Diarrhea

What is diarrhea?

Diarrhea is loose, watery stools. A person with diarrhea typically passes stool more than three times a day. People with diarrhea may pass more than a quart of stool a day. Acute diarrhea is a common problem that usually lasts 1 or 2 days and goes away on its own without special treatment. Prolonged diarrhea persisting for more than 2 days may be a sign of a more serious problem and poses the risk of dehydration. Chronic diarrhea may be a feature of a chronic disease.

Diarrhea can cause dehydration, which means the body lacks enough fluid to function properly. Dehydration is particularly dangerous in children and older people, and it must be treated promptly to avoid serious health problems.

People of all ages can get diarrhea and the average adult has a bout of acute diarrhea about four times a year. In the United States, each child will have had seven to 15 episodes of diarrhea by age 5.

Contents 1 What causes diarrhea? 1.1 things you'll need: 2 Instruction to Prevent Diarrhea 3 Tips & Warnings

[edit] What causes diarrhea?

Acute diarrhea is usually related to a bacterial, viral, or parasitic infection. Chronic diarrhea is usually related to functional disorders such as irritable bowel syndrome or inflammatory bowel disease.

A few of the more common causes of diarrhea include the following:

• Bacterial infections- Several types of bacteria consumed through contaminated food or water can cause diarrhea. Common culprits include Campylobacter, Salmonella, Shigella, and Escherichia coli (E. coli).

• Viral infections- Many viruses cause diarrhea, including rotavirus, Norwalk virus, cytomegalovirus, herpes simplex virus, and viral hepatitis.

• Food intolerances- Some people are unable to digest food components such as artificial sweeteners and lactose—the sugar found in milk.

• Parasites- Parasites can enter the body through food or water and settle in the digestive system. Parasites that cause diarrhea include Giardia lamblia, Entamoeba histolytica, and Cryptosporidium.

• Reaction to medicines- Antibiotics, blood pressure medications, cancer drugs, and antacids containing magnesium can all cause diarrhea.

• Intestinal diseases- Inflammatory bowel disease, colitis, Crohn’s disease, and celiac disease often lead to diarrhea.

• Functional bowel disorders- Diarrhea can be a symptom of irritable bowel syndrome.

Some people develop diarrhea after stomach surgery or removal of the gallbladder. The reason may be a change in how quickly food moves through the digestive system after stomach surgery or an increase in bile in the colon after gallbladder surgery.

People who visit foreign countries are at risk for traveler’s diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or parasites. Traveler’s diarrhea can be a problem for people visiting developing countries. Visitors to the United States, Canada, most European countries, Japan, Australia, and New Zealand do not face much risk for traveler’s diarrhea.

In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes away on its own, an extensive search for the cause is not usually necessary.

What are the symptoms of diarrhea?

Diarrhea may be accompanied by cramping, abdominal pain, bloating, nausea, or an urgent need to use the bathroom. Depending on the cause, a person may have a Fever or bloody stools.

Diarrhea is characterized by an unusual frequency and consistency of the stool. There is no sure way to prevent diarrhea, but common sense will help to minimize your risk.

What are common causes of acute diarrhea?

The most common cause of acute diarrhea is infection--viral, bacterial, and parasitic. Bacteria also can cause acute food poisoning. A third important cause of acute diarrhea is starting a new medication.

Viral gastroenteritis

Viral gastroenteritis (viral infection of the stomach and the small intestine) is the most common cause of acute diarrhea worldwide. Symptoms of viral gastroenteritis (nausea, vomiting, abdominal cramps, and diarrhea) typically last only 48-72 hrs. Unlike bacterial enterocolitis (bacterial infection of the small intestine and colon), patients with viral gastroenteritis usually do not have blood or pus in their stools and have little if any fever.

Viral gastroenteritis can occur in a sporadic form (in a single individual) or in an epidemic form (among groups of individuals). Sporadic diarrhea probably is caused by several different viruses and is believed to be spread by person-to-person contact. The most common cause of epidemic diarrhea (for example, on cruise ships) is infection with a family of viruses known as caliciviruses of which the genus norovirus is the most common (for example, "Norwalk agent"). The caliciviruses are transmitted by food that is contaminated by sick food-handlers or by person-to-person contact.

Food poisoning

Food poisoning is a brief illness that is caused by toxins produced by bacteria. The toxins cause abdominal pain (cramps) and vomiting and also cause the small intestine to secrete large amounts of water that leads to diarrhea. The symptoms of food poisoning usually last less than 24 hours. With some bacteria, the toxins are produced in the food before it is eaten, while with other bacteria, the toxins are produced in the intestine after the food is eaten.

Symptoms usually appear within several hours when food poisoning is caused by toxins that are formed in the food before it is eaten. It takes longer for symptoms to develop when the toxins are formed in the intestine (because it takes time for the bacteria to produce the toxins). Therefore, in the latter case, symptoms usually appear after 7-15 hours.

Staphylococcus aureus is an example of a bacterium that produces toxins in food before it is eaten. Typically, food contaminated with Staphylococcus (such as salad, meat or sandwiches with mayonnaise) is left un-refrigerated at room temperature overnight. The Staphylococcal bacteria multiply in the food and produce toxins. Clostridium perfringens is an example of a bacterium that multiplies in food (usually canned food), and produces toxins in the small intestine after the contaminated food is eaten.

Traveler's diarrhea

There are many strains of E. coli bacteria. Most of the E. coli bacteria are normal inhabitants of the small intestine and colon and are non-pathogenic, meaning they do not cause disease in the intestines. Nevertheless, these non-pathogenic E. coli can cause diseases if they spread outside of the intestines, for example, into the urinary tract (where they cause bladder or kidney infections) or into the blood stream (sepsis).

Certain strains of E. coli, however, are pathogenic (meaning they can cause disease in the small intestine and colon). These pathogenic strains of E. coli cause diarrhea either by producing toxins (called enterotoxigenic E. coli or ETEC) or by invading and inflaming the lining of the small intestine and the colon and causing enterocolitis (called enteropathogenic E. coli or EPEC). Traveler's diarrhea usually is caused by an ETEC strain of E. coli that produces a diarrhea-inducing toxin.

Tourists visiting foreign countries with warm climates and poor sanitation (Mexico, parts of Africa, etc.) can acquire ETEC by eating contaminated foods such as fruits, vegetables, seafood, raw meat, water, and ice cubes. Toxins produced by ETEC cause the sudden onset of diarrhea, abdominal cramps, nausea, and sometimes vomiting. These symptoms usually occur 3-7 days after arrival in the foreign country and generally subside within 3 days. Occasionally, other bacteria or parasites can cause diarrhea in travelers (for example, Shigella, Giardia, Campylobacter). Diarrhea caused by these other organisms usually lasts longer than 3 days.

Bacterial enterocolitis

Disease-causing bacteria usually invade the small intestines and colon and cause enterocolitis (inflammation of the small intestine and colon). Bacterial enterocolitis is characterized by signs of inflammation (blood or pus in the stool, fever) and abdominal pain and diarrhea. Campylobacter jejuni is the most common bacterium that causes acute enterocolitis in the U.S. Other bacteria that cause enterocolitis include Shigella, Salmonella, and EPEC. These bacteria usually are acquired by drinking contaminated water or eating contaminated foods such as vegetables, poultry, and dairy products.

Enterocolitis caused by the bacterium Clostridium difficile is unusual because it often is caused by antibiotic treatment. Clostridium difficile is also the most common nosocomial infection (infection acquired while in the hospital) to cause diarrhea. Unfortunately, infection also is increasing among individuals who have neither taken antibiotics or been in the hospital.

E. coli O157:H7 is a strain of E. coli that produces a toxin that causes hemorrhagic enterocolitis (enterocolitis with bleeding). There was a famous outbreak of hemorrhagic enterocolitis in the U.S. traced to contaminated ground beef in hamburgers (hence it is also called hamburger colitis). Approximately 5% of patients infected with E. coli O157:H7, particularly children, can develop hemolytic uremic syndrome (HUS), a syndrome that can lead to kidney failure . Some evidence suggests that prolonged use of anti-diarrhea agents or use of antibiotics may increase the chance of developing HUS.

Parasites

Parasitic infections are not common causes of diarrhea in the U. S. Infection with Giardia lamblia occurs among individuals who hike in the mountains or travel abroad and is transmitted by contaminated drinking water. Infection with Giardia usually is not associated with inflammation; there is no blood or pus in the stool and little fever. Infection with amoeba (amoebic dysentery) usually occurs during travel abroad to undeveloped countries and is associated with signs of inflammation--blood or pus in the stool and fever.

Cryptosporidium is a diarrhea-producing parasite that is spread by contaminated water because it can survive chlorination. Cyclospora is a diarrhea-producing parasite that has been associated with contaminated raspberries from Guatemala.

Drugs

Drug-induced diarrhea is very common because many drugs cause diarrhea. The clue to drug-induced diarrhea is that the diarrhea begins soon after treatment with the drug is begun. The medications that most frequently cause diarrhea are antacids and nutritional supplements that contain magnesium. Other classes of medication that cause diarrhea include:

• nonsteroidal anti-inflammatory drugs (NSAIDs),

• chemotherapy medications,

• antibiotics,

• medications to control irregular heartbeats (antiarrhythmics), and

• medications for high blood pressure.

A few examples of specific medications that commonly cause diarrhea are:

• misoprostol (Cytotec),

• quinidine (Quinaglute, Quinidex),

• olsalazine (Dipentum),

• colchicine (Colchicine),

• metoclopramide (Reglan), and

• cisapride (Propulsid, Motilium).

When should the doctor be called for diarrhea?

Most episodes of diarrhea are mild and of short duration and do not need to be brought to the attention of a doctor. The doctor should be consulted when there is:

• High fever (temperature greater than 101 F)
• Moderate or severe abdominal pain or tenderness
• Bloody diarrhea that suggests severe intestinal inflammation
• Diarrhea in persons with serious underlying illness for whom dehydration may have more serious consequences, for example, persons with diabetes, heart disease, and AIDS
• Severe diarrhea that shows no improvement after 48 hours.
• Moderate or severe dehydration
• Prolonged vomiting that prevents intake of fluids orally
• Acute diarrhea in pregnant women because of concern for the health of the fetus
• Diarrhea that occurs during or immediately after completing a course of antibiotics because the diarrhea may represent antibiotic-associated infection with C. difficile that requires treatment
• Diarrhea after returning from developing countries or from camping in the mountains because there may be infection with Giardia (for which there is treatment)
• Diarrhea that develops in patients with chronic intestinal diseases such as colitis, or Crohn's disease because the diarrhea may represent worsening of the underlying disease or a complication of the disease, both requiring treatment
• Acute diarrhea in an infant or young child in order to ensure the appropriate use of oral liquids (type, amount, and rate), to prevent or treat dehydration, and to prevent complications of inappropriate use of liquids such as seizures and abnormal blood electrolytes
• Chronic diarrhea

[edit] things you'll need:

• Antibacterial Soaps

[edit] Instruction to Prevent Diarrhea

1. Practice good hand-washing hygiene, especially when you are around a group of children, or after using public bathrooms or shopping. Wash your hands after you have a bowel movement, or after wiping up your children after their bowel movements. It's possible to spread bacteria.

2. Avoid huge dietary changes. For example, don't go on an all-grapes diet. Introduce new foods slowly into your diet, especially fruits, vegetables, grains and milk products.

3. {{tip|Throw food away if it drops onto the floor or the ground}. Parasites and germs are found at ground level.

4. Wash fruits and vegetables thoroughly before eating.

5. Cook food thoroughly, especially meat.

6. Avoid foods that have a tendency to loosen bowels, like the sorbitol found in many diet foods.

7. Practice good stress management if your diarrhea is caused by anxiety. (See the Related "Irritable Bowel Syndrome" eHows.)

8. Forgo milk products if your diarrhea is caused by a lactose intolerance.

9. Cut back on caffeine, which can cause stools to loosen.

10. Read your medication labels carefully. If one of the side effects is diarrhea, check with your physician about changing medications.

[edit] Tips & Warnings

Diarrhea and loose stools are not the same thing. Diarrhea is watery; loose stools are soft and runny, but at least partially formed.

Antibiotics can cause diarrhea by upsetting the normal microbial balance in the intestine, thus leading to infection and diarrhea.

However, if you need to take antibiotics, you can combat diarrhea by eating yogurt, which contains a live active culture that restores this balance and prevents infection.

If you have any questions or concerns, contact a physician or other health care professional before engaging in any activity related to health and diet. This information is not intended as a substitute for professional medical advice or treatment.