Diarrhea

What is diarrhea?

Diarrhea describes bowel movements (stool) that are loose and watery. Diarrhea is a common condition and is usually not serious. Many people will have diarrhea once or twice a year. It typically lasts two to three days and can be treated with over-the-counter medicines.

Some cases require medical attention because diarrhea can quickly deplete the body's supply of water and salts that tissues need to function. The very young, old, and sick may have difficulty replacing these lost fluids. Diarrhea that lasts for several weeks or contains blood may indicate a serious illness. In these cases, you should contact your healthcare provider.

What are the symptoms of diarrhea?

The symptoms of mild diarrhea include:

• Abdominal bloating or cramps
• Thin or loose stools
• Watery stool
• A sense of urgency to have a bowel movement
• In some cases, nausea (upset stomach) and vomiting

In addition to the symptoms described above, symptoms of severe diarrhea include:

• Blood, mucus, or undigested food in the stool
• Weight loss or dehydration
• Fever
• Severe pain

Severe diarrhea may be a sign of a more serious illness and should prompt you to call your doctor. Contact your healthcare provider if you have prolonged diarrhea or a fever that lasts more than 24 hours. Also, see your doctor right away if vomiting prevents you from drinking liquids to replace lost fluids.

What causes diarrhea?

The most common cause of diarrhea is a virus that infects the bowel. The infection usually lasts for two days and is sometimes called intestinal flu. Diarrhea also may be caused by:

• Infection by bacteria
• Infections by other organisms
• Eating foods that upset the digestive system
• Allergies to certain foods
• Medications
• Radiation therapy

Diarrhea also may follow constipation, especially for people who have irritable bowel syndrome.

How is diarrhea treated?

If you have a mild case of diarrhea, you can treat it with an over-the-counter medicine. Common brand names include Pepto-Bismol®, Imodium A-D®, and Kaopectate®. These are available as liquids or tablets. Follow the instructions on the package.

Tips for managing mild diarrhea with medication:

• Take 30ml of Kaopectate or 30 ml of Pepto Bismol after each loose stool, not to exceed 8 doses.
• If Kaopectate does not help in 12 hours, take two tablets of Imodium after each loose stool (do not take more than eight tablets in 24 hours).
• If the Imodium does not help in 24 hours or if the diarrhea is still severe after 12 hours, call your doctor.

Tips for managing diarrhea without medication:

• Drink liquids frequently. Increase the amount to 2 to 3 liters or quarts daily as tolerated, or try sipping liquids in small amounts throughout the day. Choose diluted, pulpless fruit juices, broths, oral rehydration drinks or sodas (without caffeine). Chicken broth (without the fat), tea with honey, and sports drinks also are good choices. Instead of drinking liquids with your meals, drink liquids between meals.
• Try these low-fiber foods: potatoes, rice, noodles, ripe bananas, applesauce, smooth peanut butter, white bread, chicken or turkey without the skin, lean ground beef, fish, yogurt or cottage cheese.
• Avoid greasy, fatty, or fried foods; raw vegetables and fruits; strong spices, and whole-grain cereals and breads.
• Limit food or beverages with caffeine, such as chocolate, coffee, strong tea, and some sodas.
• If you have cramping with diarrhea, avoid gas-forming foods and beverages such as beans, cabbage, and carbonated beverages.
• If you are taking an antibiotic, add yogurt with active cultures to your diet. Call your health care provider if diarrhea continues.
• Diarrheal illness may result in temporary intolerance to lactose, (dairy) so avoid these foods if they are making diarrhea worse.

What can be done to relieve discomfort in the rectal area?

If your rectal area becomes sore because of frequent bowel movements, or if you experience itching, burning, or pain during bowel movements, try sitting in a few inches of warm water in a bathtub. Afterward, pat the area dry (do not rub) with a clean, soft towel. Also, apply petroleum jelly or a hemorrhoid cream to the anus.

Can diarrhea harm your health?

Ongoing diarrhea causes the body to lose large amounts of water and nutrients. If you have diarrhea more than three times a day and you are not drinking enough fluids, you could become dehydrated. Dehydration is the loss of water from body tissues, which disturbs the balance of essential substances in your body. Dehydration can cause serious complications if it is not treated.

Notify your healthcare provider if you have ongoing diarrhea and are experiencing any of the following signs of dehydration:

• Dark urine
• Small amount of urine
• Rapid heart rate
• Headaches
• Flushed, dry skin
• Irritability
• Confusion

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