Diarrhea

Diarrhea is more than three loose, liquid stools in a single day. It depletes your body of fluids and electrolytes. Diarrhea can be:

• Acute—occurring suddenly and lasting briefly
• Chronic—long-term
• Recurring—coming and going

If you lose too much fluid, you can become dehydrated. Dehydration is especially dangerous for babies, young children, and elderly people.

Causes may include:

• Chronic diseases, such as:
  • AIDS
  • Addison's disease
  • Amyloidosis
  • Colon cancer
  • Diabetes
  • Hyperthyroidism
  • Liver disease
  • Pellagra
  • Scleroderma
• Food intolerance, such as lactose intolerance
• Infections, including food poisoning, such as:
  • Bacterial: Campylobacter, Clostridium difficile, Salmonella, Shigella, and Escherichia coli
  • Fungal: Candida (yeast)
  • Parasitic: Giardia lamblia , Entamoeba histolytica , Cryptosporidium,tapeworm , roundworm , flukes
  • Viral: rotavirus, Norwalk virus , cytomegalovirus , herpes simplex virus, and viral hepatitis
• Inflammatory bowel diseases ( ulcerative colitis , Crohn's disease )
• Malabsorption syndromes, such as:
  • Celiac disease
  • Intestinal lymphangiectasia
  • Short bowel syndrome
  • Tropical sprue
  • Whipple's disease
• Diseases of the pancreas and/or gallbladder
• Injury to the bowel after radiation treatments for cancer
• Intestinal surgery
• Irritable bowel syndrome (episodes of diarrhea often alternate with periods of constipation )
• Medicines, including:
  • Cancer chemotherapy
  • Antibiotics
  • High blood pressure medications
  • Laxatives
  • Magnesium-containing antacids
  • Quinine

Risk factors include:

• Traveling to a developing country where the water and food supply may be contaminated
• Having a severely weakened immune system, such as with AIDS or after an organ transplant
• Taking certain medicines

Symptoms may include:

• Abdominal pain, cramping
• Blood and/or mucus in stool
• Dehydration
• Fever
• Frequent, loose, liquid stools
• Malnutrition
• Muscle aches and pains
• Nausea, vomiting
• Urgent need to defecate
• Weight loss

The doctor will ask about your symptoms and medical history. A physical exam will be done. To determine the cause of your diarrhea, the doctor will ask questions, such as:

• Do you drink well water?
• Do you have any symptoms other than diarrhea (eg, fever, rash, aching joints)?
• Do you use laxatives?
• Do your children attend daycare?
• Does anyone else in your family have diarrhea?
• Have you ever had abdominal surgery?
• Have you traveled recently?
• What is your sexual history?
• What kinds of food have you eaten recently?
• What medicines do you take?

Tests may include:

• Barium enema —insertion of fluid into the rectum that makes the lining of your colon show up on an x-ray
• Biopsy —removal of a sample of colon tissue for testing (may be done as part of a flexible sigmoidoscopy or colonoscopy)
• Blood tests
• Colonoscopy —a thin, lighted tube inserted through the rectum and into the colon to examine the lining of the colon
• Digital rectal exam—examination of the rectum with the doctor's gloved finger inserted into your rectum
• Fasting or food elimination tests
• Flexible sigmoidoscopy —a thin, lighted tube inserted into the rectum to examine the rectum and the lower colon.
• Laboratory analysis of a stool sample
• Upper GI Series —a series of x-rays of the upper digestive system taken after drinking a barium solution

Treating the underlying condition may help to relieve the diarrhea.

General recommendations for treating diarrhea include:

To reduce your chance of getting diarrhea:

• If you are traveling:
  • Avoid drinks that contain ice.
  • Do not eat food purchased from street vendors.
  • Do not eat raw vegetables or fruits. (All produce should be peeled and/or cooked.)
  • Drink bottled water.
  • Eat only pasteurized dairy products.
  • If you eat seafood, make sure it is very hot.
  • Make sure meats are cooked thoroughly.
  • Use bottled water when brushing your teeth.
• If you have diarrhea, do not prepare food for others.
• Practice good handwashing.
• Practice safe food preparation and food storage.

Rotavirus is a common cause of diarrhea in children under five years of age. There is a vaccine to prevent rotavirus. The first dose is given at age two months. Make sure your infant has received this vaccine.