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Diarrhea

Diarrhea is not a disease but a symptom that almost everyone experiences at some point. In most cases, it resolves on its own. However, if diarrhea persists or leads to significant fluid loss causing dehydration, it’s essential to seek medical help.  

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What is diarrhea?

Diarrhea is characterized by frequent, watery bowel movements that disrupt the normal pattern. It can be acute, often caused by an intestinal infection, and typically clears up within a few days. If it lasts for more than two weeks, it is considered chronic and may indicate an underlying health condition. 

What causes diarrhea?

The potential causes of diarrhea include: 

  • Sudden intestinal infection: Acute diarrhea is often due to a virus, bacteria, or parasite. This includes viral gastroenteritis (commonly called stomach flu), which is contagious. Bacterial infections may result from consuming contaminated food or water, such as raw meat, unpasteurized dairy, or seafood. 
  • Stress: Stress can interfere with digestion, leading to diarrhea as the body absorbs fewer fluids and nutrients. 
  • Medications: Antibiotics can disrupt the balance of healthy bacteria in the gut, causing diarrhea. Other medications like metformin for diabetes or thyroid medication may also contribute. 
  • Food intolerances: Conditions like lactose intolerance or celiac disease (gluten intolerance) can trigger diarrhea. 
  • Accelerated metabolism: An overactive thyroid can speed up metabolism, leading to diarrhea. 
  • Gastrointestinal diseases: Chronic conditions such as Crohn’s disease or ulcerative colitis often involve diarrhea, especially during flare-ups. 
  • Irritable Bowel Syndrome (IBS): This condition may cause alternating bouts of diarrhea and constipation
  • Overflow diarrhea: This occurs when hard stool blocks the bowel, causing watery stool to pass around the blockage. 
  • Certain foods: Ingredients like mannitol, fructose, sorbitol, and xylitol, often found in sweets and drinks, can speed up digestion. 
  • Traveler’s diarrhea: This occurs when traveling to regions with lower hygiene standards. 
How to recognize diarrhea

Symptoms of diarrhea may include: 

  • Frequent, watery stools 
  • Foul-smelling feces 
  • Abdominal cramps 
  • Difficulty controlling bowel movements 
  • Possible nausea and vomiting 
  • General feelings of weakness and fatigue 
  • Headaches due to dehydration 
  • Reduced urination 
  • Occasionally, a fever
Managing diarrhea

If you have diarrhea, consider the following steps: 

  • Stay hydrated: Drink plenty of fluids with salts and sugars, like broth or tea with sugar, to replace lost fluids. Avoid soft drinks. 
  • Eat if possible: Fiber-rich foods can help thicken the stool. 
  • Practice good hygiene: Wash your hands thoroughly, especially after using the bathroom or handling food. 
  • Review your medication: Consult your doctor if you suspect your medication is causing diarrhea. Do not stop medication without medical advice. 
Treatment options

The treatment for diarrhea depends on its cause. Acute diarrhea usually doesn’t require medication and will resolve within a few days. Preventing dehydration is crucial. 

  • ORS (Oral Rehydration Solution): Helps replenish lost fluids and electrolytes. If symptoms persist, consult a doctor. 
  • Loperamide: Can temporarily relieve symptoms by slowing intestinal movement. Use only for short periods and stop if symptoms worsen. 
  • Azithromycin and ORS: May be prescribed for severe infectious diarrhea. In some cases, a stool test may be needed to identify the cause. 

Alternative treatments

Currently, no proven alternative treatments are available. Activated charcoal (norit) was once used but lacks scientific evidence of effectiveness. 

Lifestyle changes

Maintaining a healthy lifestyle with a balanced diet, regular exercise, sufficient sleep, and stress management can reduce symptoms of chronic gastrointestinal issues. For food intolerances, avoid problem foods like gluten or lactose. 

Additional risks and side effects

The main risk with diarrhea is dehydration. Signs of dehydration include: 

  • Dark urine 
  • Dry mouth 
  • Fatigue or dizziness 
  • Rapid heartbeat 
  • Cold extremities 

Certain medications may need to be adjusted during bouts of diarrhea. Always consult a doctor for guidance. 

Preventing diarrhea

To avoid diarrhea, follow these tips: 

  • Practice good food hygiene: Wash your hands, cook meat thoroughly, and keep perishables refrigerated. 
  • Avoid contaminated foods: Pay attention to expiration dates and storage guidelines. 
Traveler’s diarrhea prevention

When traveling, take the following precautions: 

  • Check local water safety: Use bottled water for drinking, cooking, and brushing teeth. 
  • Avoid ice and unpeeled fruits: Stick to bottled drinks and peel fruits before eating. 
  • Be cautious with street food: Only buy from vendors with good hygiene practices. 
  • Keep food covered and cool: Avoid spoiled or undercooked foods. 
  • Consult a travel clinic for necessary vaccinations: Bring ORS as a precaution. 
Sources
 Foundation for intestinal health. (z.d.). What is the cause of diarrhoea? Consulted on 27 April 2019 at https://www.darmgezondheid.nl/darmklachten/darmaandoeningen/diarree/

Foundation for intestinal health. (z.d.). What is the cause of diarrhoea? Consulted on 27 April 2019 at https://www.darmgezondheid.nl/darmklachten/darmaandoeningen/diarree/

Harm, G., Kerskes, M., NVN Developers’ Guideline. (6 April 2018). Adjusting medicines. Consulted on 27 April 2019 at https://www.nieren.nl/bibliotheek/83-oppassen-met-medicijnen/309-medicijngebruik-als-u-diarree-hebt-of-moet-overgeven

 Nutritional center. (z.d.). What helps with diarrhoea? Consulted on 27 April 2019 at https://www.voedingscentrum.nl/encyclopedie/diarree.aspx

 Nutritional center. (z.d.). Expiry date (THT/TGT). Consulted on 27 April 2019 at https://www.voedingscentrum.nl/encyclopedie/houdbaarheidsdatum-tht-tgt-.aspx

 Pharmacotherapeutic compass. (z.d.). Diarree/treatment flame. Consulted on 27 April 2019 at https://www.farmacotherapeutischkompas.nl/bladeren/indicatieteksten/acute_diarree

 Stomach liver bowel foundation. (z.d.). Crohn’s disease. Consulted on 27 April 2019 at https://www.mlds.nl/chronische-ziekten/crohn-ziekte-van/leven-met-de-ziekte-van-crohn/

 Stomach liver bowel foundation. (z.d.). Ulcerative colitis. Consulted on 27 April 2019 at https://www.mlds.nl/chronische-ziekten/colitis-ulcerosa/hoe-de-ziekte-ontstaat/ 

 Stomach liver bowel foundation. (z.d.). Complaints and symptoms of diarrhoea. Consulted on 27 April 2019 at https://www.mlds.nl/klachten/diarree/?gclid=Cj0KCQjw5J_mBRDVARIsAGqGLZCG4NpAjFzYip7YrEZ5yhq9O60iTANIWOihgMUDYbavBBV6JRtoCQwaAmQBEALw_wcB#klachten-en-symptomen

 Thuisarts.nl. (z.d.). I have diarrhoea in short. Consulted on 27 April 2019 on https://www.thuisarts.nl/diarree/ik-heb-diarree

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