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.
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.
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.
Symptoms associated with diarrhea include abdominal pain, especially cramping. Other symptoms depend on the cause of the diarrhea.
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, electrolyte (mineral) abnormalities, and irritation of the anus.
Tests that are useful in the evaluation of acute diarrhea include examination of stool for white blood cells
or enzymes that they produce, parasites, cultures of stool for bacteria, testing of stool for the toxins 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,
small intestinal endoscopy, hydrogen breath testing, measurement of fat in the stool,
and pancreatic function tests.
Dehydration can be treated at home with home remedies, oral rehydration solutions.
Absorbents (that absorb water in the intestine), anti-motility medications, bismuth compounds,
and IV fluids if necessary.
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.
Diarrhea is an increase in the frequency of bowel movements or a decrease in the form of stool (greater looseness of stool). Although changes in frequency of bowel movements and looseness of stools can vary independently of each other, changes often occur in both.
Diarrhea needs to be distinguished from four other conditions. Although these conditions may accompany diarrhea, they often have different causes and different treatments than diarrhea. These other conditions are:
Incontinence of stool, which is the inability to control (delay) bowel movements until an appropriate time, for example, until one can get to the toilet
Rectal urgency, which is a sudden urge to have a bowel movement that is so strong that if a toilet is not immediately available there will be incontinence
Incomplete evacuation, which is a sensation that another bowel movement is necessary soon after a bowel movement, yet there is difficulty passing further stool the second time