Diarrhea is a very common water-borne disease. A person who has diarrhea passes loose or liquid stool at least three times a day or more frequently than what is normal for the person. The reason behind the consistency and frequency of these bowel movements in a case of diarrhea is the increased flow of fluid through the intestines, causing abdominal pain and sudden contractions of the stomach muscles.
What is diarrhea?
Diarrhea is a problem that can range from being a mild and temporary condition to a life-threatening one. An estimated 2 billion cases of diarrhea occur every year globally. The World Health Organization (WHO) has pointed to diarrhea as the second leading cause of death among children under the age of five - 1.9 million children under five years old, most of them in developing countries, die annually. While many people confuse diarrhea with the frequent passing of stool of normal consistency, diarrhea is instead characterized by abnormally loose or watery stool. It is loose or watery stool that passes through the intestines several times a day that is called diarrhea. Generally, it lasts for a few hours or a few days and goes away by itself. However, if the symptoms last and continue for more than 14 days, the diarrhea is considered either persistent (lasting two to four weeks) or chronic (lasting beyond four weeks).
Diarrhea can be absolute and relative. When someone goes through five or more bowel movements a day passing loose or watery stool, it is called absolute diarrhea. Relative diarrhea, on the other hand, refers to when an individual has an increased number of bowel movements in comparison with their normal bowel habit, especially when the stool is loose or watery. Diarrhea can be either acute or chronic, having different symptoms, duration, and causes, thus requiring different treatments. Diarrhea can range in severity from slightly watery feces and a brief upset stomach to longer-term, extremely watery feces and cramping stomach pains with a frequent, urgent need to go to the toilet. Other common symptoms associated with diarrhea are nausea or vomiting, a temperature of 38° C degrees or higher, headache and loss of appetite.
Many people complain of diarrhea at least once or twice a year and this lasts for two to three days. The individual can control his or her diet patterns and intake over the counter medicines as treatment. Some people have irritable bowel syndrome due to which they complain of frequent problems of diarrhea. Also people may complain of constipation after diarrhea.
A person is likely to come down with acute diarrhea after coming into contact with any of the following infectious organisms and agents, usually by eating or drinking contaminated food or water:
- Viruses, such as rotavirus, winter vomiting disease (Norwalk virus or norovirus), enterovirus, or a hepatitis virus
- Bacteria, such as E. coli, salmonella, shigella, C diff (clostridium), or cholera (Vibrio cholerae)
- Parasites, such as those that cause giardiasis and amoebiasis
The length of time a person suffers diarrhea often depends on what caused it. For instance, diarrhea from norovirus lasts around two days, and from rotavirus, the duration is three to eight days. Campylobacter and salmonella infections may last two to seven days, while diarrhea from giardiasis can last several weeks.
Meanwhile, persistent and chronic diarrhea are usually the result of any of a hold host of varied causes.
Causes of diarrhea
Diarrhea can be caused by host of varied reasons. Few of these are listed below:
- Excess intake of alcohol or alcohol abuse
- Intake of too much laxatives
- Having foods which could upset the digestive system
- Intake of too much spicy food
- Diabetic patients
- Crohn’s disease or any disease of the intestines
- Food poisoning or infection caused due to bacteria
- Intake of medications for any ongoing or existing illness
- Any surgery performed on the digestive system
- Radiation therapy
- Travelers or runner’s diarrhea
- Drugs side effects
Symptoms of diarrhea
The person complaining of diarrhea may experience the below signs and symptoms:
- Cramps which may get severe over time
- Passing watery stools
- Nausea and vomiting
- Bloating in the belly
- Within minutes having an urgent need to empty your bowel
During diarrhea one should increase the intake of water else it would lead to dehydration. That can cause serious complications if not treated on time.
Classification of diarrhea
There are three types of diarrhea depending on the duration they last:
It does not last long and recovery comes within several hours to less than 14 days. When someone has three or more bowel movements within a day, it is considered acute diarrhea. When acute diarrhea contains blood, it is called dysentery. An especially virulent cause of acute diarrhea is cholera, which can lead to profuse diarrhea, vomiting, and severe dehydration, and death in a matter of hours if left untreated.
- Gastroenteritis, an intestinal infection, is most commonly responsible for acute diarrhea. Infants and youngsters are an easy target for such intestinal infections caused by rotavirus.
- Travelers, tourists, and adventurers can easily be downed by acute diarrhea. The infectious viruses and germs are transmitted to their body through contaminated food or by a person who does not show any symptom of the disease yet carries the virus responsible for the infection.
- Food poisoning is a common reason for diarrhea. When a person eats food contaminated with certain viruses or bacteria, diarrhea occurs. An example of bacteria that contaminates food is Escherichia coli (E. coli) bacteria, which, when introduced into the body through food or fluids, releases enterotoxins in the gut and causes intestinal infection and fluid secretion.
- Acute diarrhea can also result from completing a full course of antibiotics. There are a lot of drugs and alcoholic products that bring on this condition.
Persistent diarrhea takes more time than acute diarrhea to recover from. Persistent diarrhea lasts from 14 days to four weeks. Sometimes, persistent diarrhea occurs right after any surgery on the stomach, for instance, an operation that removes part of the stomach, such as a stomach cancer.
It is the most serious type of diarrhea, causing extreme abdominal pain and continuing for more than four weeks.
- Inflammatory bowel diseases such as Crohn's disease or ulcerative colitis can cause chronic diarrhea when the body's immune system attacks a part of the digestive tract.
- Irritable bowel syndrome is most commonly responsible for chronic diarrhea. It attacks the colon (large intestine) and causes abdominal pain. IBS also develops in a human body when it's infected with another virus.
- An endocrine disorder is caused by an overactive thyroid, which in turn causes chronic diarrhea. Diabetes patients may also suffer from this condition when the digestive tract gets injured and food cannot pass through properly.
- People who have celiac disease cannot tolerate gluten, which is found in wheat flour. When they eat food containing gluten, their body fails to digest it resulting in chronic diarrhea. Lactose intolerant people also face gastric problems and diarrhea when they eat dairy foods.
When to seek medical assistance
Seek doctor’s assistance if you have:
- Black, tarry stools
- Sudden high fever that lasts for more than 24 hours
- While drinking fluids, you feel nausea or you vomit out the liquid
- Continuous diarrhea which lasts for more than two days
- Sudden diarrhea once you return from vacation
- Excessive pain in the abdomen or rectum which doesn’t get better even after the intake of antibiotics
Very sugary drinks including natural sugars which are also found in fruits can make diarrhea worse. Sugar draws fluid into the intestines during digestion which dilutes the stools.
A person may also start to dehydrate during diarrhea, hence check with your doctor immediately if you experience any of the below symptoms of dehydration:
- Dark-colored urine
- Constant headaches
- Dryness in skin and mouth
- Feeling of irritability and confusion
If your child is dehydrated, then there would be smaller amounts of urine which is less than normal.
Treatment for diarrhea
Diarrhea often goes away without treatment after a few days, because our body’s immune system automatically fights the infection. However, you must still contact your doctor if you observe or experience any of the following:
- Diarrhea that has blood in it
- Diarrhea and persistent vomiting
- Unexplained weight loss
- Bleeding from your rectum (back passage)
- Passing large volumes of very watery diarrhea (presenting the risk of dehydration)
- Symptoms at night that cause sleep disturbances
- Diarrhea that lasts longer than a week
- A chronic illness, for example diabetes
A person suffering from diarrhea can also be cured through a self-care regimen which may include:
- Eating normally and making sure to have meals regularly
- Maintaining good personal hygiene
- Not sharing personal items such as towels, toothbrushes or face cloths
- Staying hydrated constantly
- Having fruit juices and avoiding caffeine
- Drinking liquid in between meals instead of having them with your meals
- A warm bath- Due to constant bowel movements, the rectal area may become sore hence for relief you can have a warm bath.
- If you feel itching, burning or a painful sensation in the rectal area, use petroleum jelly and apply on the affected area. Do not rub hard on the area.
- Eating a little bit of fat could ease diarrhea. The diarrhea symptoms can reduce since fats are slow to get digested.
- Including fibrous food in your diet- Insoluble foods may speed up stools as they pass through the intestines, whereas soluble fibers absorb water in the intestines and make stool firm. Peeled fruits, vegetables, oats and beans contain soluble fiber. Skins of raw fruits and vegetables and whole grains contain insoluble fiber.
Also, over the counter medications such as subsalicylate, loperamide or bismuth can be taken. These are available in both liquid and tablet form. Have them as mentioned on the label.
Dehydration – a serious risk of diarrhea
During diarrhea, a person loses a lot of fluid. This loss of fluid, if continuous, results in dehydration. Particularly, children are more affected with dehydration. If a child is dehydrated, look out for signs such as sunken spots on the child’s head, dryness in the mouth and skin, feeling very thirsty, the child cries without tears and also urinates with just drops of urine. At times, adults may also come across similar symptoms including lethargy, sunken eyes, weakness and tiredness. In such instances, increase the intake of fluids, non-caffeinated drinks and oral re-hydration solutions or fruit juices.
Diarrhea in babies
A baby’s poop is usually based on what he or she is eating. The poop is normally much softer than that of adults, and at times its softer than usual. However, the cause of concern should be once it starts getting watery or much looser along with the rise in frequency of the poop. Then it is cause of worry, since it could be diarrhea.
Diarrhea in babies could be due to varied causes:
- Sensitivity to medicines
- Any food allergy or first time contact with a new food for which the stomach is not ready yet
- Food poisoning
- Contact with unclean food, water or any surfaces with germs can increase the risk of diarrhea
Teething in babies also is a main concern for diarrhea. Babies often have the habit of picking up anything and putting it in their mouths since babies get very irritated during the teething period.
Immediately call your doctor if the diarrhea worsens or if the baby starts having dehydration effects. Below are few signs to make a note of:
- High fever
- Consistant vomiting
- Poop which is black or red color
- Pus or blood in the stool
Doctors usually do not prescribe over the counter medications for babies. They would rather recommend antibiotics in cases of bacterial infection or anti-parasitics in cases of parasite infection. Fluid intakes should be increased for kids since they can get dehydrated easily. Oral re-hydration approved by WHO would be recommended for a baby with diarrhea. This oral re-hydration has electrolytes that can prevent dehydration and energize the child. If the child is on solid foods, then switch to bland foods rather than oily and spicy foods. In cases of infants, the mother who is breastfeeding would need to make adjustments in her diet and avoid any foods which can worsen the condition for the child or trigger diarrhea.
Diarrhea is contagious if it is caused by viral or bacterial infections. Hence, wash your hands thoroughly with water and soap every time you feed the baby or change a diaper. The diaper changing area should be kept clean and disinfected. Keep a watch on your baby to see what he or she puts in his or her mouth. Ensure to also wash your baby’s hands and legs. Try to keep the area clean where the baby is present, so there are less chances of getting infected with germs.
The bottom line
Diarrhea is essentially the passing of loose stool more frequently than usual. One should avoid food and water from dubious sources. When one has diarrhea, re-hydration is of upmost importance, and if blood and vomiting are present, one should not waste a single minute and treat the matter as a medical emergency requiring immediate medical help.