Treatment for Chronic Diarrhea

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About Diarrhea

Diarrhea—loose, watery stools occurring more than three times in one day—is a common problem that usually lasts a day or two and goes away on its own without any special treatment. However, prolonged diarrhea can be a sign of other problems. People with diarrhea may pass more than a quart of stool a day.

Diarrhea can cause dehydration, which means the body lacks enough fluid to function properly. Dehydration is particularly dangerous in children and the elderly, and it must be treated promptly to avoid serious health problems.

Symptoms

Diarrhea may be accompanied by cramping abdominal pain, bloating, nausea, or an urgent need to use the bathroom. Depending on the cause, a person may have a fever or bloody stools.

Diarrhea can be either acute (short-term) or chronic (long-term). The acute form, which lasts less than 4 weeks, is usually related to a bacterial, viral, or parasitic infection. Chronic diarrhea lasts more than 4 weeks and is usually related to functional disorders like irritable bowel syndrome or inflammatory bowel diseases like celiac disease.

Causes

Diarrhea may be caused by a temporary problem, like an infection, or a chronic problem, like an intestinal disease. A few of the more common causes of diarrhea are

Bacterial infections. Several types of bacteria, consumed through contaminated food or water, can cause diarrhea. Common culprits include Campylobacter, Salmonella, Shigella, and Escherichia coli.
Viral infections. Many viruses cause diarrhea, including rotavirus, Norwalk virus, cytomegalovirus, herpes simplex virus, and viral hepatitis.
Food intolerances. Some people are unable to digest some component of food , such as lactose, the sugar found in milk.
Parasites. Parasites can enter the body through food or water and settle in the digestive system. Parasites that cause diarrhea include Giardia lamblia, Entamoeba histolytica, and Cryptosporidium.
Reaction to medicines, such as antibiotics, blood pressure medications, and antacids containing magnesium.
Intestinal diseases, like inflammatory bowel disease or celiac disease.
Functional bowel disorders, such as irritable bowel syndrome, in which the intestines do not work normally.

Treatment

In most cases, replacing lost fluid to prevent dehydration is the only treatment necessary. Medicines that stop diarrhea may be helpful in some cases, but they are not recommended for people whose diarrhea is caused by a bacterial infection or parasite—stopping the diarrhea traps the organism in the intestines, prolonging the problem.

Instead, doctors usually prescribe antibiotics. Viral causes are either treated with medication or left to run their course, depending on the severity and type of the virus.

Preventing Dehydration

Dehydration occurs when the body has lost too much fluid and electrolytes (the salts potassium and sodium). The fluid and electrolytes lost during diarrhea need to be replaced promptly—the body cannot function properly without them. Dehydration is particularly dangerous for children, who can die from it within a matter of days.

Although water is extremely important in preventing dehydration, it does not contain electrolytes. To maintain electrolyte levels, you could have broth or soups, which contain sodium, and fruit juices, soft fruits, or vegetables, which contain potassium.

Natural Remedies

An organism related to brewer's yeast, saccharomyces boulardii (Sb), is widely used in Europe to prevent antibiotic-induced diarrhea. It is also available as a supplement in the United States. Animal research with Sb shows interference with Clostridium difficile, a common bacterial cause of diarrhea. In double-blind trials, Sb has prevented antibiotic-induced and other forms of infectious diarrhea.

An intake of 500 mg four times per day has been used in some of this research. Sb has also helped tourists prevent traveler’s diarrhea, according to double-blind research. In one trial, positive results were obtained at amounts as low as 150–450 mg per day.

References for Diarrhea Article

Pothoulakis C, Kelly CP, Joshi MA, et al. Saccharomyces boulardii inhibits Clostridium difficile toxin A binding and enterotoxicity in rat ileum. Gastroenterology 1993;104:1108–15.
Surzwicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: a prospective study. Gastroenterology 1989;96:981–8.
Bleichner G, Blehaut H, Mentec H, Moyse D. Saccharomyces boulardii prevents diarrhea in critically ill tube-fed patients. A muticenter, randomized, double-blind placebo-controlled trial. Intensive Care Med 1997;23:517–23.
Kollaritsch H, Holst H, Grobara P, Widermann G. Prevention of traveler’s diarrhea with Saccharomyces boulardii. Results of a placebo controlled double-blind study. Fortschr Med 1993;111:152–6 [in German].
Kirchelle A, Fruhwein N, Toburen D. Treatment of persistent diarrhea with S. boulardii in returning travelers. Results of a prospective study. Forstchr Med
Poupard JA, Hussain J, Norris RF. Biology of the bifidobacteria. Bact Rev 1973;37:136–65.
Saavedra J. Probiotics and infectious diarrhea. Am J Gastroenterol 2000;95:S16–8 [review].
National Institutes of Health

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