What is Diarrhea?
Diarrhea refers to frequent loose or liquid bowel movements. A patient of diarrhea may pass stools three times or more every day. One of most common diseases, acute diarrhea usually lasts for 1-2 days before going away by itself, without any special treatment. However, a more prolonged diarrhea lasting for more than 2 days may be a sign of serious problem. Diarrhea may lead to dehydration, a condition in which the body lacks normal amount of liquid.
Diarrhea can occur to people of any age. An adult usually suffers from it for four times every year. Although treatments are readily available, it is one of the most common reasons for infant deaths around the world. Also, diarrhea is one of the major reasons of deaths in developing countries.
Symptoms of Diarrhea
The most common symptoms of diarrhea include cramping, abdominal pain, bloating, nausea and an urgent need for bowel movements. Fever and bloody stools may also be the symptoms of diarrhea. In case of children, symptoms such as stools containing blood or pus, black stools, temperature above 102 degrees and signs of dehydration may also be due to diarrhea. If these symptoms persist for more than 24 hours, consult the doctor immediately.
The most common symptoms of dehydration include thirst, less frequent urination, dry skin, fatigue, light-headedness and dark-colored urine. In case of children, the common symptoms of dehydration, which may be due to diarrhea, may include dry mouth and tongue, no tears when crying, no wet diapers for 3 hours or more, sunken abdomen, eyes, or cheeks, high fever, listlessness or irritability and skin that does not flatten when pinched and released
Diagnosis of Diarrhea
The diagnosis of diarrhea may include medical history inspection, physical tests, stool culture, blood tests, fasting test for detecting food allergies, sigmoidoscopy and colonoscopy.
Stool culture refers to collection and analysis of stool of the patient. It is helpful to determine whether the patient has diarrhea through stool culture. It is usually performed to detect various bacteria, fungi, parasites and viruses present in the intestine. The organisms are allowed to grow and chemical tests and analysis is performed on the sample.
The blood tests are usually performed to detect the electrolyte levels and blood count.
Although fasting test are more related to diabetes, these tests can also be performed to detect diseases associated with the digestive system. In case of diarrhea, it is usually used to test food allergies.
Sigmoidoscopy is usually performed to test the inner lining of the lower large intestine for testing the bowel habits, in case of diarrhea. A sigmoidoscope is used to perform the test.
Colonoscopy is usually performed to test the diseases of lower gastrointestinal tract. It is used basically to verify diseases that show symptoms such as abdominal pain, anemia (low red blood cells), blood in the stool, change in bowel habits and unexplained weight loss. It is also common with screening for colon cancer.
Causes of Diarrhea
The most common cause of diarrhea is infection of the gut by a virus. Other causes may include Infection by bacteria, infections by other organisms, eating foods that upset the digestive system and allergies to certain foods. Medications, radiation therapy and diseases of the intestines, such as Crohn’s disease and ulcerative colitis may also result to the onset of diarrhea.
Inability of the body to adequately absorb certain nutrients from the diet known as malabsorption , hyperthyroidism, and some cancers may also be the reason behind diarrhea. Moreover, Laxative and alcohol abuse also leads to diarrhea in some cases. The other most prominent reasons include digestive tract surgery, diabetes and competitive running.
Types of Diarrhea
There are four types of diarrhea- secretory, osmotic, motility-related and inflammatory.
Secretory diarrhea: Secretory diarrhea leads to an increase in active secretion or inhibition of absorption. This type of diarrhea usually occurs due to the cholera toxin which increases the secretion of anions.
Osmotic diarrhea: When too much water is drawn into the bowels, the diarrhea is known as osmotic diarrhea. This can happen due to maldigestion. This type of bacteria can also occur due to osmotic laxatives. The major causes of osmotic diarrhea include too much amount of magnesium, Vitamin C or undigested lactose.
Motility related diarrhea: This type of diarrhea occurs due to rapid movement of food through the intestines, which is known as hypermotility. Due to rapid movements, insufficient digestion occurs in the gastrointestinal tract. This type of diarrhea can be caused by vagotomy or diabetic neuropathy, a complication of menstruation and hyperthyroidism.
Inflammatory diarrhea: Inflammatory diarrhea occurs due to damage to the mucosal lining to the brush border, leading to passive loss of protein-rich fluids. This results in a decreased ability to absorb the lost fluids. The major reasons of this type of diarrhea include parasitic, bacterial or viral infections, or autoimmune problems such as inflammatory bowel diseases. This type of diarrhea shoiws features of all three other types.
Treatment of Diarrhea
Usually, diarrhea automatically subsides within a span of two to three days. During this period the adult patient may take enough fluids in the form of regular soda and soft drinks to replenish the lost water and electrolytes. Milk and alcohol should be avoided as these foods may increase the severity of the disease. The patients should try to eat and the food needs not to be bland. However, greasy and fatty foods must be avoided. If symptoms of nausea persists use ice chips for sucking. Usual activities should be continued but strenuous exercises should be avoided.
If children are affected with diarrhea, the BRAT diet- banana, rice, applesauce and toast should be provided. Very young infants may suffer from dehydration due to loss of water and electrolytes due to diarrhea. They should be given solutions such as pedialyte which replenishes the lost electrolytes and salts. However, salt tablets should be avoided.
The medical treatment for diarrhea usually includes intravenous line if the patient is dehydrated and cannot drink. It replaces the lost fluids and brings back a quick recover. Sometimes, antibiotics are also prescribed to shorten the duration of diarrhea. The healthcare provider may also offer specific medication if the diarrhea is caused due to travel. OTC antidirrheal drugs such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol) may also be prescribed. Antidiarrheal medications are usually not prescribed for children. In severe cases, hospitalization maybe required for providing intravenous medication.
Living with Diarrhea
Diarrhea is not a long term disease. It usually goes away within a span of few days. However, it is important to keep the levels of liquids intact while an individual suffers from diarrhea. Taking ample amounts of liquid frequently can reduce the harmful effects of diarrhea. It is also important to maintain a healthy diet and avoid junk foods, milk and alcohol. Knowing about the disease helps in becoming alert when the disease occurs by understanding to read the symptoms.
Prevention of Diarrhea
Prevention of diarrhea requires an immediate attention to healthy diet and taking ample amounts of liquid every day. It is found that the most common pathway of attack of harmful bacteria and virus, which causes diarrhea, is through the foods we take. Therefore, it is essential to ensure that the foods are cooked well and are germ free before they are taken. It is necessary to take pasteurized foods for the same reason. The liquids that we take should also be inspected well before drinking them. The best way to drink bottled water, soda, beer or wine is from their original container. Tap water and ice cubes should be avoided. It should also be remembered that alcohol and caffeine can aggravate diarrhea and dehydration. So, their use should be limited and over-consumption should be avoided.
The doctor may be consulted for using antibiotics and pepto bismol, especially to avoid traveler’s diarrhea. It has been found that antibiotics can significantly reduce the chances of acquiring traveler’s diarrhea.