When Should You Worry About Diarrhea?

Diarrhea is the passage of loose, watery stools, with or without pain, for two or more times a day.

It is a common condition that affects a large number of people, both adults and children, and usually is of no concern other than distress and inconvenience.

Diarrhea can be of two types:

• Acute:
  • Lasts for one to two days
  • Usually, no intervention is needed
• Chronic:
  • Lasts for four weeks or more
  • Diarrhea on and off for a long period

Depending on the cause, along with diarrhea, you may have additional symptoms such as:

• Abdominal pain
• Cramps
• Uncontrolled bowel movements (increased urgency and frequency to defecate)
• Nausea
• Vomiting
• Bloating
• Loss of appetite
• Heaviness
• Flatulence
• Fever

Diarrhea is diagnosed in the following ways:

• Medical history
• Stool sample (to analyze signs of infection and presence of blood)
• Blood tests
• Rectal examination
• Sigmoidoscopy
• Colonoscopy

You can take the following measures to prevent diarrhea:

• Maintain hygiene by washing hands with soap and water after visiting the washroom and before eating or cooking food.
• Disinfect the toilet seat and handles after each episode of diarrhea.
• Maintain food hygiene by washing kitchen surfaces and utensils regularly.
• Avoid intake of raw or undercooked foods.
• Always cook food thoroughly.
• Avoid unpasteurized milk and dairy products.
• Check seals of water bottles and canned foods.
• Do not use expired food cans.
• Vaccinate children against rotavirus.

Most cases will resolve within a week, but excessive water is lost in the stools that may lead to dehydration if not diagnosed early or left untreated.

• Drink plenty of water to keep the body hydrated.
• Drink fluids that contain salt and sugar.
• Avoid heavy, oily, spicy, and processed foods.
• Consume soft, semisolid, and bland foods.
• Consume fruit juices, soups, and broths.
• Use an oral rehydration solution to avoid dehydration.
• Take rest.
• Take over-the-counter medications such as loperamide.
• Taking probiotics (yogurt) speeds up recovery.
• Limit tea and coffee intake.
• Rice water is an effective way to make stools firm and prevent dehydration.
• Try the BRAT diet that stands for bananas, rice, applesauce, and toast (white bread).

If the above methods do not suffice, consult a healthcare professional who may prescribe:

• Antidiarrheal medicines:
  • Slow down muscle movements in the gut, increase water absorption make stools firmer, and reduces the frequency
• Antibiotics:
  • In case of specific bacterial infection and severe diarrhea
• Painkillers:
  • To relieve additional symptoms such as abdominal pain, cramps, and fever
• Intravenous fluids and electrolytes:
  • In severe cases of dehydration, hospital admission is inevitable

If left untreated, diarrhea could lead to the following complications:

• Dehydration (loss of water)
• Electrolyte imbalance (loss of sodium, potassium, and magnesium)
• Kidney failure due to hypovolemia

Diarrhea can be caused by different reasons including:

Short-term diarrhea

• Food poisoning due to Escherichia coli, salmonella, or shigella
• Anxiety (nervous diarrhea)
• Food allergies (foods that contain gluten or milk)
• Gastroenteritis (stomach flu) caused by:
  • Viruses such as norovirus or rotavirus
  • Bacteria such as campylobacter and Clostridium difficile, often due to contaminated food
  • Parasites such as Giardia intestinalis that causes giardiasis (spreads through contaminated water)
• Traveler’s diarrhea (during travel in areas of poor hygiene)
• Medications such as:
  • Antibiotics clindamycin and erythromycins
  • Laxatives
  • Antacids
  • Metformin (antidiabetic)
  • Proton pump inhibitors
  • Nonsteroidal anti-inflammatory drugs
  • Selective serotonin reuptake inhibitors
  • Statins (cholesterol-lowering drugs)
  • Chemotherapy medicines

Long-term diarrhea

• Inflammatory bowel disease
  • Crohn’s disease
  • Ulcerative colitis
• Irritable bowel syndrome
• Coeliac disease
• Lactose intolerance
• Pancreatitis
• Diverticular disease
• Bile acid malabsorption
• Colon cancer
• Removal of gallbladder