What is diarrhea?
Diarrhoea is having more frequent, loose, watery stool.
You may get diarrhoea after being in contact with someone
else who has it, or you may get it from food poisoning - after eating
contaminated food or drinking contaminated water.
Almost everyone has diarrhoea at some point in his or her
life, including on holiday abroad, called traveller's diarrhoea.
Diarrhoea that comes on suddenly and lasts for no longer
than a couple of days is usually referred to as "acute diarrhoea".
Most people with acute diarrhoea recover on their own. Diarrhoea that lasts
more than two weeks is thought of as "chronic diarrhoea". Typically,
chronic diarrhoea requires medical care to find the underlying cause and treat
complications, such as dehydration.
What causes diarrhoea?
Many different problems can cause diarrhoea. Here are the
major causes:
You are most likely to come down with diarrhoea after coming
into contact with these infectious organisms and agents:
A virus, such as
rotavirus, winter vomiting disease (Norwalk
virus or norovirus), enterovirus, or a hepatitis virus.
A bacterium, such
as E. coli, salmonella, shigella, C.diff (clostridium), or cholera (Vibrio
cholerae).
A parasite, such
as those that cause giardiasis and amoebiasis.
The length of time diarrhoea lasts often depends on what
caused it. Diarrhoea from norovirus lasts around two days, for rotavirus, the
duration is three to eight days, Campylobacter and salmonella infections may
last two to seven days and diarrhoea from giardiasis can several weeks.
Other medical conditions
A number of non-infectious medical conditions may cause diarrhoea,
too. These include:
Inability to
digest certain foods, including a lactose intolerance (difficulty digesting the
type of sugar found in dairy products); coeliac disease (an intolerance of
gluten in wheat and some other grains); and pancreatic problems, such as those
caused by cystic fibrosis, which interfere with production of important
digestive substances.
Surgery to remove
part of your intestine. A shortened intestine may be unable to absorb all the
substances you eat. This is referred to as short-bowel syndrome.
The after-effects
of surgery to remove the gallbladder. An increase in bile in the colon may
result in watery stools.
Certain diseases
of the endocrine (hormonal) system, including thyroid disease, diabetes,
adrenal disease, and Zollinger-Ellison syndrome.
Certain rare
tumours (including carcinoid tumour and pheochromocytoma) that produce
diarrhoea-causing substances.
Inflammation in
the intestinal tract, which can result in chronic diarrhoea. If you have inflammatory
bowel disease (such as ulcerative colitis or Crohn's disease), you will have
bouts of diarrhoea during flare-ups of your disease.
Pouches of the
intestinal wall in diverticular disease can lead to diarrhoea, especially if
they become infected and inflamed ( diverticulitis)
Irritable bowel
syndrome, which may cause alternating bouts of diarrhoea and constipation.
Bowel cancer
produces a change in bowel habit that may include diarrhoea or alternating
diarrhoea and constipat
Prevention
Medication and other substances
Many medications can cause diarrhoea. Some of the most
common include antacids containing magnesium, laxatives, digitalis, diuretics,
a number of antibiotics, chemotherapy drugs, cholesterol-lowering agents,
lithium, theophylline, thyroid hormone and colchicine.
Radiotherapy for prostate cancer or cancers in the abdomen
can damage the intestine and cause diarrhoea.
Toxins such as insecticides, psychedelic mushrooms, and
arsenic can cause diarrhoea, and overuse of caffeine or alcohol may contribute
to diarrhoea.
What are the symptoms of diarrhoea?
Increased
frequency of bowel movements
Loose, watery
stools
Urgency (having to
go right away)
Incontinence
(leakage of stools)
Bloating, wind
Rectal pain
Lower abdominal pain or cramping
Nausea, vomiting
Fever
Blood or flecks of
mucus in the stool
Loss of appetite,
weight loss
Seek medical advice if:
Seek medical advice if you have diarrhoea for more than
three to four days, or if you have diarrhoea with any of the following:
Blood in your
stool
Dark-black stool
that looks like tar (but tell your doctor if you have been taking
over-the-counter medications, which also can make the stool look darker than
usual)
Mucus passed with
no stools
Abdominal pain
Rectal pain
Fever
Dehydration
Recent travel
abroad
Recent seafood
consumption
Reason to believe
that you have food poisoning
Family members who
have similar illness
Colleagues, associates or friends who have
similar symptoms after eating in the same venue
How do I know if I have diarrhoea?
Your doctor's most important tool for diagnosing the cause
of your diarrhoea is the information you provide. You will need to inform the
doctor about recent travel and whether other people in your family are ill.
Providing details about the stools may be embarrassing to you, but they are
very important, such as presence of blood or mucus; how watery it is; how long
you've had diarrhoea; whether you are also experiencing severe urgency,
abdominal pain, or pain in your rectum; and whether it occurs more often after
eating certain foods.
Your doctor may want to examine a sample of your stools and
may send it to a laboratory for testing. If your doctor suspects food
intolerance, the doctor may ask you to avoid a particular type of food for a
while to see if this helps stop your diarrhoea. If your doctor needs more
information to make a diagnosis, you may need to undergo sigmoidoscopy, which
is an examination of the rectum and lower part of the colon with a lighted
tube-like instrument, or colonoscopy, which is an examination of the entire
colon with a similar instrument. If your symptoms suggest food intolerance or a
hormonal disturbance, other tests may be ordered.
What are the treatments for diarrhoea?
The most important aspect of treating diarrhoea involves
avoiding dehydration and replacing lost fluid. Because plain water does not
contain sugar, sodium, or potassium, which are also lost in diarrhoea, it is
important to consume plenty of fluids that contain these substances. Examples
of appropriate drinks include water, prepared re-hydration solutions, chicken
or beef soup. Fruit juice or fizzy drinks can make diarrhoea worse in children.
If you also are vomiting, try taking tiny amounts of liquid
every 15 minutes. After you are able to hold down liquids, you can advance to a
bland, soft diet.
You may be asked to avoid fats, sweets, coffee, and milk
products until you are completely over the diarrhoea.
Effective antidiarrhoeal medicines such as loperamide, that
works by slowing down the muscle movements in the gut, are available over the
counter for adults and children over 12. This medicine shouldn’t be used if
breastfeeding. Pharmacists can advise on suitable products.
Seek medical advice before using anti-diarrhoea medicines if
there is blood in the poo,a high temperature or other symptoms, and in the case
of severe or persistent diarrhoea in a child under 12.
In severe diarrhoea due to infectious bacteria, your doctor
may advise taking antibiotics to help resolve the symptoms. However,
antibiotics won't help with viral diarrhoea, which is the most common type of
infectious diarrhoea.
How can I prevent diarrhoea?
The most important way to avoid diarrhoea is to avoid coming
into contact with infectious agents that can cause it. This means that hygienic
food preparation and storage techniques, and good hand washing, especially when
preparing food and after using the toilet are very important.
If someone in your home has diarrhoea, take precuations to
stop it spreading:
Disinfectant the
toilet, handle and the seat after the person has used it each time.
Don't share
towels, flannels, cutlery or utensils with the person who is unwell.
Keep them at home
until at least 48 hours after the last episode of diarrhoea.
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