Diarrhea

 What is diarrhea?

Diarrhea means that you have a change in your bowel movements and pass unusually loose stools. Stool is what is left after your digestive system (stomach, small intestine, and colon) absorbs nutrients and fluids from what you eat and drink. Stool passes out of the body through the rectum. If fluids are not absorbed, or if your digestive system produces extra fluids, stools will be loose and watery. Loose stools are larger than usual. People with diarrhea often have frequent bowel movements and may pass more than a quart of watery stool a day.

What other symptoms accompany diarrhea?

People who have diarrhea may also have

• crampy pain in the abdomen, the area between the chest and the hips
• swelling in the abdomen
• an uncomfortable feeling around the anus
• an urgent need to have a bowel movement
• an inability to control their bowels (fecal incontinence)
• chills
• fever

Also, people with diarrhea may feel sick to their stomach or be dehydrated

Who gets diarrhea?

Anyone can get diarrhea. This common problem can last a day or two or for months or years, depending on the cause. Most people get better on their own, but diarrhea can be serious for babies and older people if lost fluids are not replaced. Many people throughout the world die from diarrhea because of the large volume of water lost and the accompanying loss of salts.

What causes diarrhea?

Diarrhea can be caused by:

• bacteria, viruses, or parasites (tiny organisms that live inside a larger organism)
• medicines such as antibiotics
• foods such as milk
• diseases that affect the stomach, small intestine, or colon, such as Cohn's disease and irritable bowel syndrome

Sometimes no cause for diarrhea can be found.

When should I talk to a doctor?

Diarrhea often goes away by itself, but it can be a sign of a more serious problem. You should talk to your doctor if your diarrhea lasts for more than 3 days. You should also call your doctor if you have

• signs of dehydration (see page 3)
• a severe pain in your abdomen or rectum
• a fever of 102°F or higher
• stools that are bloody or black and tarry

Children younger than 12 become dehydrated much more easily than adults. If your child does not improve after 24 hours or has any of the following symptoms along with diarrhea, call the doctor. (This is especially important if your child is 6 months old or younger.)

• stools containing blood or pus
• black stools
• a fever above 101.4°F
• signs of dehydration (see page 4)

If a particular food or medicine is the cause, you should avoid it.

Also, while you are waiting for the diarrhea to end, you should avoid foods that can make it worse:

• milk and milk products, such as ice cream or cheese
• high-fat or greasy foods, such as fried foods
• foods that have a lot of fiber, such as citrus fruits
• very sweet foods, such as cakes and cookies

As you feel better, begin eating soft, bland food, such as bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. Children can eat bananas, rice, applesauce, and toast (sometimes called the BRAT diet).

What tests might be done?

Your doctor may want to perform tests to find the cause of the diarrhea:

• a physical exam
• stool or blood tests to look for bacteria, parasites, or other signs of disease or infection
• fasting tests to see whether diarrhea goes away when you stop eating a particular food
• a sigmoidoscopy, an examination of the inside of the rectum and part of the colon

• a colonoscopy, an examination of the inside of the whole colon

For a sigmoidoscopy or colonoscopy, the doctor uses a thin, flexible, lighted tube with a lens on the end.

  How is diarrhea treated?

In many cases of diarrhea, replacing lost fluid and salts is the only treatment needed.

• Adults should consume broth, soup, fruit juices, soft fruits, or vegetables.
• Children should drink a special liquid that has all the nutrients they need. These solutions are sold without a prescription in grocery stores or drugstores. Pedialyte, Ceralyte, or Infalyte are some examples.

Taking medicine to stop diarrhea can be helpful in some cases. Medicines that are available without a doctor's prescription include loperamide (Imodium) and bismuth subsalicylate (Pepto Bismol and Kaopectate). Stop taking these medicines if symptoms get worse or if diarrhea lasts more than 2 days.

 

If a particular food or medicine is the cause, you should avoid it.

Also, while you are waiting for the diarrhea to end, you should avoid foods that can make it worse:

• milk and milk products, such as ice cream or cheese
• high-fat or greasy foods, such as fried foods
• foods that have a lot of fiber, such as citrus fruits
• very sweet foods, such as cakes and cookies

As you feel better, begin eating soft, bland food, such as bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. Children can eat bananas, rice, applesauce, and toast (sometimes called the BRAT diet).

  Points to Remember

• Diarrhea is a common problem.
• Diarrhea is caused by bacteria, viruses, parasites, some foods or medicines, or diseases that affect the digestive system.
• Diarrhea is dangerous if you become dehydrated.

• Replacing lost fluids is the main treatment for diarrhea.

 

Talk to a doctor if you have strong pain in the abdomen or rectum, a fever, blood in your stool, signs of dehydration, or severe diarrhea for more than 3 days (1 day in the case of children).