Have you found yourself making more trips to the bathroom than usual?
Are your stools a bit more watery and loose than they should be? It sounds like you’re experiencing diarrhea.
But what is it, and why are you suffering from it?
Do I have diarrhea?
The symptoms of diarrhea are:
- Frequent, watery stools, typically occurring three or more times daily
- An urgent need to use the restroom
- Abdominal pain/cramping
- Inability to control bowel movements
In cases of infection-related diarrhea, additional symptoms may include:
- Bloody stools
- Fever and chills
- Feeling light-headed or dizzy
Why Do I Have Diarrhea?
There are many situations that can trigger tummy troubles. Trying to pin-point the cause can be a tricky task- you might need to go through a process of elimination to find the right one.
Common causes of Diarrhea include:
- Traveller’s diarrhea from consuming food or water containing unfamiliar microbes
- Toxins in food due to spoilage or food-borne pathogens for example E.coli, campylobacter, C.difficile, Salmonella, Shigella
- Food intolerances, such as lactose intolerance
- Hormonal imbalances can affect gut motility, such as problems with the thyroid or menstrual symptoms
- Inflammatory diseases, for example Celiac Disease, ulcerative colitis, Crohn’s disease
- Medications, notably antibiotics, which can disrupt the gut’s natural microbial balance, metformin, proton pump inhibitors, some antidepressants, antacids
- Anxiety/Stress- an upset brain can trigger an upset stomach
Is Diarrhea dangerous?
Diarrhea poses a significant hazard, particularly to vulnerable populations like babies, the elderly, and those with weakened immune systems. It has the potential to result in severe dehydration, which claims the lives of millions of children worldwide each year.
I Still Have Diarrhea, Do I Go to The Doctor?
It’s time to seek medical care when you notice:
- The diarrhea persists for more than 24 hours in infants or small children, or two days in adults without any improvement.
- Signs of severe dehydration, such as:
- Unusual thirst
- Dark-coloured urine or reduced urine production
- Dryness of the skin, mouth, and eyes
- Fatigue or dizziness
- Rapid heartbeat or fast breathing
- A high fever, with a temperature of 102 °F (39 °C) or more.
- Persistent, severe abdominal or rectal pain
- Stools become bloody or appear black
What Should I Do If I Have Diarrhea?
Firstly, drink water. You may also need to replace salts and sugars—apple juice, sports drinks and soda are a good option. You could try dietary adjustments to ease certain types of diarrhea. For example, avoiding substances that can irritate the digestive system such as spicy foods, oil or coffee.
If you are suffering with acute diarrhea, over-the-counter medications could be worth a try.
Pepto-Bismol is a popular, FDA-approved medicine you can buy without a prescription. Pepto-Bismol’s active ingredient, bismuth subsalicylate, provides effective immediate relief for patients experiencing mild, moderate, and severe diarrhea symptoms compared to a placebo.
Loperamide sold under the brand name Imodium, works by targeting the digestive system’s smooth muscles and nerves. It inhibits excessive and rapid muscle contractions in the intestines, slowing the movement of food.
This extended transit time allows for increased absorption of water and electrolytes, resulting in less watery stool. Loperamide also tightens the anal sphincter muscle, which helps to reduce the urgency and frequency of diarrhea. This medicine is especially effective for Motility-Related Diarrhea.
Attapulgite binds to substances in the digestive tract that contribute to diarrhea. It can also form a protective coating on the surface of the intestinal lining, effectively absorbing excess fluids, toxins, and other irritants that may be causing diarrhea. This helps to reduce the fluidity of stool and decrease the frequency of bowel movements, providing relief from general diarrhea symptoms.
What about chronic diarrhea?
Chronic diarrhea, unlike acute diarrhea, can often be a sign of a more serious underlying medical condition. Treatment for chronic diarrhea can range from medications targeting specific conditions (IBD) to dietary modifications, probiotics, and lifestyle changes. In some extreme cases, chronic diarrhea may necessitate surgical interventions. Collaborating closely with a healthcare provider, especially a gastroenterologist, is essential to create a personal treatment plan that addresses both the underlying condition and symptom management, ultimately improving your well-being.
What Causes Diarrhea?
The large intestine plays a crucial role in helping the body absorb water. Normally, our bloodstream has more dissolved particles than the large intestine due to the absorption of electrolytes from the food we eat through our digestive system.
This causes water to naturally move from the large intestine into the bloodstream to balance it out. We call this “water absorption”.
When undigested food sits in the intestines, it can disrupt water absorption from the large intestine into the bloodstream. Instead, water collects in the intestines, leading to the watery stools we associate with diarrhea.
Fortunately, avoiding certain diets such as foods that are spicy, high in fat, and dairy products can often help resolve this issue.
When you have a bacterial or viral infection, the cells that line your intestines jump into action to expel the bugs and protect you from the infection. These cells secrete salts into your intestines, drawing water from your bloodstream into the gut.
While other factors are also involved, the primary concept here is that when you’re ill, your gut cells function like water cannons. The cells actively push water out, which results in the build-up of fluid in your intestines and leads to watery stools. This is secretory diarrhea.
Inflammatory diarrhea occurs when the lining of your intestines becomes irritated or damaged. This disruption upsets the normal process of water absorption. Inflammatory diarrhea often comes along with autoimmune conditions like Inflammatory Bowel Disease (IBD) or infections.
For instance, in IBD, your immune system mistakenly targets and actively damages the cells that line your intestines, which are crucial for water absorption. Inflammatory diarrhea tends to be a chronic condition and can lead to symptoms such as blood or mucus in your stool, severe abdominal pain, and fever.
If you’re experiencing these symptoms, it’s essential to see a doctor as soon as possible so they can identify the underlying cause and provide you with the right treatment options.
Motility-related diarrhea occurs when food passes through your digestive system too quickly due to excessive muscle contractions that propel it along, a process known as peristalsis.
Peristalsis keeps food moving through your digestive system, regardless of your position, even if you’re upside down doing a handstand! Your body requires time to soak up nutrients and water from food. When the process accelerates excessively, there isn’t a long enough interval for your intestines to absorb the water, so it stays in your stool.
Conditions such as overactive thyroid can lead to this type of diarrhea.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Symptoms & causes of diarrhea—NIDDK. Symptoms & Causes of Diarrhea. November 2016. Accessed October 22, 2023. https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea/symptoms-causes.
Birhan TA, Bitew BD, Dagne H, et al. Prevalence of diarrheal disease and associated factors among under-five children in flood-prone settlements of Northwest Ethiopia: A cross-sectional community-based study. Front Pediatr. 2023;11:1056129. Published 2023 Jan 23. doi:10.3389/fped.2023.1056129
Bindslev N, Skadhauge E. Sodium chloride absorption and solute-linked water flow across the epithelium of the coprodeum and large intestine in the normal and dehydrated fowl (Gallus domesticus). In vivo perfusion studies. J Physiol. 1971;216(3):753–768. doi:10.1113/jphysiol.1971.sp009551
Field M. Intestinal ion transport and the pathophysiology of diarrhea. J Clin Invest. 2003;111(7):931–943. doi:10.1172/JCI18326
Weir SBS, Akhondi H. Bland Diet. In: StatPearls. Treasure Island (FL): StatPearls Publishing; July 25, 2023.
Thiagarajah JR, Verkman AS. Chloride channel-targeted therapy for secretory diarrheas. Curr Opin Pharmacol. 2013;13(6):888–894. doi:10.1016/j.coph.2013.08.005
Semrad CE. Approach to the Patient with Diarrhea and Malabsorption. Goldman’s Cecil Medicine. 2012;895-913. doi:10.1016/B978-1-4377-1604-7.00142-1
Anbazhagan AN, Priyamvada S, Alrefai WA, Dudeja PK. Pathophysiology of IBD associated diarrhea. Tissue Barriers. 2018;6(2):e1463897. doi:10.1080/21688370.2018.1463897
Sweetser S. Evaluating the patient with diarrhea: a case-based approach. Mayo Clin Proc. 2012;87(6):596–602. doi:10.1016/j.mayocp.2012.02.015
Spiller R. Role of motility in chronic diarrhoea. Neurogastroenterol Motil. 2006;18(12):1045-1055. doi:10.1111/j.1365-2982.2006.00836.x
Huizinga JD, Lammers W J. Gut peristalsis is governed by a multitude of cooperating mechanisms. Am J Physiol Gastrointest Liver Physiol. 2009;296(1):G1-G8. doi:10.1152/ajpgi.90380.2008
Daher R, Yazbeck T, Jaoude JB, Abboud B. Consequences of dysthyroidism on the digestive tract and viscera. World J Gastroenterol. 2009;15(23):2834–2838. doi:10.3748/wjg.15.2834
Brum JM, Gibb RD, Ramsey DL, Balan G, Yacyshyn BR. Systematic Review and Meta-Analyses Assessment of the Clinical Efficacy of Bismuth Subsalicylate for Prevention and Treatment of Infectious Diarrhea. Dig Dis Sci. 2021;66(7):2323–2335. doi:10.1007/s10620-020-06509-7
Mainguet P, Fiasse R. Double-blind placebo-controlled study of loperamide (Imodium) in chronic diarrhoea caused by ileocolic disease or resection. Gut. 1977;18(7):575–579. doi:10.1136/gut.18.7.575
Sun WM, Read NW, Verlinden M. Effects of loperamide oxide on gastrointestinal transit time and anorectal function in patients with chronic diarrhoea and faecal incontinence. Scand J Gastroenterol. 1997;32(1):34–38. doi:10.3109/00365529709025060
Read M, Read NW, Barber DC, Duthie H L. Effects of loperamide on anal sphincter function in patients complaining of chronic diarrhea with fecal incontinence and urgency. Dig Dis Sci. 1982;27(9):807–814. doi:10.1007/BF01391374
Zaid MR, Hasan M, Khan AA. Attapulgite in the treatment of acute diarrhoea: a double-blind placebo-controlled study. J Diarrhoeal Dis Res. 1995;13(1):44–46.