"On The Go" Living With Chronic Diarrhea


Medical Author: Jay W. Marks, MD

It often amazes me how much discomfort and inconvenience people who are psychologically and (otherwise) physically healthy can live with. For example, there are the people who suffer from chronic diarrhea. Some are helped by over-the-counter anti-diarrheal medications and some by prescription drugs. Many do not or prefer not to, take drugs continuously. These people often are diagnosed with irritable bowel syndrome (IBS). Eventually, some of them see physicians who look further for a cause other than IBS for the diarrhea. That's when they are sent to me, a gastroenterologist, for evaluation.

When I talk with these patients, I usually find that they have been suffering from diarrhea for years and it is interfering with their lives. Some patients don't leave the house in the morning until their diarrhea subsides. Others plan trips out of the house that always allow them to be near a bathroom. When visiting a new place, they don't relax until they locate the bathroom--just in case.

The test I'm most commonly asked to do is a breath test for diagnosing bacterial overgrowth of the small bowel. Usually, all the other tests--blood tests, tests on stool, x-rays, and endoscopy (colonoscopy and upper gastrointestinal endoscopy)--have been done and are normal. The breath test often is abnormal and a diagnosis of bacterial overgrowth can be made. The patient is treated with a short course of antibiotics and the diarrhea improves dramatically. (Some patients realize how much the diarrhea has interfered with their lives only when the condition resolves.)

What amazes me is that these people can adapt to inconvenience and discomfort for prolonged periods of time. The record I have encountered is 30 years. What these people all seem to have in common is busy, stable lives. They have jobs, are raising children, and are in stable relationships. They adjust to the inconvenience and discomfort so that they can go on with their lives. We sometimes hear about people with serious, debilitating illnesses who adapt remarkably to their limitations. So do "healthy" people.