Diarrhea

Diarrhea is loose, watery, and frequent stools. Diarrhea is considered long-term (chronic) when you have had loose or frequent stools for more than 4 weeks. Considerations Diarrhea in in infants and children (especially under age 3) can caused dangerous dehydration very quickly. Diarrhea in adults is usually mild and goes away quickly without complications. Causes The most common cause of diarrhea is viral gastroenteritis, or the stomach flu. This is a mild viral infection that goes away on its own within a few days. Eating or drinking contaminated food or water can also lead to diarrhea. Such common causes of diarrhea include: Food poisoning Traveler's diarrhea

Certain medications may also cause diarrhea, including: Certain antibiotics Chemotherapy Laxatives containing magnesium

Diarrhea may also be caused by certain medical conditions, including: Celiac disease Inflammatory bowel diseases (Crohn's disease and ulcerative colitis) Irritable bowel syndrome (IBS) Lactose intolerance Malabsorption syndromes

Less common causes of diarrhea include: Carcinoid syndrome Nervous systems disorders, including autonomic neuropathy or diabetic neuropathy Partial removal of the stomach (gastrectomy) Radiation therapy Zollinger-Ellison syndrome

Home Care

It is important to drink plenty of fluids to prevent dehydration. Dehydration means your body does not have the proper amount of water and fluids. Dehydration can be especially dangerous for infants and young children and people who live in a hot climate. Signs of severe dehydration include: Decreased urine (fewer wet diapers in infants) Dry mouth Sunken eyes Few tears when crying

Children with diarrhea should be given fluids only for the first 4 to 6 hours. Try 2 tablespoons (1 ounce) of fluid every 30 to 60 minutes. Brands such as Pedialyte can be helpful. Do not water down these fluids. Pedialyte popsicles are also available. Watered-down fruit juice or broth may also help.

If you are breastfeeding your infant, continue to do so. If you are using formula, use it at half strength for 2 to 3 feedings after the child's diarrhea starts. You can use the regular amount of formula after this. Adults and older children who have diarrhea may feel better by following these steps: Drink 8 to 10 glasses of clear fluids every day. Water is best. Drink at least 1 cup of liquid every time you have a loose bowel movement. Eat small meals throughout the day, instead of 3 big meals. Eat salty foods, such as pretzels, soup, and sports drinks. Eat high potassium foods, such as bananas, potatoes without the skin, and watered-down fruit juices. Get plenty of rest

Avoid over-the-counter antidiarrhea medications unless instructed to use them by your doctor. Certain infections can be made worse by these drugs. If you have a chronic form of diarrhea, such as is caused by irritable bowel syndrome, try adding bulk to your diet to thicken your stool and regulate bowel movements. Such foods include fiber from wholewheat grains and bran. Psyllium-containing products such as Metamucil or similar products can also add bulk to stools and help solidify them. When to Contact a Medical Professional Call for an appointment with your health care provider if you have: Blood or pus in your stools Black stools Stomach pain that does not go away after a bowel movement Symptoms of dehydration (thirst, dizziness, light-headedness)

Diarrhea with a fever above 101F (100.4F in children) Recently traveled to a foreign country and developed diarrhea

Also call your doctor if: The diarrhea gets worse or does not get better in 2 days for an infant or child, or 5 days for adults A child over 3 months old has been vomiting for more than 12 hours; in younger babies, call as soon as vomiting or diarrhea begins

What to Expect at Your Office Visit Your doctor perform a physical exam and ask you questions about your medical history and symptoms, including: When did your diarrhea start? What is the color and consistency of your stool? Do you have blood in your stool? Are you passing large amounts of mucus with your stool? What other symptoms do you have? Do you have abdominal pain or severe cramping with the diarrhea? Do you have fever or chills? Are any other people in your house sick? Have you recently traveled out of the country? Have you possibly been exposed to unpurified water or spoiled food? What makes your pain worse? Stress? Specific foods? Have you had abdominal surgery? Have you taken antibiotics recently? What medications do you take? Any recent changes to your medications? Do you drink coffee? How much? Do you drink alcohol? How much? How often? Do you smoke? How much each day? Are you on a special diet?

Laboratory tests may be done on your stools to determine the cause of your diarrhea. If there are signs of dehydration in addition to the diarrhea, your doctor may order: Basic metabolic panel Urine specific gravity

Prevention Over-the-counter supplements that contain healthy bacteria, called probiotics, may help prevent diarrhea associated with antibiotics. Yogurt with active or live cultures is a good source of these healthy bacteria. The following healthy steps can help you prevent illnesses that cause diarrhea: Wash your hands often, especially after going to the bathroom and before eating.

Use alcohol-based hand gel frequently. Teach children to not put objects in their mouth.

When traveling to underdeveloped areas, follow the steps below to avoid diarrhea: Drink only bottled water and do not use ice, unless it is made from bottled or purified water. Do NOT eat uncooked vegetables or fruits that do not have peels. Do NOT eat raw shellfish or undercooked meat. Do NOT consume dairy products.

Definition
Most people experience frequent, watery bowel movements once or twice a year. This change from the usual pattern of stools is recognized as diarrhea, although many less "formal" names are sometimes used.

Description
For most people, the episode is more an inconvenience than an illness. Symptoms commonly disappear in a short time, and the only important effect is that water and salts are lost from the body. Sometimes diarrhea lasts for weeks or months, and then it can be an indication of major disease. This more serious form of diarrhea may be accompanied by blood, mucus, or undigested food in the stools. The underlying cause of diarrhea also may produce fever, abdominal cramps, weight loss, nausea, and/or vomiting. So, we should try to separate the mild and short-lived episodes of diarrhea from continuous and severe diarrhea with these other features. People living in certain areas are usually well adjusted to commonly found bacteria in their environment, but people who are new arrivals are susceptible to these bacterial infections. Although most infectious diarrheas are brief illnesses, some do not go away after a few days. More serious forms can be caused by microbes such as amoebae and giardia, which can become established in the bowel and cause problems that persist for weeks or months. Contaminated food or water, public swimming pools, and communal hot tubs are possible sources of these infections. Infectious diarrhea can have serious consequences in certain persons. Young infants, very old people, or those who have major illnesses can be seriously weakened by even a minor infection. Simple infectious diarrhea is still a major killer in underdeveloped countries, where infections of the bowel are estimated to cause millions of deaths annually among infants.

Causes
A hundred or more different diseases can be associated with diarrhea. Fortunately, most of the severe causes are rare and the most common form is the one that affects most of us for a few days each year. It is due to a simple infection, usually caused by a virus. Bacterial infections can cause more serious cases of diarrhea as a result of eating contaminated food or drinks (food poisoning). Common bacteria are campylobacter, salmonellae, and shigella organisms; less common are Escherichia coli (E coli), yersinial, listerial, and cryptosporidial bacteria. These can cause fairly severe diarrhea with vomiting, abdominal cramping and fever.

The more serious causes include ulcerative colitis (when blood is usually present in the stools), regional ileitis (Crohn's disease), some forms of intestinal cancer (when pain and weight loss might also be present), and some disorders of the intestine that lead to poor digestion of food. "Nervous diarrhea," in its more severe form a component of irritable bowel syndrome (IBS), is very common and often shows up briefly when we face the stress of a term paper or a job interview. However, some people suffer nervous stress fairly constantly and may have continuous diarrhea because of it.

Symptoms
The common illness, which may last several days, often called "intestinal flu," is often due to one of a number of viruses that infect the bowel, making it weep fluid. The excess of fluid in the bowel leads to liquid stools. The inflammation may also be associated with cramping abdominal pain, nausea, and vomiting. Other common infectious diarrheas may be caused by bacteria. These bacteria irritate the bowel and make it pour out fluid. The inflammation may also be associated with cramping abdominal pain. "Travelers' diarrhea" is due to particular bacteria common in certain areas of the world.