Diarrhea

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Author:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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• 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.
• Diarrhea can be defined absolutely or relatively. Absolute diarrhea is defined as more than five bowel movements a day or liquid stools. Relative diarrhea is defined as an increase in the number of bowel movements per day or an increase in the looseness of stools compared with an individual's usual bowel habit.
• Diarrhea may be either acute or chronic, and each has different causes and treatments.
• Complications of diarrhea include dehydration, electrolytes (mineral) abnormalities, and irritation of the anus.
• Dehydration can be treated with oral rehydration solutions and, if necessary, with intravenous fluids.
• Tests that are useful in the evaluation of acute diarrhea include examination of stool for white blood cells and parasites, cultures of stool for bacteria, testing of stool for the toxin of C. difficile and blood tests for electrolyte abnormalities.
• Tests that are useful in the evaluation of chronic diarrhea include examination of stool for parasites, upper gastrointestinal X-rays (UGI series), barium enema, esophago-gastro-duodenoscopy (EGD) with biopsies, colonoscopy with biopsies, hydrogen breath testing, and measurement of fat in the stool.
• Diarrhea may be treated with absorbents, anti-motility medications, and bismuth compounds.
• Antibiotics should not be used in treating diarrhea unless there is a culture-proven bacterial infection that requires antibiotics, severe diarrhea that is likely to be infectious in origin, or when an individual has serious underlying diseases.