Diarrhoea is passing looser or more frequent stools than is normal for you. Diarrhoeal disease is the second leading cause of death in children under five years old, and is responsible for killing around 525 000 children every year. Many people get diarrhea a few times a year. It normally lasts 2 to 3 days. Some people get it more often. It could be because they have Irritable Bowel Syndrome (IBS) or other conditions.
Diarrhoea can last several days, and can leave the body without the water and salts that are necessary for survival. In the past, for most people, severe dehydration and fluid loss were the main causes of diarrhoea deaths. Now, other causes such as septic bacterial infections are likely to account for an increasing proportion of all diarrhoea-associated deaths. Children who are malnourished or have impaired immunity as well as people living with HIV are most at risk of life-threatening diarrhoea.
Diarrhoea is defined as the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual). Frequent passing of formed stools is not diarrhoea, nor is the passing of loose, “pasty” stools by breastfed babies.
Diarrhoea is usually a symptom of an infection in the intestinal tract, which can be caused by a variety of bacterial, viral and parasitic organisms. Infection is spread through contaminated food or drinking-water, or from person-to-person as a result of poor hygiene.
There are three clinical types of diarrhoea:
- acute watery diarrhoea – lasts several hours or days, and includes cholera;
- acute bloody diarrhoea – also called dysentery; and
- persistent diarrhoea – lasts 14 days or longer.
Usually, diarrhea happens because of a virus that gets into your gut. Some people call it “intestinal flu” or “stomach flu”
Other causes include:
- Alcohol Abuse
- Allergies to certain foods
- Diseases of the intestines (such as Crohn’s disease or Ulcerative colitis)
- Eating foods that upset the digestive system
- Infection by bacteria (the cause of most types of food poisoning) or other organisms
- Laxative Abuse
- Radiation Therapy
- Some Cancers
- Overactive Thyroid (Hyperthyroidism)
- Surgery on your digestive system
- Trouble absorbing certain nutrients, also called “malabsorption”
Diarrhea may also follow constipation, especially for people who have irritable bowel syndrome.
You may have:
- Bloating in your belly
- Thin or loose stools
- Watery stools
- An urgent feeling that you need to have a bowel movement
- Nausea and throwing up
More serious symptoms include:
- Blood or mucus in your stool
- Weight loss
If you have watery stools more than three times a day and you’re not drinking enough fluids, you could become dehydrated. That can be a serious problem if it’s not treated.
Prevention and Treatment
Key measures to prevent diarrhoea include:
- Access to safe drinking-water;
- Use of improved sanitation;
- Hand washing with soap;
- Exclusive breastfeeding for the first six months of life;
- Good personal and food hygiene;
- Health education about how infections spread; and
- Rotavirus vaccination
- If your case is mild, you may not need to take anything. Adults can take an over-the-counter medicine such as Bismuth Subsalicylate or Loperamide, which you can get as liquids or tablets.
- You also need to stay hydrated. You should drink at least 6 to 8-ounce glasses of fluids each day.
- Rehydration: with oral rehydration salts (ORS) solution. ORS is a mixture of clean water, salt and sugar. It costs a few cents per treatment. ORS is absorbed in the small intestine and replaces the water and electrolytes lost in the faeces.
- Zinc supplements: zinc supplements reduce the duration of a diarrhoea episode by 25% and are associated with a 30% reduction in stool volume.
- Rehydration: with intravenous fluids in case of severe dehydration or shock.
- Nutrient-rich foods: the vicious circle of malnutrition and diarrhoea can be broken by continuing to give nutrient-rich foods – including breast milk – during an episode, and by giving a nutritious diet – including exclusive breastfeeding for the first six months of life – to children when they are well.
- Choose electrolyte replacement drinks or soda without caffeine.
- Chicken broth (without the fat), tea with honey, and sports drinks are also good choices.
- Instead of drinking liquids with your meals, drink liquids between meals. Sip small amounts of fluids often.
- Liquid probiotics may also help.
How Can I Feel Better?
Your rectal area may become sore because of all the bowel movements that diarrhea brings. You may have itching, burning, or pain when you go to the bathroom.
For relief, take a warm bath or sitz bath. Afterward, pat the area dry (don’t rub) with a clean, soft towel. You may also try using a hemorrhoid cream or petroleum jelly on the affected area. If this continues for several days, you should contact your doctor.
When Should I Call My Doctor?
Call your doctor right away if you have:
- Blood in your diarrhea or black, tarry stools
- A fever that is high (above 101 F) or that lasts more than 24 hours
- Diarrhea lasting longer than 2 days
- Nausea or throwing up that prevents you from drinking liquids to replace lost fluids
- Severe pain in your belly (especially the right lower quadrant) or rear end
- Diarrhea after coming back from a foreign country
Also, call your doctor right away if you have diarrhea and any of these signs of dehydration:
- Dark urine
- Smaller than usual amounts of urine or, in a child, fewer wet diapers than usual
- Rapid heart rate
- Dry skin