also safe.
If your diarrhea lasts more than a few days, you might want to investigate the foods you are eating, as some can irritate your bowel and make diarrhea worse. These include foods high in fiber (bran, whole grains, brown rice) as well as greasy or excessively sweet foods. Foods that are sweetened with sorbitol may also aggravate diarrhea, Bickston says. If loose stools are a problem, then you may want to avoid these foods.
If you suspect your diarrhea is caused by a certain food, try an elimination diet. Cut the suspected food from your diet until you can determine whether or not it is a problem. If it's not the problem, feel free to keep eating that food. “The difficulty I see in a lot of patients is that they don’t put things back into their diet even if they’re not causing a problem, and now they’ve painted themselves into a dietary corner,” Bickston says. “All they’re eating is mashed potatoes and rice.”
3. Try Some Over-the-Counter Medications
In most cases, over-the-counter medications can be helpful in stopping an occasional bout of diarrhea — especially traveler's diarrhea (ingesting contaminated food or water while abroad). Over-the-counter medications include loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol, Kaopectate). “These are reasonable to use on occasion and have the great advantage of not requiring a doctor’s prescription,” Bickston says. However, they should not be used for more than two days.
One thing to keep in mind is that if you take pharmaceutical remedies for traveler's diarrhea, they may make you feel better sooner, but they could keep any bacteria, parasites, or viruses in your system longer. In most cases, diarrhea will go away on its own within in a few days. If your diarrhea persists, talk to your doctor.
Your body can lose a lot of fluids and salts when you have diarrhea, making dehydration a major concern. Frequent loose and watery stools can quickly lead to fluid loss. Here are some easy ways to stay hydrated:
- Select sports drinks. “Sports drinks make sense and are available in a wide variety of flavors," Dr. Bickston says. Sports drink work because of their sugar and salt content, both allow water to be more easily absorbed, and even more so when taken together. People can make their own sports drinks by adding a teaspoon of salt to a quart of apple juice, Bickston says. “That little amount of salt will help the body absorb fluids but isn't enough to make the apple juice taste bad.” Bickston recommends keeping your drinks at room temperature because a warm drink will sit better with you than a cold one.
- Stick to clear liquids. Some other good choices for treating diarrhea include clear broth and water (unless you are traveling out of the country).
- Avoid drinks that can worsen symptoms. Caffeinated, alcoholic, and sugary drinks can worsen dehydration. Milk and other dairy products can make your symptoms feel worse because diarrhea can cause temporary lactose-intolerance.
2. Try Eating a Bland Diet
When dealing with a brief bout of diarrhea, you want to keep your diet bland. You may find it best to only have clear liquids for the first 24 hours. Then, you can slowly add bland foods to your diet. Some bland foods include bananas, rice, applesauce, and toast — otherwise known as the BRAT diet. Crackers and mashed potatoes (minus the butter) are also safe.
If your diarrhea lasts more than a few days, you might want to investigate the foods you are eating, as some can irritate your bowel and make diarrhea worse. These include foods high in fiber (bran, whole grains, brown rice) as well as greasy or excessively sweet foods. Foods that are sweetened with sorbitol may also aggravate diarrhea, Bickston says. If loose stools are a problem, then you may want to avoid these foods.
If you suspect your diarrhea is caused by a certain food, try an elimination diet. Cut the suspected food from your diet until you can determine whether or not it is a problem. If it's not the problem, feel free to keep eating that food. “The difficulty I see in a lot of patients is that they don’t put things back into their diet even if they’re not causing a problem, and now they’ve painted themselves into a dietary corner,” Bickston says. “All they’re eating is mashed potatoes and rice.”
3. Try Some Over-the-Counter Medications
In most cases, over-the-counter medications can be helpful in stopping an occasional bout of diarrhea — especially traveler's diarrhea (ingesting contaminated food or water while abroad). Over-the-counter medications include loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol, Kaopectate). “These are reasonable to use on occasion and have the great advantage of not requiring a doctor’s prescription,” Bickston says. However, they should not be used for more than two days.
One thing to keep in mind is that if you take pharmaceutical remedies for traveler's diarrhea, they may make you feel better sooner, but they could keep any bacteria, parasites, or viruses in your system longer. In most cases, diarrhea will go away on its own within in a few days. If your diarrhea persists, talk to your doctor.
Statistics for diarrhea
Diarrhoea remains a leading killer of young children, despite the availability of a simple treatment solution Diarrhoea is a leading killer of children, accounting for 9 per cent of all deaths among children under age 5 worldwide in 2015. This translates into over 1,400 young children dying each day, or about 530,000 children a year, despite the availability of simple effective treatment. Most deaths from diarrhoea occur among children less than 2 years of age living in South Asia and sub-Saharan Africa. Despite this heavy toll, progress is being made. From 2000 to 2015, the total annual number of deaths from diarrhoea among children under 5 decreased by more than 50 per cent – from over 1.2 million to half a million. Many more children could be saved through basic interventions to improve drinking water, sanitation and hygiene (WASH) for diarrhoea prevention, and the widespread use of a simple solution of oral rehydration salts (ORS) and zinc supplementation during episodes of diarrhoea.