with its loose, watery stools, frequent trips to the
bathroom and other unpleasant symptoms is a digestive
disorder that virtually everyone has or will eventually
experience. It is estimated that up to 5 percent of
US population is affected by diarrhea at any given time
with the average adult experiencing a bout of diarrhea
about four times a year. People of all ages can get
diarrhea but it can be particularly dangerous in children
and the elderly because it can rapidly cause dehydration
and needs to be treated promptly to avoid serious health
healthy adults the most common type of diarrhea, acute
or short-term, usually lasts a few days at most and
goes away on its own without any special treatment.
However, if diarrhea persists beyond 1 week or extreme
dehydration is suggested by excessive thirst, dry mouth
and skin, little or no urination, severe weakness, dizziness
or lightheadedness, medical attention is needed. Also
get medical help if there is severe, persistent abdominal
or rectal pain, bloody or black, tarry stools, or a
temperature of more than 101 F. Chronic or long-term
diarrhea where the symptoms are continuous or reoccur
frequently is an indication of more serious underlying
problems such as irritable bowel syndrome, inflammatory
bowel disease, chronic infection, or malabsorption of
signs and symptoms associated with diarrhea often include:
Frequent loose, watery stools
An urgent need to use the bathroom
Nausea and vomiting
Treatment & Prevention of Diarrhea
Most commonly, acute diarrhea is the result of an inflammation
of the intestinal tract. The inflammation can be the
result of pathogenic bacteria overgrowth (often after
antibiotic treatment, a viral or parasitic infection
or irritation caused by medications or foods) or a viral
or parasitic infections and irritations caused by medications
and certain foods including artificial sweeteners. Normally,
the food you eat remains in liquid form during most
of the digestive process up to and including the small
intestine. At the point where food passes into and through
the colon most of the fluids are absorbed and what remains
is a semisolid stool. Inflamation can disrupt the normal
processes of the digestive system causing food and fluids
to pass too quickly or in to large an amount (or both)
through the colon. As a result, the fluids aren't sufficiently
absorbed and the result is a watery bowel movement.
The most common causes of the intestinal infection or
irritation that causes diarrhea include:
Contaminated food or water can introduce pathogenic
bacteria into your intestinal tract. Common bacterial
causes of diarrhea include campylobacter, salmonella,
shigella and Escherichia coli. Normally your intestinal
tract is home to billions of beneficial bacteria that
perform vital functions in the digestion of food. These
beneficial bacteria compete with pathogenic bacteria
and help keep them in check. When a harmful strain like
E. coli is able to overwhelm the body’s beneficial
(also known as probiotic) bacteria and grow out of control
they can injure the intestinal walls are irritate the
Rotavirus and adenovirus are common causes of diarrhea
in young children as direct contact easily spreads these
Diarrhea can be a side effect of many medications, particularly
antibiotics. Antibiotics disturb the natural balance
of beneficial bacteria (probiotics) in your intestines
leaving you vulnerable to infection. Some high blood
pressure medications, cancer drugs and antacids containing
magnesium can cause irritation and diarrhea.
intolerances and allergies
Some people are unable to digest a component of food,
such as lactose, the sugar found in milk and milk products.
In addition, the artificial sweeteners sorbitol and
mannitol found in chewing gum and other sugar-free products
can cause irritation and diarrhea. Many otherwise healthy
people may have some difficulty with these sweeteners.
When an allergy is present one strategy is to avoid
the offending food initially, then try slowly reintroducing
it to the diet along with the use of digestive
surgery or radiation of the abdomen or gastrointestinal
Some people develop diarrhea after stomach surgery or
removal of the gallbladder. The reason may be a change
in how quickly food moves through the digestive system
after stomach surgery or an increase in bile in the
colon that can occur after gallbladder surgery.
Parasites like Giardia lamblia and cryptosporidium can
People who visit foreign countries are at risk for traveler's
diarrhea, which is caused by eating food or drinking
water contaminated with bacteria, viruses, or in some
cases, parasites. Traveler's diarrhea is a particular
problem for people visiting developing countries. Visitors
to the United States, Canada, most European countries,
Japan, Australia, and New Zealand are not as much at
In many cases, the reason for a particular attack diarrhea
is hard to determine and as long as the diarrhea goes
away on its own an extensive search for the cause is
not necessary. However, Chronic Diarrhea, where symptoms
are continuous or frequently re-occur, can be a signal
underlying serious health issues that need to be addressed.
Diagnosis of the cause of chronic diarrhea can start
with a careful review of the person’s medical
history and blood and stool tests. Stool cultures may
be used to test for bacteria and to detect parasites.
Other procedures can include X-rays and endoscopy. Endoscopy
is a procedure in which a tube is inserted into the
mouth or rectum so that the gastroenterologist can look
at the intestine from the inside. Since chronic diarrhea
is one of the most common symptoms of food allergy,
testing for this shouldn’t be overlooked.
can have a substantial impact on quality of life and
overall health. At its mildest, the condition may be
an inconvenience; at its worst, it may be disabling
and even life-threatening. The two common classifications
often associated with chronic diarrhea are Irritable
Bowel Syndrome and Inflammatory Bowel Disease.
Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS) is a condition often
associated with frequent stools, alteration in bowel
habits, abdominal pain and diarrhea (although many with
IBS have constipation rather than diarrhea or alternate
between the two). Emotional or physiological distress
is often present and IBS is characterized as a condition
with this persistent group of symptoms where no anatomic
or organic diseases can be detected.
Bowel Disease (IBD)
Pain with defecation, unintentional weight loss, fever,
abdominal cramping and chronic bloody diarrhea suggests
Inflammatory Bowel Diseases such as ulcerative colitis
and Crohn's disease. Ulcerative colitis is primarily
an inflammation of the colon and rectum. Crohn's disease,
or regional enteritis, is inflammation and deep ulcer
formation in the lining of any region of the intestinal
most cases of acute diarrhea the body is utilizing its
self cleansing mechanism to eliminate an irritant. This
is therapeutic and the diarrhea can be left to run its
course. Unless the diarrhea is a chronic and/or recurring
problem the only treatment that may be necessary is
to replace lost fluid and electrolytes to prevent dehydration
and possible probiotic supplementation to prevent recurrence.
Medicines that stop diarrhea may be helpful in some
cases, but they are not recommended for people whose
diarrhea is from a bacterial or infection or parasites
as stopping the diarrhea traps the organism in the intestines,
prolonging the problem. Severe bacterial infections
are sometimes treated with antibiotics although the
infection often returns when the treatment is stopped
unless the intestinal flora is rebalanced with probiotic
(beneficial bacteria) supplements. Viral causes
are either treated with medication or left to run their
course, depending on the severity and type of the virus.
water and prevent dehydration.
The fluid lost during diarrhea need to be replaced
promptly as the body cannot function properly
without them. Drink plenty of water and avoid
alcohol and caffeine as they act to dehydrate
- Replace electrolytes (potassium,
Although water is extremely important
in preventing dehydration, it does not contain
electrolytes. Broth or soup containing sodium,
and fruit or vegetable juices containing potassium
help with electrolyte levels as do rehydration
solutions such as Pedialyte* and Oralyte*.
- Eat easy to digest foods.
Until diarrhea subsides, try to avoid milk products
and foods that are greasy, highly seasoned, high-fiber,
or very sweet as these foods tend to aggravate
diarrhea. At first it’s advisable to refrain
from eating solid food. As the condition improves
add soft, bland low-fiber foods including bananas,
plain rice, boiled potatoes, toast, crackers,
cooked carrots, and baked chicken without the
skin or fat. For children a pediatrician may recommend
what is called the “BRAT” diet: bananas,
rice, applesauce, and toast.
- Reestablish intestinal flora with probiotic
supplementation. Probiotics are beneficial
bacteria necessary to digestive functions. They
can be lost in a variety of ways including antibiotic
treatment and infection. Supplementing our diets
with an effective probiotic re-populates the
intestinal tract with friendly strains, puts
the gut flora back in balance, improves intestinal
health and helps guard against further infection.
While there is no absolute protection against occasional
diarrhea, here are some things we can do to make it
- Maintain your immune system, your first defense
against pathogenic bacteria and infection, through
proper nutrition, sleep and exercise.
- Drink at least 8 to 10 glasses (2 to 2 1/2
quarts) of clean purified water every day and be careful
of the source, especially when traveling.
- Take probiotic
supplements to restore and maintain healthy intestinal
microflora balance and protect against infection.
- Maintain proper hand-washing habits. You
can help prevent the spread of viral diarrhea by washing
your hands and encouraging your children to wash their
hands. Because viral diarrhea spreads easily, it's
a good idea to keep your child home from school or
child care if he or she has diarrhea.
- Use only pasteurized dairy products. Pasteurization
involves heating dairy products for a period of time
to kill bacteria.
- Serve food right away or refrigerate it after
it has been cooked or reheated. Leaving food out at
room temperature encourages growth of bacteria.
- Limit caffeine and alcohol intake, especially
if you are sensitive to them.