- Acute vs. Chronic
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Diarrhea is usually harmless and resolves within a few days. However, diarrhea can be a problem on occasion.
What is the difference between acute diarrhea and chronic diarrhea?
Acute diarrhea is a sudden onset of diarrhea that typically lasts one to three days but can last up to two weeks. A viral infection, often known as gastroenteritis, is the most frequent cause. Rotavirus is the most frequent cause of illness in children. Adults are more frequently infected with norovirus. Acute diarrhea may also be brought on by parasite and bacterial infections.
Dehydration signs and symptoms include:
- Dark-colored urine
- Excessive thirst
- Fatigue, dizziness, or light-headedness
- Skin that remains raised after pinching it, instead of flattening back out
- Urinating less than normal
Because infants, toddlers, and children are unable to communicate their feelings, it can be difficult to determine whether they are dehydrated. The following are symptoms of dehydration in newborns and young children:
- Dry mouth and tongue
- Listlessness or irritability
- No tears with crying
- No wet diapers for three hours
- Sunken eyes, cheeks, or soft spots
Preventing dehydration is the primary goal of treating acute diarrhea. When you have diarrhea, it is critical to drink plenty of fluids containing electrolytes; this allows your body to replenish the lost fluids. Electrolytes must also be replaced, and options include sports drinks and salty broths. You can also eat bland foods such as plain toast, rice, and plain crackers. Avoid greasy, fatty, spicy, or high-fiber foods, as they might make diarrhea severe.
Over-the-counter antidiarrheal medications are available for adults with viral diarrhea. If you have bloody diarrhea or a high fever, which can indicate a bacterial or parasite illness, do not take these medications. If this is the case, they may exacerbate diarrhea. Additionally, you should never give these medications to minors.
Diarrhea that is chronic lasts four weeks or more. Usually, it indicates that something other than a viral infection is the underlying reason. It can just be a simple food intolerance, or it might be a more serious issue such as colon cancer.
Chronic diarrhea is typically categorized by doctors as:
- Malabsorptive diarrhea or fatty diarrhea: Caused by a problem with fat absorption in the small intestine, including cystic fibrosis and other issues with pancreatic enzymes, which aid in food digestion.
- Inflammatory diarrhea: Crohn's disease or ulcerative colitis are the two most common inflammatory bowel diseases.
- Watery diarrhea: Dietary intolerances and medication side effects are just a couple of possible reasons for watery diarrhea.
Some chronic diarrheal disease causes do not neatly fit into one of the three categories. It's possible that international travelers acquired an intestinal parasite. Irritable bowel syndrome and uncontrolled diabetes are two additional suitable examples.
Typically, diagnostic testing is necessary to identify the cause of chronic diarrhea. Examining the bowel and how it functions may involve imaging techniques, stool samples, and laboratory tests. Depending on the underlying cause of diarrhea, treatment may be required.
What are the symptoms of diarrhea?
Diarrhea symptoms can differ from person to person but may include:
- Abdominal cramps
- Stomach pain
- Swelling (bloating)
- Urgent need to go to the bathroom
- Bloody stools
- Dehydration (loss of body fluids)
- Leaking stool and not being able to control your bowels (incontinence)
Diarrhea has a serious effect on dehydration, which may include symptoms such as:
- Feeling thirsty
- Not urinating as often
- Having dry skin and a dry mouth and nostrils (mucous membranes)
- Feeling very tired
- Feeling that you may pass out or faint (light-headed)
- Rapid heart rate
- Sunken fontanelle (soft spot) on baby's head
Diarrhea symptoms can resemble those of other health issues. Diarrhea with blood is never a good sign. To be sure, always visit your doctor. If you experience any bleeding, fever, or vomiting, inform your doctor immediately.
What are the complications of diarrhea?
Dehydration caused by diarrhea can be life-threatening if left untreated. Dehydration is especially dangerous for young people, older people, and people with weakened immune systems.
Seek medical attention if you show indications of severe dehydration.
Symptoms of dehydration in adults
- Excessive thirst
- Dry mouth or skin
- Little or no urination
- Weakness, dizziness, or light-headedness
- Dark-colored urine
Symptoms of dehydration in newborns and young children
- Not having a wet diaper in three or more hours
- Dry mouth and tongue
- Fever above 102°F (39°C)
- Crying without tears
- Drowsiness, unresponsiveness, or irritability
- Sunken appearance to the abdomen, eyes, or cheeks
What causes diarrhea?
Diarrhea can be caused by several illnesses and disorders, including:
- Viruses: Viruses that can cause diarrhea include the Norwalk virus (also known as the norovirus), enteric adenoviruses, astroviruses, cytomegaloviruses, and viral hepatitis. The most typical cause of severe childhood diarrhea is rotavirus. The virus that causes coronavirus disease 2019 (COVID-19) has also been linked to gastrointestinal symptoms such as nausea, vomiting, and diarrhea.
- Parasites and bacteria: Diarrhea results from exposure to parasites or pathogenic bacteria through contaminated food or water, such as E. coli. In developing nations, diarrhea caused by bacteria and parasites is frequently referred to as traveler's diarrhea. Another bacterium that can cause diarrhea is Clostridioides difficile, generally referred to as C. diff. Diarrhea caused by C. diff can occur following an antibiotic course or while in the hospital.
- Medications: Many drugs, including antibiotics, can result in diarrhea. Antibiotics treat infections by destroying harmful bacteria, but they also kill beneficial bacteria. This upsets the normal bacterial balance in your intestines, which can result in diarrhea or a secondary illness caused by C. diff. Anticancer medications and magnesium-containing antacids are other medications that can result in diarrhea.
- Lactose intolerance: Lactose, the sugar in milk, cannot be fully absorbed by people who have lactose intolerance. They experience diarrhea, gas, and bloating after consuming dairy products. Although the condition, also known as lactose malabsorption, is typically not harmful, some people may experience uncomfortable symptoms. Age-related declines in lactose-digesting enzyme levels can increase lactose intolerance.
- Fructose: Fructose is a sugar that occurs naturally in honey and fruits. It is occasionally added as a sweetener to various beverages. It can cause diarrhea in people who have difficulty digesting it.
- Artificial sweeteners: Some healthy individuals may get diarrhea after consuming sorbitol, erythritol, or mannitol—artificial sweeteners that are nonabsorbable sugars found in chewing gum and other sugar-free goods.
- Surgery: Although there are many possible causes of diarrhea, one of them is surgery, particularly abdominal surgery. This could be due to several things, such as bacterial overgrowth or poor nutrient absorption. When taken care of properly, diarrhea frequently goes away on its own. Although it's a frequent side effect, one shouldn't ignore it. Dehydration may result from vomiting, diarrhea, or other digestive problems that occur frequently or repeatedly. If this occurs, it is best to call your surgeon.
- Other digestive disorders: In addition to irritable bowel syndrome, Crohn's disease, ulcerative colitis, celiac disease, microscopic colitis, and small intestinal bacterial overgrowth are other conditions that can cause chronic diarrhea.
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How is diarrhea diagnosed?
Your healthcare professional will perform a physical examination on you and enquire about your medical history to determine whether you have diarrhea. Additionally, lab tests to evaluate your blood and urine may be performed.
Other tests might involve:
- Stool studies, including culture and other assays: Look for any unusual bacteria that may be causing diarrhea and other issues in your digestive system. A little stool sample is collected and sent to a lab.
- Sigmoidoscopy: Your doctor can examine the interior of a portion of your large intestine using this test. It aids in determining the source of diarrhea. Through the rectum, a small, flexible, illuminated tube called a sigmoidoscope is inserted into your gut. This tube causes your intestine to enlarge by forcing air into it. This makes it simpler to see inside. If necessary, a biopsy can be performed.
- Colonoscopy: The entire length of your large intestine is examined during this examination. It can be used to look for any abnormal growths, bleeding, sores (ulcers), or tissue that is red or swollen. The colonoscope is inserted into your rectum and advanced into the colon. Using this tube, your doctor can examine the lining of your colon and remove a sample of tissue (a biopsy) to examine. Additionally, they can treat some potential issues.
- Imaging tests: These examinations can detect any issues with your organs' development (structural abnormalities).
- Fasting tests: These tests determine whether you are unable to digest particular meals (food intolerance). They can determine whether some foods trigger an immune system reaction (food allergy).
- Blood tests: These can search for metabolic issues such as thyroid illness, anemia (low blood count), low vitamin levels indicating poor absorption, and celiac disease, among others.
How is diarrhea treated?
Your doctor will create a care plan based on:
- Your age, overall health, and past health
- How serious your case is
- How well do you handle certain medicines, treatments, or therapies
- If your condition is expected to get worse
- What would you like to do
In most cases, replacing the lost fluids is necessary.
You could also need an antibiotic if a bacterial infection is the root cause of your diarrhea.
Can diarrhea be prevented?
Diarrhea can be both prevented and treated. Safe drinking water, adequate hygiene, and sanitation can prevent a significant proportion of diarrheal disease. It is crucial to:
- Eat foods that have been cleaned and cooked safely.
- Wash your hands frequently.
- Use alcohol-based hand sanitizers.
- Avoid taking foods or drinks that may have been contaminated with bacteria or viruses.
Make sure everything you eat and drink while traveling is not contaminated. If you visit underdeveloped nations, this is much more essential.
Water and other liquid travel safety precautions include:
- Avoid drinking or using tap water to wash your teeth.
- Avoid using ice manufactured from tap water.
- Avoid consuming milk or milk products that have not been pasteurized (subjected to a method that kills specific bacteria).
Food travel safety tips include:
- Only consume fresh or raw fruits and vegetables you have personally washed and peeled.
- Avoid eating raw or rare meat or fish and ensure that all meat and shellfish, such as shrimp, crab, and scallops, are hot when served. Avoid food from street sellers or food trucks.
Diarrhea is characterized by loose, watery stools (bowel movements). Acute diarrhea typically goes away on its own within a day or two.
Because of the dangers of dehydration, acute diarrhea in infants and young children can be fatal.
Adults should not hold off on seeking medical attention until they have had diarrhea for a week. If your diarrhea does not improve in two to three days, visit your doctor.
What caused diarrhea will determine the best course of action; however, many infections go away on their own. Moreover, prevention is important. This calls for careful handling and storage of food and frequent handwashing. Additionally, you might want to think about cholera and rotavirus vaccinations.
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