What Is It?
Diarrhea is typically defined as having frequent loose or watery bowel movements that may include abdominal cramping or bloating. Diarrhea is, in fact, a symptom and not a disease. It can occur for many reasons, one of the most common of which is increased bowel motility. This in turn accelerates the movement of food through the intestines and does not provide enough time for water in the intestinal tract to be reabsorbed into the body. The result is that the stool retains water and becomes liquefied.
Diarrhea may be either acute or chronic. Acute diarrhea takes the form of an isolated incident caused by a temporary problem, often an infection. Chronic diarrhea is much more complex and may last for several days or months. Bowel disease is a common cause of chronic diarrhea.
What Causes It?
The intestinal irritation and increased bowel motility that can trigger diarrhea may be caused by a number of factors, including:
Who Gets Diarrhea?
People of any age who can relate to any of the causes listed above can develop diarrhea. It is a particularly serious condition when it occurs in the very old or very young. Diarrhea has long been the leading cause of death among infants and children worldwide. For most people in the U.S., it is an acute, self-limiting condition brought on by a pathogen (disease-causing organism). The average American will experience a bout of diarrhea approximately four times a year.
What are the Signs & Symptoms?
Diarrhea, which consists of the frequent passage of loose, watery stools, is often accompanied by:
When to Contact a Doctor
Increased thirst, along with dry mouth, anxiety or restlessness, decreased urine output, severe weakness, and dizziness or lightheadedness are all signs of possible dehydration from the loss of fluid. If any of these signs occur, or if diarrhea persists for more than a few days, a doctor should be contacted immediately. Seek medical help also if severe abdominal or rectal pain is experienced, if other family members experience the same symptoms, if fever exceeds 101°F, if there is blood in the stool or if stool appears black or “tarry” in appearance. If left untreated, diarrhea can lead to more serious health problems, including malnutrition, electrolyte imbalance, and in severe cases, even death.
How Is It Diagnosed?
Although relatively easy to diagnose, determining the cause of diarrhea can be more difficult. As with other disorders, a thorough patient history may help pinpoint possible causes. It is important to know what medications the patient is taking, his or her dietary habits (including glucose/lactose intolerance) and whether or not he or she has traveled recently outside of the country.
Because most cases of diarrhea in the U.S. are self-limiting and relatively mild, specific laboratory tests are not always done. With more severe cases, a stool test is often performed to help identify a bacterial or fungal infection. In the case of traveler’s diarrhea, a parasite test will likely be ordered if diarrhea persists once the traveler has returned home, although many holistic physicians recognize the widespread nature of parasitic infection and will test for parasites even if international travel is not involved. Further tests may also be ordered to help rule out food sensitivities, nutrient deficiency, disease or other possible causes.
In the case of secretory diarrhea (caused by a disease process that results in fluid secretion in the intestines) your doctor may perform additional tests in order to rule out hidden tumors (often located in the pancreas). It is important to bear in mind that the effects of laxatives and diuretic medications can mimic secretory diarrhea, so be sure to let your doctor know if you are taking either of these.
What Is the Standard Medical Treatment?
Treatment of diarrhea depends upon the cause. For example, if it is related to lactose intolerance, dairy foods will need to be eliminated from the diet. If diarrhea is brought on by medication use, it may be necessary to adjust or discontinue the medication regimen. In cases where infection is present, medication, herbal remedies, or a combination of both may be recommended.
There is some disagreement in medical circles with regard to the treatment of acute diarrhea. Some doctors will prefer to let a mild case run its course, while others will offer symptomatic relief through the use of drugs that help reduce intestinal secretions. However, such drugs may worsen the condition by preventing the elimination of the diarrhea-causing organism(s). A safer, natural alternative includes a mixture of kaolin clay and apple pectin, which helps eliminate harmful bacteria and adds necessary bulk to the stool, and some doctors may recommend a short-term BRAT diet (bananas, rice, applesauce and toast). This diet, however, has its drawbacks: the sugar from the fruit can aid bacterial growth, and the gluten content of the bread may aggravate any underlying gluten sensitivity.
In cases of chronic diarrhea, consult your physician so that he/she may rule out lactose intolerance, food sensitivity, parasite infection, or underlying infection/disease that may cause persistent loose stools.
Avoiding Travelers’ Diarrhea
Although some doctors prescribe symptom-suppressing medication on a “preventive” basis for patients who will be traveling to developing countries, the use of such antibiotics can actually destroy the beneficial bacteria in the intestines that help crowd out disease-causing pathogens. If traveling internationally, it is better to simply avoid drinking the local water (this includes ice cubes), avoid eating raw vegetables or unpeeled fruit, and avoid dairy products.
Temporary Diet Changes
After symptoms begin to subside, begin with a soft diet for 1 to 2 days, consisting of potatoes, soup, and steamed vegetables. Go very slowly. Drink plenty of water.
Try to determine if there have been any changes in your lifestyle recently that might have brought about the diarrhea condition. You can then refer to the causes listed earlier in this section and take the appropriate steps.
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