Diarrhea (Acute)

What causes diarrhea?

Diarrhea is basically your body's reaction to toxins, an infection, or irritation in your intestines. It's caused by a multitude of problems and can be divided into acute (diarrhea that lasts a few days) and chronic (diarrhea that lasts longer than four weeks). Acute diarrhea is usually caused by the presence of a toxin (poison) in the gastrointestinal tract. Chronic diarrhea is usually related to functional disorders such as irritable bowel syndrome.

The culprit in acute diarrhea, which is usually a virus, parasite, or bacteria from contaminated food or water, invades your system and your body then tries to flush it out. When the intestine is inflamed, it can't digest food or absorb liquid as it usually does. This leads to frequent, runny stools.

Basically, anything that inflames the intestine can cause diarrhea, from parasites such as giardia to bacteria such as E. coli. Although dairy products don't inflame the intestines, people whose stomachs are sensitive to milk often experience diarrhea if they eat such products. (Their intestines lack an enzyme that breaks milk sugars into products that can be easily absorbed; when exposed to colon bacteria, the undigested portion of the sugar in milk ferments, often causing pain, gas, and diarrhea.)

Diarrhea is also a common side effect of some medications, so be sure to tell your doctor what you are currently taking. And because your brain and gut are in constant communication with each other, some people come down with diarrhea when they're extremely anxious -- perhaps before they take a test or step onstage to give a speech.

How can I avoid getting diarrhea?

Here's something very simple you can do to help prevent diarrhea: Wash your hands, especially after you've been around people who are sick. Use soap and warm water and scrub well for at least 15 seconds, including under your fingernails. Studies conducted at daycare centers have shown that frequent handwashing can greatly reduce the incidence of diarrhea in children.

And of course, be extra careful when traveling. Never drink water from streams or lakes; no matter how pristine they look, they may contain bacteria or toxins from human or animal contamination upstream. If you travel in an area with poor sanitation, drink and brush your teeth only with bottled water. (If there's no bottled water available, boil your water at least one full minute or disinfect it with iodine pills.) Pass up food from sidewalk vendors (tempting as it may be), and avoid salads and raw vegetables. It's better to eat only cooked foods that are still hot, or fruits and vegetables that you've peeled yourself.

Your diarrhea may also be triggered by a food allergy, such as one to shellfish or peanuts. Some of the biggest culprits also include prune juice and other fruit juices, fatty or fried food, caffeine (found in coffee, soda, and chocolate), the artificial sweetener sorbitol (found in many gums and candies), and raw vegetables.

How is diarrhea treated?

The biggest concern with diarrhea is dehydration, so be sure to drink plenty of water and other fluids. But go easy on the juice, since fruit juice can actually cause diarrhea and gas if you drink it in large quantities. Try water, clear broth, or herb tea instead. If you or your child experience symptoms of dehydration -- dry mouth and lips, sticky saliva, sunken cheeks, dark yellow urine or an inability to pass much urine, dizziness, inattention to surroundings (in children), and tearless crying (in infants), see a doctor immediately. In the meantime, drink a drugstore solution containing essential sugars and mineral salts, which can become depleted when you're dehydrated. (These liquids, including Pedialyte and similar brands, are oral rehydration solutions, or ORS, which are used to treat dehydration caused by severe diarrhea.)

Avoid greasy foods, alcohol, and dairy products, which can be hard on the stomach. Instead, until you feel better, try the diet perfected by Peace Corps volunteers and budget travelers, which consists solely of white rice and bananas. Physicians often recommend an expanded version, known as the BRAT diet, which includes bananas, rice, applesauce, and dry toast.

Is it OK to take medicine to control my diarrhea?

Drugstore shelves are full of potions and pills designed to stop you up, but doctors recommend staying away from over-the-counter medications unless diarrhea persists for several days or is interfering too much with your daily life. If you do need to take something, your doctor may recommend that you start with the pink stuff, bismuth subsalicylates (brand name Pepto-Bismol), which is relatively benign and will ease cramping and abdominal pain as well as loose stools. When traveling overseas, taking two tablets of Pepto-Bismol four times daily may prevent up to 50 percent of traveler's diarrhea.

Some physicians also recommend Kaopectate, made from pectin and an absorbent clay. The stronger over-the-counter medications, such as loperamide (Imodium), work by slowing down the work of the intestines. Your doctor may recommend this medication if you don't have fever or dysentery (bloody diarrhea).

But if your diarrhea is caused by a bacterial infection or parasite, taking medicine to stop the diarrhea may do more harm than good, according to the National Institutes of Health. Your body needs to purge the offending bacteria or parasite, and taking medicine to stop the diarrhea may prolong the problem. In a case like this, your doctor may want you to take antibiotics.

Finally, be sure to read the label carefully. Even over-the-counter medicines may not be suitable for everyone, and some can interact with other medicines you might be taking. If you have any questions, ask your doctor or pharmacist.

When should I call the doctor?

See a doctor immediately if you have fever or bloody stools, or if you're dehydrated. If you can't reach a doctor, go to an emergency room for these conditions:

  • If your diarrhea is accompanied by a fever of 102 degrees or higher, or you have chills, vomiting, and light-headedness.
  • If you're showing signs of dehydration: you feel weak, have dark yellow urine or are unable to urinate, have a dry mouth, sunken cheeks, sticky saliva, or dry, wrinkled skin.
  • Call for an appointment if you've been traveling and drinking water that's untreated: you may have a bacterial infection or a parasite.
  • Finally, if your diarrhea doesn't clear up on its own within 3 days, call your doctor for a consultation.

References

National Digestive Diseases Information Clearinghouse. Diarrhea.

MayoClinic.com. Diarrhea.

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