Diarrhea is characterized by loose, watery stools or a frequent need to have a bowel movement. It usually lasts a few days and often disappears without any treatment. Diarrhea can be acute or chronic.
Acute diarrhea occurs when the condition lasts for one to two days. You might experience diarrhea as a result of a viral or bacterial infection. Other times, it could be due to food poisoning.
There’s even a condition known as traveler’s diarrhea, which happens when you have diarrhea after being exposed to bacteria or parasites while on vacation in a developing nation. Acute diarrhea is fairly common.
Chronic diarrhea refers to diarrhea that lasts for at least four weeks. It’s usually the result of an intestinal disease or disorder, such as celiac disease or Crohn’s disease.
Luckily, diarrhea is usually short-lived, lasting no more than a few days. But, when diarrhea lasts for weeks, it usually indicates that’s there’s another problem. If you have diarrhea for weeks or longer, you may have a condition such as irritable bowel disorder, or a more serious disorder, such as a persistent infection or inflammatory bowel disease.
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.
What Is Diarrhea?
Going to the bathroom, having a bowel movement, pooping – no matter what you call it, stool is a regular part of your life. However, sometimes this process of getting waste out of your body changes. When you have loose or watery stool, it’s called diarrhea. This is a very common condition and usually resolves without intervention.
Diarrhea can happen for a wide variety of reasons and it usually goes away on its own in one to three days. When you have diarrhea, you may need to quickly run to the bathroom with urgency and this may happen more frequently than normal. You may also feel bloated, have lower abdominal cramping and sometimes experience nausea.
Although most cases of diarrhea are self-limited (happening for a fixed amount of time and steady level of severity), sometimes diarrhea can lead to serious complications. Diarrhea can cause dehydration (when your body loses large amounts of water), electrolyte imbalance (loss of sodium, potassium and magnesium that play a key role in vital bodily functions) and kidney failure (not enough blood/fluid is supplied to the kidneys). When you have diarrhea, you lose water and electrolytes along with stool. You need to drink plenty of fluids to replace what’s lost. Dehydration can become serious if it fails to resolve (get better), worsens and is not addressed adequately.
What’s The Difference Between Normal Diarrhea and Severe Diarrhea?
There are actually several different ways to classify diarrhea. These types of diarrhea include:
- Acute diarrhea: The most common, acute diarrhea is loose watery diarrhea that lasts one to two days. This type doesn’t need treatment and it usually goes away after a few days.
- Persistent diarrhea: This type of diarrhea generally persists for several weeks – two to four weeks
- Chronic diarrhea: Diarrhea that lasts for more than four weeks or comes and goes regularly over a long period of time is called chronic diarrhea.
What Are the Symptoms of Diarrhea?
The symptoms you can experience when you have diarrhea can vary depending on if it’s mild or severe and what the cause of the diarrhea happens to be. There’s a link between severe cases of diarrhea and a medical condition that needs to be treated.
When you have diarrhea, you may experience all of these symptoms or only a few. The main symptom of diarrhea is loose or watery stool.
Other symptoms of mild diarrhea can include:
- Bloating or cramps in the abdomen.
- A strong and urgent need to have a bowel movement.
- Nausea (upset stomach).
If you have severe diarrhea, you may experience symptoms like:
- Fever.
- Weight loss.
- Dehydration.
- Severe pain.
- Vomiting.
- Blood.
Severe diarrhea can lead to significant complications. If you have these symptoms, call your healthcare provider and seek medical attention.
Causes of Diarrhea
Viral infections cause most cases of diarrhea and are typically associated with mild-to-moderate symptoms with frequent, watery bowel movements, abdominal cramps, and a low-grade fever. Viral diarrhea generally lasts approximately three to seven days.
The following are the common causes of diarrhea caused by viral infections (viral gastroenteritis):
- Rotavirus is a common cause of diarrhea in infants.
- Norovirus (for example, Norwalk virus, caliciviruses) is the most common cause of epidemics of diarrhea among adults and school-age children (for example, cruise ship infection, schools, nursing homes, day care facilities, and restaurants).
- Adenovirus infections are common in all age groups.
Bacterial infections cause the more serious cases of infectious diarrhea. Typically, infection with bacteria occurs after eating contaminated food or drinks (food poisoning). Bacterial infections also cause severe symptoms, often with vomiting, fever, and severe abdominal cramps or abdominal pain. Bowel movements occur frequently and may be watery and individuals may experience “explosive diarrhea” which is a very forceful, almost violent, expulsion of loose, watery stool along with gas.
The following are examples of diarrhea caused by bacterial infections:
- In more serious cases, the stool may contain mucus, pus, or blood. Most of these infections are associated with local outbreaks of disease. Family members or others eating the same food may have similar illnesses.
- Foreign travel is a common way for a person to contract traveler’s diarrhea. (Traveler’s diarrhea also may be caused by unfamiliar viruses or parasites.)
- Campylobacter, salmonellae, and Shigella organisms are the most common causes of bacterial diarrhea.
- Less common causes are Escherichia coli (commonly called E. coli) Yersinia, and Listeria.
- Medications that one takes long-term may cause chronic diarrhea, including antibiotic-associated diarrhea. Use of antibiotics can lead to an overgrowth of Clostridium difficile (C diff) bacteria in the intestines.
Parasites cause infection of the digestive system by the use of contaminated water. Common parasitic causes of diarrheal disease include Giardia lamblia, Entamoeba histolytica, and Cryptosporidium.
Intestinal disorders or diseases (including those that affect the small intestine or colon) including inflammatory bowel disease including ulcerative colitis and Crohn’s disease, irritable bowel syndrome (IBS), diverticulitis, microscopic colitis, and celiac disease, and malabsorption (trouble digesting certain nutrients) are non-infectious causes of chronic diarrhea. Many of these disorders can cause the diarrhea to be yellow in color.
Reaction to certain medications can cause drug-induced diarrhea including antibiotics, blood pressure medications, cancer drugs, gout medications, weight loss drugs, and antacids (especially those containing magnesium).
Intolerance or allergies to foods such as artificial sweeteners found in sugar-free foods and lactose intolerance (to the sugar found in milk) can cause chronic diarrhea.
Alcohol abuse can cause diarrhea. Both binge drinking and chronic alcoholism may lead to loose stools.
Laxative abuse is one of the biggest self-induced causes of diarrhea, by taking too many laxatives, or taking them too frequently.
Diabetic diarrhea can be a complication of diabetes.
Radiation therapy or chemotherapy may cause loose stools and the diarrhea may last for up to three weeks after treatment ends.
Some cancers are more likely to cause diarrhea, including carcinoid syndrome, colon cancer, lymphoma, medullary carcinoma of the thyroid, pancreatic cancer, and pheochromocytoma.
Digestive surgery including stomach or intestinal surgery may cause diarrhea.
Running can cause diarrhea (sometimes referred to as “runner’s trots”). This usually happens after longer distances over 10K or particularly hard runs.
How Is the Cause of Diarrhea Diagnosed?
Your doctor will complete a physical examination and consider your medical history when determining the cause of your diarrhea. They may also request laboratory tests to examine urine and blood samples.
Additional tests your doctor may order to determine the cause of diarrhea and other related conditions can include:
- fasting tests to determine whether a food intolerance or allergy is the cause
- imaging tests to check for inflammation and structural abnormalities of the intestine
- a stool culture to check for bacteria, parasites, or signs of disease
- a colonoscopy to check the entire colon for signs of intestinal disease
- a sigmoidoscopy to check the rectum and lower colon for signs of intestinal disease
A colonoscopy or sigmoidoscopy is especially helpful for determining if you have an intestinal disease if you have severe or chronic diarrhea.
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%Trusted Source of nonsevere diarrhea cases.
Zinc supplementation may also reduce the severity and duration of diarrhea in children. Various products are available to purchase online.
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 online 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 bananas
- 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
How to Prevent Diarrhea
While diarrhea may be a sign of an underlying health condition and may be unavoidable, there are steps you can take to avoid some of the causes.
One of the most important things you can do to prevent diarrhea is to wash your hands frequently. Be sure to wash your hands after using the bathroom, before preparing or eating food, before and after caring for someone who is ill, after touching garbage, and after touching an animal, animal feed, and animal waste.
If soap and clean water are not available, use an alcohol-based hand sanitizer that contains 60 percent alcohol, per the CDC.
Another important way to prevent diarrhea in children is to get them vaccinated against rotavirus, which causes severe diarrhea mostly in babies and young kids. The virus can also lead to vomiting, fever, and dehydration. The CDC recommends babies get their first dose of the rotavirus vaccine at 2 months old. The second dose should be administered at 4 months old, and the third, if needed, at 6 months old.
The rotavirus vaccine will protect babies from severe diarrhea caused by rotavirus and most babies will not get rotavirus diarrhea at all, the CDC says.
Finally, you can take steps to avoid traveler’s diarrhea by watching what you eat and drink while traveling abroad, especially in developing countries, and talking to your doctor before you leave about taking antibiotics as a precaution, notes the CDC.
Read more Diet & Nutrition for Diarrhea
