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Diarrhea

Definition

Diarrhea describes loose, watery stools that occur more frequently than usual. Diarrhea is something everyone experiences. Diarrhea often means more frequent trips to the toilet and a greater volume of stool.

In most cases, diarrhea signs and symptoms usually last a couple of days. But sometimes diarrhea can last for weeks. In these situations, diarrhea can be a sign of a serious disorder, such as inflammatory bowel disease, or a less serious condition, such as irritable bowel syndrome.

Diarrhea may cause a loss of significant amounts of water and salts. Most cases of diarrhea go away without treatment. But see your doctor if diarrhea persists, if you become dehydrated or if you pass blood in your stool.

Symptoms

Signs and symptoms associated with diarrhea may include:

Frequent, loose, watery stools
Abdominal cramps
Abdominal pain
Fever
Blood in the stool
Bloating
When to see a doctor
If you're an adult, see your doctor if:

Your diarrhea persists beyond three days
You become dehydrated — as evidenced by excessive thirst, dry mouth or skin, little or no urination, severe weakness, dizziness or lightheadedness, or dark-colored urine
You have severe abdominal or rectal pain
You have bloody or black stools
You have a temperature of more than 102 F (39 C)
In children, particularly young children, diarrhea can quickly lead to dehydration. Call your doctor if your child's diarrhea doesn't improve within 24 hours or if your baby:

Hasn't had a wet diaper in three or more hours
Has a fever of more than 102 F (39 C)
Has bloody or black stools
Has a dry mouth or cries without tears
Is unusually sleepy, drowsy, unresponsive or irritable
Has a sunken appearance to the abdomen, eyes or cheeks
Has skin that doesn't flatten if pinched and released
Causes

Diarrhea occurs when the food and fluids you ingest pass too quickly or in too large an amount — or both — through your colon. Normally, your colon absorbs liquids from the food you eat, leaving a semisolid stool. But if the liquids from the foods you eat aren't absorbed, the result is a watery bowel movement.

A number of diseases and conditions can cause diarrhea. Common causes of diarrhea include:

Viruses. Viruses that can cause diarrhea include Norwalk virus, cytomegalovirus and viral hepatitis. Rotavirus is a common cause of acute childhood diarrhea.
Bacteria and parasites. Contaminated food or water can transmit bacteria and parasites to your body. Parasites such as Giardia lamblia and cryptosporidium can cause diarrhea. Common bacterial causes of diarrhea include campylobacter, salmonella, shigella and Escherichia coli. Diarrhea caused by bacteria and parasites can be common when traveling in developing countries, and is often called traveler's diarrhea.
Medications. Many medications can cause diarrhea. The most common are antibiotics. Antibiotics destroy both good and bad bacteria, which can disturb the natural balance of bacteria in your intestines. This disturbance sometimes leads to an infection with bacteria called Clostridium difficile, which also can cause diarrhea.
Lactose intolerance. Lactose is a sugar found in milk and other dairy products. Many people have difficulty digesting lactose and experience diarrhea after eating dairy products. Your body makes an enzyme that helps digest lactose, but for most people the levels of this enzyme drop off rapidly after childhood. This causes an increased risk of lactose intolerance as you age.
Fructose. Fructose, a sugar found naturally in fruits and honey and added as a sweetener to some beverages, can cause diarrhea in people who have trouble digesting it.
Artificial sweeteners. Sorbitol and mannitol, artificial sweeteners found in chewing gum and other sugar-free products, can cause diarrhea in some otherwise healthy people.
Surgery. Some people may experience diarrhea after undergoing abdominal surgery or gallbladder removal surgery.
Other digestive disorders. Chronic diarrhea has a number of other causes, such as Crohn's disease, ulcerative colitis, celiac disease, microscopic colitis and irritable bowel syndrome.
Treatment & Drugs

Most cases of diarrhea clear on their own within a couple of days without treatment. If you've tried lifestyle changes and home remedies for diarrhea without success, your doctor may recommend medications or other treatments.

Antibiotics
Antibiotics may help treat diarrhea caused by bacteria or parasites. If a virus is causing your diarrhea, antibiotics won't help.

Treatment to replace fluids
Your doctor likely will advise you to take steps to replace the fluids and salts lost during diarrhea. For most people, replacing fluids means drinking water, juice or broth. If drinking liquids upsets your stomach or causes diarrhea, your doctor may recommend getting fluids through a vein in your arm (intravenously).

Water is a good way to replace fluids, but it doesn't contain the salts and electrolytes — minerals such as sodium and potassium — you need in order to maintain the electric currents that keep your heart beating. Disruption of your body's fluid and mineral levels creates an electrolyte imbalance that can be serious. You can help maintain your electrolyte levels by drinking fruit juices for potassium or eating soups for sodium.

Adjusting medications you're taking
If your doctor determines that an antibiotic medication caused your diarrhea, your doctor may modify your treatment plan by lowering your dose or switching to another medication.

Treating underlying conditions
If your diarrhea is caused by a more serious disease or condition, such as inflammatory bowel disease, your doctor will work to control that condition. You may be referred to a specialist, such as a gastroenterologist, who can help devise a treatment plan for you.

Lifestyle & Home Remedies

Most diarrhea clears up on its own within a few days. To help you cope with your signs and symptoms until they go away, try to:

Drink plenty of clear liquids,including water, broths and juices every day. But, avoid apple and pear juices until you feel better because they can make your diarrhea worse. Avoid caffeine and alcohol. Eating gelatin also may help.
Add semisolid and low-fiber foods gradually as your bowel movements return to normal. Try soda crackers, toast, eggs, rice or chicken.
Avoid certain foods such as dairy products, fatty foods, high-fiber foods or highly seasoned foods for a few days.
Ask about anti-diarrheal medications. Over-the-counter (OTC) anti-diarrheal medications, such loperamide (Imodium A-D) and bismuth subsalicylate (Pepto-Bismol), may help reduce the number of watery bowel movements you experience. Certain infections — bacterial and parasitic — may be made worse by these OTC medications because they prevent your body from getting rid of what's causing the diarrhea. Also, these drugs aren't always safe for children. Check with your doctor before taking these medications or giving these medications to a child.


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