Diarrhea is more than three loose, liquid stools in one day. It causes the body to lose fluids and electrolytes. Diarrhea can be:
- Acute—sudden and brief
- Chronic—long term
- Recurring—diarrhea that comes and goes over time
Fluid loss can lead to dehydration . This can be dangerous for babies, young children, and older adults.
Causes may be:
- Food intolerance, such as lactose intolerance
- Certain medicines, such as:
- Magnesium-containing antacids
- Irritable bowel syndrome
- Injury to the bowel after radiation treatments for cancer
- Malabsorption syndromes, such as celiac disease
- Diseases of the pancreas or gallbladder
- Inflammatory bowel diseases, such as ulcerative colitis and Crohn disease
- Chronic diseases, such as:
- Intestinal surgery
- Infections such as:
Things that may raise the risk of this problem are:
- Traveling to a developing country where the water and food supply may be contaminated
- Taking certain medicines
- Being in a hospital
- Having a severely weakened immune system, such as with AIDS or after an organ transplant
Problems may be:
- Frequent loose, liquid stools
- Belly pain and cramping
- An urgent need to have a bowel movement
- Blood and mucus in the stool
- Nausea and vomiting
- Muscle aches and pains
- Weight loss
The doctor will ask about your symptoms and health history. A physical exam will be done. The doctor may insert a gloved finger into the rectum to examine it. This is called a digital rectal exam.
The doctor may ask these questions to find the cause of diarrhea:
- Does anyone else in the family have diarrhea?
- What kinds of food and drinks have you had?
- Do your children attend daycare?
- Have you traveled recently?
- What is your sexual history?
Blood tests and stool tests may be done.
The rectum and colon may need to be examined. This can be done with:
A biopsy may also be taken.
Images may be taken of the colon. This can be done with:
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Any underlying cause will need to be treated.
The goal of treatment is to ease diarrhea and prevent dehydration. Choices are:
- An oral rehydration solution to replace lost fluids
- Dietary changes, such as a clear diet and avoiding foods that trigger diarrhea
- Antidiarrheal medicine
The risk of diarrhea may be lowered by:
- Practicing proper hand hygiene
- Practicing safe food preparation and storage
- Taking care when traveling, such as:
- Drinking bottled water and avoiding drinks with ice
- Avoiding foods from street vendors
- Not eating raw vegetables or fruits
- Cooking foods well
- Only eating pasteurized dairy products
Rotavirus is a common cause of diarrhea in children under 5 years of age. The rotavirus vaccine can prevent it.
When Should I Call My Doctor?
Call your doctor if you:
- Have diarrhea that lasts longer than three days
- Are not able to eat or drink to stay hydrated
- Have a fever
Call your doctor if your young child:
- Has diarrhea that lasts longer than a day
- Has pus in his or her stool
- Does not have wet diapers
- Is crying without tears
- Is unusually sleepy or irritable
- Has a fever
When Should I Call for Medical Help Right Away?
Call for medical help or go to the emergency room right away if you or your child has:
- Severe belly pain and cramping
- Bloody or black stool
- Acute diarrhea in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/acute-diarrhea-in-adults. Accessed February 9, 2021.
- Diarrhea. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/diarrhea.html. Accessed February 9, 2021.
- Diarrhea. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea. Accessed February 9, 2021.
- Rotavirus vaccines. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccinesafety/vaccines/rotavirus-vaccine.html. Accessed February 9, 2021.
- Shane AL, Mody RK, et al. 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):e45-e80.
- James P. Cornell, MD
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