Diarrhea is the frequent passage of loose, watery, soft stools with or without abdominal bloating, pressure, and cramps commonly referred to as gas or flatulence.
Seek medical care if severe abdominal pain, fever, dehydration, rectal bleeding, sleepiness, or vomiting accompany the diarrhea. People who have diarrhea and are pregnant or have underlying medical conditions should also see a doctor.
Treatment of diarrhea depends upon the cause of the loose stools, as well as the patient’s general health.
Causes of diarrhea
Include viral and bacterial infections, as well as parasites, intestinal disorders or diseases (such as irritable bowel syndrome [IBS]), reactions to medications, and food intolerance. The main symptom of diarrhea is watery, liquid stools. In addition, other symptoms of diarrhea include the following:
- Stomach cramps
- Fever
- Bloating
- Bowel movement urgency
- Dehydration
Diarrhea is usually diagnosed by the appearance of the symptoms, and no tests may need to be ordered. In some cases a doctor may order a stool culture, blood tests, a colonoscopy, or imaging tests such as X-rays or CT scans to determine an underlying cause.
In most cases, diarrhea can be treated at home and it will resolve itself in a few days. Drink plenty of fluids, and follow the “BRAT” diet (bananas, rice, applesauce, and toast) to help ease symptoms. Take care to ensure infants and children stay hydrated. Electrolyte solutions such as Pedialyte can be helpful.
Over-the-counter (OTC) antidiarrheal medications may provide some relief of symptoms, including loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol, Kaopectate, etc.). Consult your doctor before treating diarrhea with these drugs, as some people may need to avoid them. Do not give them to children under 5 years of age. The prognosis for diarrhea is generally good and in most cases symptoms will resolve in a few days.
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.Common Symptoms and Signs of Diarrhea
- Watery, liquid stools: The stools may be any color. The passage of red stools suggests intestinal bleeding and could be a sign of a more severe infection. The passage of thick, tarry black stools suggests significant bleeding in the stomach or upper portions of the intestine and is not usually caused by acute infections. Diarrhea may appear green in color because stool passes through the intestines faster than usual.
- Abdominal cramps: Occasionally diarrhea is accompanied by mild-to-moderate abdominal pain. Severe abdominal or stomach pain is not common and, if present, may suggest more severe disease.
- Fever: A high fever is not common. If present, the affected person may have a more severe illness than acute diarrhea.
- Bloating and gas
- The urgent feeling or need to have a bowel movement
- Dehydration: If diarrhea leads to dehydration, it is a sign of potentially serious disease. Signs and symptoms of dehydration include the following:
- Adults may be very thirsty and have a dry mouth.
- The skin of older people may appear to be loose. The elderly may also become very sleepy or have behavioral changes and confusion when dehydrated.
- Dehydrated infants and children may have sunken eyes, dry mouths, and urinate less frequently than usual. They may appear very sleepy or may refuse to eat or drink.
- Certain infections may cause diarrhea that may also be accompanied by bloody stools, fever and chills, lightheadedness and dizziness, and vomiting.
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Home Remedies To Treat Diarrhea
Foods to avoid
Fried and greasy foods are usually not well-tolerated in people who have diarrhea. You should also consider limiting high-fiber foods like bran as well as fruits and vegetables that can increase bloating. Foods to avoid include:
- alcohol
- artificial sweeteners (found in chewing gum, diet soft drinks and sugar substitutes)
- beans
- berries
- broccoli
- cabbage
- cauliflower
- chickpeas
- coffee
- corn
- ice cream
- green leafy vegetables
- milk
- peas
- peppers
- prunes
- tea
Foods to eat
While it might sound counterintuitive to eat if you have diarrhea, eating certain foods can help alleviate your diarrhea symptoms and ensure your health doesn’t worsen from not eating. Stick to low-fiber “BRAT” foods that will help firm up your stool. These include:
- bananas
- rice (white)
- applesauce
- toast
Other foods that are usually well-tolerated when experiencing diarrhea include:
- oatmeal
- boiled or baked potatoes (with skins peeled)
- baked chicken with skin removed
- chicken soup (which also aids in rehydration)
Over-the-counter drugs
With your doctor’s supervision, several over-the-counter medications can help with acute diarrhea if your symptoms are not severe. Common over-the-counter medications include:
- bismuth subsalicylate (Pepto-
Bismol and Kaopectate) - loperamide (Imodium)
While these drugs can relieve the symptoms of diarrhea, they don’t treat the underlying cause.
If you have chronic diarrhea, you shouldn’t use these drugs without your doctor’s consent. Chronic diarrhea is diarrhea that lasts more than 14 days. It often has different causes.
You should be especially cautious if your child has diarrhea. Dehydration resulting from diarrhea can be dangerous and can occur quickly in young children. Severe dehydration can be life-threatening. Over-the-counter medications are not recommended for treatment in children, so it’s important to talk to your doctor. Infants under 3 months old who have diarrhea should be taken to the doctor right away.
If you have bloody diarrhea, a fever, more than seven days of symptoms, intense abdominal pain, or diarrhea that is getting worse, you should seek medical attention.
Probiotics
Probiotics are sources of “good” bacteria that work in your intestinal tract to create a healthy gut environment. They’re essentially live microorganisms that exist in certain foods, including:
- aged soft cheeses
- beet kvass
- cottage cheese
- dark chocolate
- green olives
- kefir
- kimchi
- kombucha
- sauerkraut
- miso
- natto
- pickles
- sourdough bread
- tempeh
- yogurt
Probiotics also come in powder or pill form.
The good bacteria that live in your intestinal tract are necessary for the normal functioning of your gastrointestinal system. They play an important role in protecting your intestines against infection. When your system is changed by antibiotics or overwhelmed by unhealthy bacteria or viruses, you can get diarrhea. Probiotics can help with diarrhea by restoring the balance of bacteria in your gut.
Saccharomyces boulardii is a yeast probiotic. While it’s not a bacterium, it acts like one. S. boulardii may improve antibiotic-associated diarrhea. It also seems to provide relief for traveler’s diarrhea. Studies suggest it may help your intestines fight off unwanted pathogens and ensure they’re absorbing nutrients properly. Because it is yeast, it should be used with caution in people with inadequate immune systems.
It’s important to receive proper medical care in cases of acute diarrhea. Talk with your health care provider before taking probiotic supplements to treat your diarrhea.
Hydration
Hydration is very important when you have diarrhea. Dehydration from diarrhea can be fatal in young children and older adults. Continue breastfeeding or formula feeding infants who are experiencing diarrhea. Over-the-counter oral pediatric hydration solutions, like Pedialyte, are the recommended fluids of choice for children with diarrhea. Small amounts of hydration solutions should be given frequently. These formulas also come in popsicle preparations.
Studies have shown that for adults with mild symptoms of diarrhea, sports drinks and over-the-counter rehydration solutions are equally effective.
Alcohol, milk, soda, and other carbonated or caffeinated drinks should not be used for hydration, as they may make your symptoms worse.
