Diarrhea is one of the most common health complaints. It can range from a mild, temporary condition to a potentially life threatening one.
Globally, an estimated 2 billion cases of diarrheal disease occur each year. Also, around 1.9 million children under the age of some years — mostly in developing countries — die from diarrhea every year. This makes it the second leading cause of death
in this age group.
Diarrhea is characterized by abnormally loose or watery stools. Most cases of diarrhea are due to bacteria, viruses, or parasites. Digestive system disorders can also cause chronic diarrhea.
If a person frequently passes stools but they are of a normal consistency, this is not diarrhea. Similarly, breastfed babies often pass loose, sticky stools. This is normal.
This article looks at the causes and treatments of diarrhea. It also looks at symptoms, diagnosis, prevention, and when to see a doctor.
Causes
Many cases of diarrhea are due to an infection in the gastrointestinal tract. The microbes responsible
for this infection include:
- bacteria
- viruses
- parasitic organisms
Some cases of chronic diarrhea are called “functional” because although all the digestive organs appear normal, they are not functioning as they ideally should. In the developed world, irritable bowel syndrome
is the most common cause of functional diarrhea.
IBS causes many symptoms, including cramping, abdominal pain, and altered bowel habits, which can include diarrhea, constipation
, or Inflammatory bowel syndrome is another cause of chronic diarrhea. IBD describes either ulcerative colitis
Some other major causes of chronic diarrhea include:
- Microscopic colitis: This is a persistent type of diarrhea that usually affects older adults. It develops due to inflammation and occurs often during the night.
- Malabsorptive and maldigestive diarrhea: The first is due to impaired nutrient absorption, and the second is due to impaired digestive function.Ciliac disease is one example.
- Chronic infections: A history of travel or antibiotics use can be clues in chronic diarrhea. Various bacteria and parasites can also be the cause.
- Drug-induced diarrhea: Laxatives and other drugs, including antibiotics, can trigger diarrhea.
- Endocrine-related causes: Sometimes, hormonal factors cause diarrhea. This is the case in Addison's disease and carcinoid tumors.
- Cancer-related causes: Neoplastic diarrhea is associated with a number of gut cancers.
Treatments
Mild cases of acute diarrhea may resolve without treatment.
For persistent or chronic diarrhea, a doctor will treat any underlying causes in addition to the symptoms of diarrhea.
The sections below will discuss some possible treatment options in more detail.
Rehydration
Children and older people are particularly vulnerable to dehydration. For all cases of diarrhea, rehydration is vital.
People can replace fluids by simply drinking more of them. In severe cases, however, a person may need intravenous fluids.
Oral rehydration solution or salts (ORS) refers to water that contains salt and glucose. The small intestine absorbs the solution to replace the water and electrolytes lost in the stool. In developing countries, ORS costs just a few cents.
The World Health Organization (WHO) say that ORS can safely and effectively treat over 90% of nonsevere diarrhea cases.Zinc supplementation may also reduce the severity and duration of diarrhea in children. Various products are avail
Antidiarrheal medication
Over-the-counter antidiarrheal medications are also available. These include loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol).
Imodium is an antimotility drug that reduces stool passage. It is available to purchase over the counter or online
Pepto-Bismol reduces diarrheal stool output in adults and children. It can also prevent traveler’s diarrhea. People can buy this product or over the counter.
There is some concern that antidiarrheal medications could prolong bacterial infection by reducing the removal of pathogens through stools.
Antibiotics
Antibiotics can only treat diarrhea due to bacterial infections. If the cause is a certain medication, switching to another drug might help.
Always talk to a doctor before switching medications.
Diet
The following diet tips may help with diarrhea:
- sipping on clear liquids, such as electrolyte drinks, water, or fruit juice without added sugar
- after each loose stool, replacing lost fluids with at least 1 cup of liquid
- doing most of the drinking between, not during, meals
- consuming high potassium foods and liquids, such as diluted fruit juices, potatoes without the skin, and banana
- consuming high sodium foods and liquids, such as broths, soups, sports drinks, and salted crackers
- eating foods high in soluble fiber, such as banana, oatmeal, and rice, as these help thicken the stool
- limiting foods that may make diarrhea worse, such as creamy, fried, high dairy, and sugary foods
Foods and beverages that might make diarrhea worse include:
- sugar-free gum, mints, sweet cherries, and prunes
- caffeinated drinks and medications
- fructose in high amounts, from fruit juices, grapes, honey, dates, nuts, figs, soft drinks, and prunes
- lactose in dairy products
- Magnesium
- olestra (Olean), which is a fat substitute
- anything that contains artificial sweeteners
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