Diarrhea

  • Author:
    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.

  • Editor: William C. Shiel Jr., MD, FACP, FACR
    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 and Digestive Distress Pictures Slideshow: Problem Foods to Avoid

When should antibiotics be used for diarrhea?

Most episodes of diarrhea are acute and of short duration and do not require antibiotics. Antibiotics are not even necessary for the most common bacterial infections that cause diarrhea.

Antibiotics, however, often are used when

  • patients have more severe and persistent diarrhea,
  • patients have additional debilitating diseases such as heart failure, lung disease, and AIDS,
  • stool examination and testing discloses parasites, more serious bacterial infections (for example, Shigella), or C. difficile, and
  • traveler's diarrhea.

What are the complications of diarrhea?

Dehydration occurs when there is excessive loss of fluids and minerals (electrolytes) from the body due to diarrhea, with or without vomiting.

  • Dehydration is common among adult patients with acute diarrhea who have large amounts of watery stool, particularly when the intake of fluids is limited by lethargy or is associated with nausea and vomiting.
  • It also is common in infants and young children who develop viral gastroenteritis or bacterial infection.
  • Patients with mild dehydration may experience only thirst and dry mouth.
  • Moderate to severe dehydration may cause orthostatic hypotension with (fainting or light-headedness upon standing) due to a reduced volume of blood, which causes a drop in blood pressure upon standing). A diminished urine output, severe weakness, shock, kidney failure, confusion, acidosis (too much acid in the blood), and coma also may occur.

Electrolytes (minerals) are lost with water when diarrhea is prolonged or severe, and mineral or electrolyte deficiencies may occur. The most common deficiencies occur with sodium and potassium. Abnormalities of chloride and bicarbonate also may develop.

Finally, there may be irritation of the anus due to the frequent passage of watery stool containing irritating substances.

Medically Reviewed by a Doctor on 10/29/2015
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