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Diarrhea
Definition
Diarrhea is when you pass loose or watery stool.
Alternative Names
Stools - watery; Frequent bowel movements; Loose bowel movements
Considerations
In some people, diarrhea is mild and goes away in a few days. Inr other people, it may last longer.
Diarrhea can make you feel weak and dehydrated.
Causes
The most common cause of diarrhea is the stomach flu (viral gastroenteritis). This mild viral infection goes away on its own within a few days.
Eating or drinking food or water that contains certain types of bacteria or parasites can also lead to diarrhea. This problem may be called food poisoning.
Certain medications may also cause diarrhea, including:
- Certain antibiotics
- Chemotherapy drugs for cancer
- Laxatives containing magnesium
Diarrhea may also be caused by certain medical disorders, including:
- Celiac disease
- Inflammatory bowel diseases (Crohn's disease and ulcerative colitis)
- Irritable bowel syndrome (IBS)
- Lactose intolerance (which causes problems with milk and other dairy products)
- Malabsorption syndromes
Less common causes of diarrhea include:
- Carcinoid syndrome
- Disorders of the nerves that supply the intestines
- Removal of part of the stomach (gastrectomy) or small intestine
- Radiation therapy
Home Care
When you or your child has diarrhea, you will need to learn:
- To drink plenty of fluids to prevent dehydration (meaning your body does not have the proper amount of water and fluids)
- Which foods you should or should not eat
- What to do if you are breast-feeding
- What danger signs to watch out for
Avoid medicines for diarrhea that you can buy without a prescription, unless your doctor tells you to use them. These drugs can make some infections worse.
If you have a long-term form of diarrhea, such as diarrhea caused by irritable bowel syndrome, changes to your diet and lifestyle may help.
When to Contact a Medical Professional
Call your health care provider right away if you or your child shows signs of dehydration:
- Decreased urine (fewer wet diapers in infants)
- Dizziness or light-headedness
- Dry mouth
- Sunken eyes
- Few tears when crying
Call for an appointment with your health care provider if you have:
- Blood or pus in your stools
- Black stools
- Stomach pain that does not go away after a bowel movement
- Diarrhea with a fever above 101°F (100.4 °F in children)
- Recently traveled to a foreign country and developed diarrhea
Also call your doctor if:
- The diarrhea gets worse or does not get better in 2 days for an infant or child, or 5 days for adults
- A child over 3 months old has been vomiting for more than 12 hours; in younger babies, call as soon as vomiting or diarrhea begins
What to Expect at Your Office Visit
Your doctor will perform a physical exam and ask you questions about your medical history and symptoms, including:
- When did your diarrhea start?
- What is the color and consistency of your stool?
- Do you have blood in your stool?
- Are you passing large amounts of mucus with your stool?
- What other symptoms do you have?
- Do you have abdominal pain or severe cramping with the diarrhea?
- Do you have fever or chills?
- Are any other people in your house sick?
- Have you recently traveled out of the country?
- Have you possibly been exposed to well or stream water or spoiled food?
- What makes your pain worse? Stress? Certain foods?
- Have you had abdominal surgery?
- Have you taken antibiotics recently?
- What medications do you take?
- Do you drink coffee or alcohol, and if so, how much?
- Do you smoke? How much each day?
- Are you on a special diet?
Laboratory tests may be done on your stools to determine the cause of your diarrhea.
Prevention
Over-the-counter supplements that contain healthy bacteria, called probiotics, may help prevent diarrhea associated with antibiotics. Yogurt with active or live cultures is a good source of these healthy bacteria.
The following healthy steps can help you prevent illnesses that cause diarrhea:
- Wash your hands often, especially after going to the bathroom and before eating.
- Use alcohol-based hand gel frequently.
- Teach children to not put objects in their mouth.
When traveling to underdeveloped areas, follow the steps below to avoid diarrhea:
- Drink only bottled water and do not use ice, unless it is made from bottled or purified water.
- Do NOT eat uncooked vegetables or fruits that do not have peels.
- Do NOT eat raw shellfish or undercooked meat.
- Do NOT consume dairy products.
References
Schiller RL, Sellin JH. Diarrhea. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 15.
Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders; 2011:chap 142.
Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
