Diarrhea

Nearly everyone will have diarrhea sometime in his or her life. Anyone can get diarrhea.

  • In the US, most adults get acute diarrhea about once a year.
  • Chronic diarrhea is less common.

What is it?

People who have diarrhea:

  • Pass stool more than 3 times per day, or
  • Pass loose, watery stool

Acute diarrhea

  • Is the most common type of diarrhea
  • Lasts a shorter timem a day or two
  • Goes away on its own
  • Is usually caused by an infection or medicines
  • Is usually treated with over-the-counter medicines

Chronic diarrhea

  • Lasts a longer time, 4 weeks or more
  • When severe, can be an indication of a more serious problem If you have chronic diarrhea, talk with your doctor to:
  • Make sure there is not a serious problem
  • Find a treatment

Diarrhea can be caused by infections, including:

Viral Infection:

  • Norovirus
  • Rotavirus

Bacterial Infection:

  • Salmonella
  • E.coli

Food Poisoning:

  • Staphylococci
  • Bacillus cereus
  • Clostridium perfringens

Diarrhea can be caused by medicines, including:

Over-the-counter:

  • Laxatives
  • Antacids that include magnesium
  • Caffeine

Prescription medicines that can cause diarrhea:

  • Antineoplastic drugs (treat certain cancers)
  • Antibiotics
  • Colchicine
  • Quinine
  • Some drugs that treat high blood pressure
  • Some cholesterol lowering medicines
  • Diuretics (help the body get rid of extra fluid)
  • Thyroid hormones

Over-the-counter diarrhea medicines include:

  • Loperamide (Immodium A-D™)
  • Bismuth subsalicylate (Pepto-Bismol™)

What are the symptoms?

Common symptoms

  • Cramping
  • Belly pain or discomfort
  • Nausea
  • Urgent need to have a bowel movement
  • Unable to control bowels (incontinence)

More serious symptoms

  • Dehydration (when the body does not have enough fluids or salts)
  • Blood, undigested food in stools, or greasy stools that float
  • Fever
  • Weight loss

Signs of dehydration include:

  • Constant or extreme thirst
  • Less frequent or dark urine
  • Extremely dry skin, mouth, or tongue
  • Feeling tired, dizzy, or light-headed

What causes it?

People may get diarrhea when:

  • Too much water is left in the intestines. This can happen when:

    • Too little fluid is absorbed by the colon. *They don't have the right kinds of bacteria in the colon. Each person has a unique set of bacteria in their colon. This bacteria is good, it helps the body digest food. But, infections, illnesses, and medicines can change the bacteria in the colon. That can cause diarrhea in two ways:

    • There isn't enough good bacteria to help digest food.

    • Too much bacteria grow and release toxins that irritate the intestine. image

Some causes of diarrhea are:

  • Bacterial infections
  • Viral infections
  • Bowel disorders, like Irritable Bowel Syndrome (IBS)
  • Certain medicines
  • Diseases that cause pain and swelling of the intestine or colon
  • Certain surgical procedures
  • Parasites
  • Allergies to certain foods

Diarrhea may be caused if a disease has caused the small intestine to swell.

Examples of these include:

  • Anemia
  • Celiac Disease
  • Colon Tumors
  • Diverticulosis/Diverticulitis
  • Diabetes
  • Hyperthyroidism
  • Inflammatory bowel disease
    • Ulcerative colitis
    • Crohn's disease
  • Irritable bowel syndrome

Some surgical procedures can cause diarrhea, including:

  • Gall bladder surgery
  • Gastric bypass surgery
  • Intestinal surgery
  • Organ transplant
  • Stomach surgery
  • Bariatric surgery

Some foods and drink can cause diarrhea, or make diarrhea worse, including:

  • Caffeine

    • Coffee, tea, cola, some over-the-counter headache me dicines, energy drinks
  • Fructose (a type of sugar)

    • Fruit juices, honey, dates, nuts, figs, prunes, soft drinks
  • Sugar substitutes (hexitol, sorbitol, mannitol)

    • Sugar-free gum, candy, mints; sweet cherries, prunes
  • Dairy products

    • Milk, ice cream, yogurt, soft cheeses
  • Magnesium

    • Magnesium containing antacids
  • Fat substitutes, like Olestra

    • Certain fat-free potato chips or certain fat-free ice creams

How do I manage it?

There are certain foods that a person can eat or avoid that may help reduce diarrhea:

  • Avoid caffeine
  • Avoid greasy foods
  • Eat yogurt with active live bacterial, particularly after taking antibiotics
  • Eating a bland diet may help diarrhea symptoms get better
  • People who are lactose intolerant should avoid dairy products

Most cases of diarrhea last for a short period of time, so it is best to just let it run its course.

For short-term diarrhea, the main treatment is drinking plenty of fluids so you don't get dehydrated.

Dehydration is when the body loses more water than it takes in. Severe dehydration can be very dangerous and in rare cases even lead to death.

Drinking extra water is very important if you have diarrhea. In more severe cases, people should drink fluids that contain electrolytes such as:

  • Sodium
  • Potassium
  • Calcium
  • Chloride
  • Bicarbonate

Common drinks with electrolytes:

  • Gatorade™
  • Propel™
  • Accelerade™
  • Powerade™

Loperamide:

  • Immodium A-D™
  • Maalox Anti-Diarrheal™
  • Kaopectate 1-D™
  • Loperamide slows down the small intestine and colon to give them more time to absorb fluid and nutrients from food
  • Taking loperamide helps people have fewer bowel movements
  • Talk to your doctor if you are using loperamide for more than a week

Bismuth subsalicylate:

Bismuth helps with diarrhea by:

  • Coating the digestive system
  • Reducing fluids released into the intestines, and
  • Helping the body get rid of bacteria.
  • Common names:
    • Pepto-Bismol™
    • Kaopectate™

Bulking Agents

Bulking agents usually help with constipation but sometimes they may also help with diarrhea.

  • Bulking agents absorb liquid and help make stool firmer.
  • It is safe to use bulking agents regularly.

Common names:

  • Psyllium
  • Citrucel™
  • Metamucil™

Peppermint

Peppermint has a soothing effect on the digestive system. It helps relieve diarrhea and bloating by calming and relaxing muscles in the digestive system. This means the digestive tract contracts less and gas can pass through more easily. Peppermint comes in:

  • Capsules
  • Contain peppermint oil
  • Most people need to take 1 or 2 capsules 2 to 3 times a day
  • Tea
  • Made from dried leaves of the plant
  • Drink 1 or 2 cups each day
  • Oil
  • Mix 1/4 teaspoon of oil in another liquid, like water or juice
  • Take once per day

Symptoms of mild to moderate dehydration include:

  • Dry, sticky mouth
  • Sleepiness
  • Thirst
  • Urinating less often
  • Few or no tears when crying
  • Dry skin
  • Headache
  • Constipation
  • Dizziness

Symptoms of severe dehydration include:

  • Extreme thirst
  • Extreme sleepiness
  • Feeling irritable or confused
  • No sweating
  • Very dry mouth, skin, mucous membranes
  • Little or no urination
  • Sunken eyes
  • Skin that doesn't bounce back when pinched
  • Low blood pressure
  • Fast heartbeat
  • Fast breathing
  • No tears when crying
  • Fever
  • Delirium or unconsciousness

Caution: If you have severe heart or kidney disease, talk to your doctor before using these drinks.

Where can I learn more?

To learn more about diarrhea, please visit these websites: