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.
People of all ages can get diarrhea. The average adult has a
bout of diarrhea about four times a year.
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.
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.
Children
Children can have acute or chronic forms of diarrhea. Causes
include bacteria, viruses, parasites, medications, functional
disorders, and food sensitivities. Infection with the rotavirus
is the most common cause of acute childhood diarrhea. Rotavirus
diarrhea usually resolves in 3 to 9 days.
Medications to treat diarrhea in adults can be dangerous to
children and should be given only under a doctor's
guidance.
Diarrhea can be dangerous in newborns and infants. In small
children, severe diarrhea lasting just a day or two can lead to
dehydration. Because a child can die from dehydration within a
few days, the main treatment for diarrhea in children is
rehydration.
Take your child to the doctor if any of the following
symptoms appear:
- stools containing blood or pus, or black stools
- temperature above 101.4 degrees Fahrenheit
- no improvement after 24 hours
- signs of dehydration (see below)
Dehydration
General signs of dehydration include
- thirst
- less frequent urination
- dry skin
- fatigue
- light-headedness
- dark colored urine
Signs of dehydration in children include
- dry mouth and tongue
- no tears when crying
- no wet diapers for 3 hours or more
- sunken abdomen, eyes, or cheeks
- high fever
- listlessness or irritability
- skin that does not flatten when pinched and
released
If you suspect that you or your child is dehydrated, call
the doctor immediately. Severe dehydration may require
hospitalization.
Medical Consultation
Although usually not harmful, diarrhea can become dangerous
or signal a more serious problem. You should see the doctor if
any of the following is true:
- You have diarrhea for more than 3 days.
- You have severe pain in the abdomen or rectum.
- You have a fever of 102 degrees Fahrenheit or
higher.
- You see blood in your stool or have black, tarry
stools.
- You have signs of dehydration.
If your child has diarrhea, do not hesitate to call the
doctor for advice. Diarrhea can be dangerous in children if too
much fluid is lost and not replaced quickly.
Diagnostic Tests
Diagnostic tests to find the cause of diarrhea include the
following:
- Medical history and physical examination. The
doctor will need to know about your eating habits and
medication use and will examine you for signs of
illness.
- Stool culture. Lab technicians analyze a sample
of stool to check for bacteria, parasites, or other signs
of disease or infection.
- Blood tests. Blood tests can be helpful in
ruling out certain diseases.
- Fasting tests. To find out if a food intolerance
or allergy is causing the diarrhea, the doctor may ask you
to avoid lactose (found in milk products), carbohydrates,
wheat, or other foods to see whether the diarrhea responds
to a change in diet.
- Sigmoidoscopy. For this test, the doctor uses a
special instrument to look at the inside of the rectum and
lower part of the colon.
- Colonoscopy. This test is similar to
sigmoidoscopy, but the doctor looks at the entire
colon.
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.
Tips About Food
Until diarrhea subsides, try to avoid milk products and
foods that are greasy, high-fiber, or very sweet. These foods
tend to aggravate diarrhea.
As you improve, you can add soft, bland foods to your diet,
including bananas, plain rice, boiled potatoes, toast,
crackers, cooked carrots, and baked chicken without the skin or
fat. For children, the pediatrician may recommend what is
called the BRAT diet: bananas, rice, applesauce, and toast.
Summary
- Diarrhea is a common problem that usually resolves on
its own.
- Diarrhea is dangerous if a person becomes
dehydrated.
- Causes include viral, bacterial, or parasitic
infections; food intolerance; reactions to medicine;
intestinal diseases; and functional bowel disorders.
- Treatment involves replacing lost fluids and
electrolytes. Depending on the cause of the problem, a
person might also need medication to stop the diarrhea or
treat an infection. Children may need an oral rehydration
solution to replace lost fluids and electrolytes.
- Call the doctor if a person with diarrhea has severe
pain in the abdomen or rectum, a fever of 102 degrees
Fahrenheit or higher, blood in the stool, signs of
dehydration, or diarrhea for more than 3 days.
Reference for
Diarrhea Article
National
Institutes of Health
Health
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