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Diarrhea

Diarrhea Definition

Acute diarrhea is something nearly everyone has experienced at one time or another. The loose, watery stools and abdominal cramps that characterize diarrhea usually last a couple of days. Diarrhea often means more-frequent trips to the toilet and a greater volume of stool.

By definition, chronic diarrhea lasts much longer than does acute diarrhea, generally longer than four weeks. It can be a sign of a serious disorder, such as inflammatory bowel disease, or a less serious condition, such as irritable bowel Syndrome.

Diarrhea may cause a loss of significant amounts of water and salts. Most cases of diarrhea clear on their own without treatment. But see your doctor if diarrhea persists, if you become dehydrated or if you pass Blood in your stool.

Diarrhea Symptoms

Signs and symptoms associated with diarrhea may include:

• Frequent, loose, watery stools
• Abdominal cramps
• Abdominal pain
• Fever
• Blood in the stool
• Bloating

In addition, other signs and symptoms such as Nausea and vomiting may precede diarrhea that's caused by, for example, an Infection. Bacterial or parasitic infections sometimes cause bloody stools, and Fever may accompany these infections as well.

When to see a doctor
If you are an adult, see your doctor if:

• Your diarrhea persists beyond three days
• You become dehydrated — as evidenced by excessive thirst, dry Mouth or Skin, little or no urination, severe weakness, Dizziness or lightheadedness, or dark-colored Urine
• You have severe abdominal or rectal pain
• You have bloody or black stools
• You have a Temperature of more than 102 F (39 C), or signs of Dehydration despite drinking plenty of liquids

In Children, particularly young children, diarrhea can quickly lead to Dehydration. Call your doctor if your child's diarrhea Doesn't improve within 24 hours or if your baby:

• Hasn't had a wet diaper in three or more hours
• Has a fever of more than 102 F (39 C)
• Has bloody or black stools
• Has a dry mouth or cries without tears
• Is unusually sleepy, drowsy, unresponsive or irritable
• Has a sunken appearance to the abdomen, eyes or cheeks
• Has skin that doesn't flatten if pinched and released

Diarrhea Causes

Normally, the food you eat remains in liquid form during most of the digestive process. When the unabsorbed food residue passes through your colon, most of the fluids are absorbed and what remains is a semisolid stool.

In diarrhea, the food and fluids you ingest pass too quickly or in too large an amount — or both — through your colon. The fluids Aren't sufficiently absorbed, and the result is a watery bowel movement. In addition, the lining of your colon may be inflamed or diseased, making it less able to absorb fluids.

The most common causes of diarrhea include:

• Viruses. Common viruses that cause diarrhea are Norwalk virus, cytomegalovirus, viral Hepatitis and the Herpes simplex virus. Rotavirus is the most common cause of acute childhood diarrhea. Viral diarrhea spreads easily.
• Bacteria and Parasites. Contaminated food or water can transmit bacteria and parasites to your body. Parasites such as Giardia lamblia and cryptosporidium can cause diarrhea. Common bacterial causes of diarrhea include campylobacter, salmonella, shigella and Escherichia coli. Diarrhea caused by bacteria and parasites can be common when traveling in developing countries, and is often called Traveler's Diarrhea.
• Medications. Many medications can cause diarrhea. The most common are Antibiotics. Antibiotics destroy both good and bad bacteria, which can disturb the natural balance of bacteria in your intestines. This disturbance sometimes leads to an infection with bacteria called Clostridium difficile, which can also cause diarrhea.

Other causes

• Lactose. A sugar found in milk and milk products, lactose is a common cause of diarrhea in some people.
• Fructose. Fructose, a sugar found in many fruits, is a common cause of diarrhea, especially in children.
• Artificial sweeteners. Sorbitol and mannitol, artificial sweeteners found in chewing gum and other sugar-free products, can cause diarrhea in some otherwise healthy people.
• Surgery. Some people may experience diarrhea after undergoing abdominal surgery or gallbladder removal surgery.
• Other digestive disorders. Chronic diarrhea has a number of other causes, such as Crohn's Disease, Ulcerative Colitis, Celiac Disease and irritable bowel syndrome.

Diarrhea Preparing for your appointment

If you have diarrhea, you're likely to start by first seeing your family doctor or a general practitioner. However, in some cases when you call for an appointment, you may be referred immediately to a digestive or gastrointestinal specialist.

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready, and what to expect from your doctor.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses, recent life changes or travel.
• Make a List of all medications, as well as any vitamins or supplements, that you're taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions ahead of time can help make the most of your visit. List your questions from most important to least important in case time runs out. For diarrhea, some basic questions to ask your doctor include:

• What is likely causing my diarrhea?
• Are there other possible causes for my diarrhea?
• What kinds of tests do I need?
• Is my diarrhea likely temporary or chronic?
• What is the best course of action?
• What are the alternatives to the primary approach that you're suggesting?
• I have these other health conditions. How can I best manage them?
• Are there any restrictions that I need to follow?
• Should I see a specialist? What will that cost, and will my insurance cover seeing a specialist?
• Is there a generic alternative to the Medicine you're prescribing me?
• Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend?
• Could the diarrhea be caused by a Medication I am taking?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to spend more time on. Your doctor may ask:

• When did you first begin experiencing your symptoms?
• Have your symptoms been continuous, or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• Do you have diarrhea that awakens you from sleep?
• Do you see blood, or are your bowel movements black in color?
• Do you have a fever?

What you can do in the meantime
While you wait for your appointment, you can help ease your symptoms by drinking lots of clear fluids — to help avoid dehydration — and avoiding fatty, high-fiber or highly seasoned foods.

Diarrhea Tests and Diagnosis

If you have diarrhea that requires medical attention, your doctor will ask about your symptoms and will want to determine if you're dehydrated. Tell your doctor about any medications you're taking, including over-the-counter medications — they may have caused the diarrhea.

Your doctor may examine your abdomen to determine the location of your pain, may listen to your abdomen with a stethoscope and may perform a rectal exam. Your doctor may suggest blood or stool tests to check for signs of infection or other abnormalities.

Diarrhea Treatments and drugs

Most cases of diarrhea clear on their own within a couple of days without treatment.

Medications
If a parasitic infection is causing your diarrhea, prescription antibiotics may ease your symptoms. Antibiotics sometimes, but not always, help ease signs and symptoms of bacterial diarrhea. However, antibiotics won't help viral diarrhea.

Therapies

• Replacing fluids. If you seek medical attention, your doctor likely will advise you to take steps to replace the fluids and salts lost during diarrhea.

  Your body needs adequate levels of salts and electrolytes — minerals such as Sodium and Potassium — in order to maintain the electric currents that keep your Heart beating. Disruption of your body's fluid and mineral levels creates an electrolyte imbalance. Unless restored by replacing fluids and drinking an electrolyte mixture, this imbalance can be serious.

• Adjusting medications you're taking. If your doctor determines that an antibiotic medication caused your diarrhea, you'll need to stop taking that medication and modify your treatment plan.
• Treating underlying conditions. If you have chronic diarrhea, treating the underlying disease may help ease your diarrhea.

Diarrhea Lifestyle and home remedies

Diarrhea caused by viral infections typically ends on its own without antibiotics. Over-the-counter (OTC) anti-diarrheal medications may slow diarrhea, but they won't speed your Recovery. Certain infections — bacterial and parasitic — may be made worse by OTC medications because they prevent your body from getting rid of what's causing the diarrhea. Also, these drugs aren't always safe for children. Check with your doctor before giving these medications to a child.

Take these measures to prevent dehydration and reduce symptoms while you recover:

• Drink plenty of clear liquids, including water, broths and juices every day. But, avoid apple and pear juices until you feel better because they can make your diarrhea worse. Avoid caffeine and alcohol. Eating gelatin may also help.
• Add semisolid and low-fiber foods gradually as your bowel movements return to normal. Try soda crackers, toast, eggs, rice or chicken.
• Avoid certain foods such as dairy products, fatty foods, high-fiber foods or highly seasoned foods for a few days.

Diarrhea Prevention

You can help prevent the spread of viral diarrhea by washing your hands and encouraging your children to wash their hands. Because viral diarrhea spreads easily, it's a good idea to keep your children home from school or child care if they have diarrhea.

To guard against diarrhea caused by contaminated food:

• Use dairy products that have been pasteurized. Pasteurization involves heating dairy products for a period of time to kill bacteria.
• Serve food right away or refrigerate it after it has been cooked or reheated. Leaving food out at room temperature can encourage growth of bacteria.

Diarrhea commonly affects people who travel to developing countries, where it is sometimes due to inadequate sanitation and contaminated food and water. To reduce your risk:

• Watch what you eat. Eat hot, well-cooked foods. Avoid raw fruits and vegetables unless you can peel them yourself. Also avoid raw or undercooked meats and dairy foods.
• Watch what you drink. Drink bottled water, soda, beer or wine served in its original container. Avoid tap water and ice cubes. Use bottled water even for brushing your teeth. Keep your mouth closed while you shower. Beverages from boiled water, such as coffee and tea, are probably safe. Remember that alcohol and caffeine can aggravate diarrhea and dehydration.
• Ask your doctor about using antibiotics or bismuth subsalicylate (Pepto-Bismol) to prevent diarrhea if you're traveling to a developing country. Either type of medication, but particularly antibiotics, can significantly reduce the odds that you'll develop traveler's diarrhea.

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