Diarrhea is the frequent passage of loose, watery or soft stools. This typically occurs more than three times a day. The average adult experiences episodes of diarrhea around four times a year. Most episodes of diarrhea resolve in a few days. Diarrhea is considered acute if it lasts less than 2 weeks. Most episodes of acute diarrhea are infectious. Chronic diarrhea is diarrhea that lasts more than 4 weeks. It can be mild but it can also be severe and debilitating.
- Frequent loose or watery stools
- Diarrhea can be accompanied by abdominal pain, cramping, gas or bloating.
- Infections with viruses, bacteria or parasites.
- Irritable bowel syndrome, a functional disorder of the bowel that is one of the most common causes of chronic diarrhea.
- Inflammatory bowel diseases, like Crohn’s disease and ulcerative colitis, are autoimmune conditions where the immune system attacks the lining of the digestive tract. Diarrhea may or may not be bloody.
- Food allergies and sensitivities such as celiac disease (allergy to gluten), gluten intolerance or lactose intolerance.
- Endocrine disorders: hyperactive thyroid, diabetes and certain rare hormone secreting tumors can result in chronic and sometimes severe diarrhea.
- Certain medications: diarrhea can be a side effect of many medications and supplements.
Acute diarrhea rarely requires any testing. The work up of chronic diarrhea may include:
- Blood tests
- Stool tests
- Hydration to replace the fluid losses due to the diarrhea.
- Treating the cause of the diarrhea. When the work up identifies a specific cause of the diarrhea, this needs to be treated. This may include using antibiotics to treat an infection, avoiding certain foods such as lactose or gluten, stopping certain medicines or long term treatment in cases such as inflammatory bowel diseases.
- Treating the symptoms. Symptomatic treatment can be used while the work up is underway or when the diarrhea is functional. This may include the use of fiber supplements and bulking agents, over the counter anti diarrhea’s (eg: Imodium) or Bismuth (eg: Kaopectate, Pepto-Bismol).