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Every person will experience diarrhoea at least once, or even several times throughout their life. Diarrhoea is a common symptom affecting millions of people all around the world and can be caused by many different factors. While many people trivialize this symptom, diarrhoea can be dangerous, as it depletes the body of its important electrolytes and leads to dehydration.
Diarrhoea is a symptom of the digestive system characterized by the passage of frequent and loose watery stools, three, or more times in a day.
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Diarrhoea can be classified into three different categories, namely acute, chronic and persistent. The classification below is based on the duration of the diarrhoea.
Acute diarrhoea refers to diarrhoea that lasts for only two to three days maximum.
Acute diarrhoea is the most common type of diarrhoea. It can be further classified into acute watery diarrhoea and acute bloody diarrhoea.
Gastroenteritis is the medical term used to refer to the inflammation of the digestive system secondary to an infection that leads to episodes of acute diarrhoea.
Chronic diarrhoea refers to diarrhoea that lasts for more than four weeks, or occurs intermittently over a long period of time.
Persistent diarrhoea involves passing loose stools persistently over several weeks.
Diarrhoea can also be classified according to the mechanism by which it occurs. Here are the main types of diarrhoea according to different mechanisms:
Secretory diarrhoea occurs when there is an increase in the secretion of electrolytes into the intestines.
Osmotic diarrhoea occurs when a lot of water is drawn into the bowels, hence resulting in watery stools.
Inflammatory diarrhoea occurs when there is damage to the inner lining of the digestive tract. It is usually caused by an infection.
Diarrhoea can be caused by a number of different factors. Below are the most common causes:
Diarrhoea is very often caused by infections from viruses, bacteria and parasites. Most patients are infected with these diarrhoea-inducing microorganisms when they consume unhygienic, poorly cooked food, or water that has been contaminated with faeces.
Diarrhoea caused by eating contaminated food, or water, is commonly referred to as traveller’s diarrhoea.
Rotavirus and Escherichia Coli are the most common microorganisms that can trigger acute diarrhoea. Clostridium Difficile is a type of bacteria that can cause serious bowel problems.
Diarrhoea can occur as a result of malnutrition. Studies show that malnutrition can cause a 73% increase in the frequency of diarrhoea in malnutrition patients.
Intolerance to certain foods, such as lactose, gluten, fructose, among others, can trigger diarrhoea. In certain people, lactose (a sugar compound present in milk) cannot undergo proper digestion, as the person has a deficiency in the enzyme involved in its breakdown. Fructose which is the naturally-occurring sugar in fruits and honey can also be difficult to digest, hence resulting in diarrhoea.
Gallbladder problems and disorders of the bile conducting system may clinically present as frequent and loose watery stools.
Medications that can trigger diarrhoea include magnesium-based antacids and antibiotics.
Artificial sweeteners, such as mannitol have also been identified as diarrhoea inducers.
Malabsorption syndromes are characterized by the inability to absorb nutrients from foods. Certain malabsorption disorders can cause diarrhoea and foul-smelling stools. Malabsorption syndromes include celiac disease, Crohn’s disease, Bile Acid Malabsorption, among others.
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The symptoms associated with diarrhoea can vary from person-to-person depending on the root cause of the diarrhoea. The most common symptoms of diarrhoea are described below:
Severe diarrhoea may lead to a more serious clinical picture. Serious signs and symptoms include:
Note that serious symptoms require immediate medical assistance. Do not delay in seeking treatment if you have any of the above serious symptoms.
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To diagnose diarrhoea and find its root cause, your doctor will want to carry out certain tests by drawing blood samples from a vein, or by other methods. Before proceeding with the investigations, your doctor will first ask you a series of vital questions with regard to the smell, the consistency, the colour, and the presence of blood in your stools. He may also ask you about any recent history of travel that could be indicative of an infection rather than a chronic problem.
Below are the usual tests used to identify the primary causes of diarrhoea.
General blood tests, such as a complete blood count, electrolyte levels, and renal function tests are usually sent to determine the general condition of a patient and rule out other potential causes of diarrhoea. Additional blood tests, such as a thyroid function test, and pancreatic enzyme tests, may be sent to rule out diarrhoea induced by an imbalance in thyroid levels, or an inflammation of the pancreas.
While most doctors can tell if you suffer from lactose intolerance simply by taking a detailed medical history, some doctors prefer more confirmatory tests, such as a hydrogen breath test, or a blood sugar test, after taking a drink rich in lactose.
Your doctor will want to order a stool test if you do not respond to the routine treatment for acute diarrhoea. The stool test is sent to the laboratory to look for the presence of harmful bacteria, viruses, or parasites.
Colonoscopy is a special test during which your doctor will use a flexible camera to view the inside of your intestines to determine the cause of the diarrhoea. Colonoscopy is not a routine test and will thus be ordered only if your doctor deems it as necessary.
Very rarely, imaging tests like CT scans may be requested.
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Diarrhoea does not usually cause serious problems however, it can be quite unpleasant, especially if you have to deal with the chronic type of diarrhoea almost every day. Acute diarrhoea is very often self-limiting and rarely requires advanced treatment. Chronic diarrhoea caused by malabsorption disorders may require medical assistance, as the problem is usually with the way the body functions, rather than an external factor that can be eliminated.
Diarrhoea can make you lose a lot of fluids. Hence, it is of utmost importance to keep yourself well hydrated throughout the day. Drink more water than usual to replenish your losses. Avoid coffee and alcohol. Mild acute diarrhoea will eventually cure by itself in three to four days. Just make sure to keep yourself well-hydrated to avoid the complications associated with electrolytes imbalances and dehydration.
If you are currently experiencing an episode of diarrhoea, it is best to avoid consuming certain ‘trigger foods’. Lactose intolerant patients should eliminate all lactose-containing products. Great alternatives for lactose intolerant patients include almond milk, rice milk, carob bars and hazelnut milk. However, it is best to avoid milk if you are currently experiencing diarrhoea. Your doctor may also prescribe lactase enzyme tablets with dairy products to help you prevent symptoms.
Fructose intolerant patients should avoid high-fructose foods, such as fruit juices, grapes, peas, courgettes, watermelon and apples. Keep a food diary to jot down all the foods that give you symptoms and all the foods that you can tolerate. Always read labels and train yourself to watch out for the following no-nos:
Commodes can help if you're struggling with mobility and suffering with diarrhoea. We have a selection of commodes available from our website.
If you have been diagnosed with acute infective diarrhoea, it is imperative to maintain proper hygiene, so as not to spread the infective agent to your surroundings and family members. Wash your hands properly after using the toilet with soap and water for at least 20 seconds to eliminate any harmful pathogens that may be present on your hands. Clean the door handles and disinfect the toilet.
Our Senset Moist Patient Skin Wipes are great for keeping clean after diarrhoea issues.
Because diarrhoea involves a lot of fluid losses, one of the most important treatment options for any type of diarrhoea remains the replacement fluids. A diarrhoeal episode does not only involve the loss of water, but also the loss of important electrolytes such as sodium, potassium and bicarbonate. Your doctor may recommend an oral rehydration salts (ORS) solution. An ORS solution is simply a well-proportionated mixture of salt, sugar, and other important electrolytes that have been pre-made and packaged for instant use. In case of severe dehydration, your physician will provide rehydration via an intravenous route.
Your physician may prescribe zinc supplements, as studies show that zinc supplementation can reduce the duration of diarrhoea by 25% and can also reduce stool volume by 30%. Probiotics may also reduce the duration of the illness. If malnutrition is at the root of the diarrhoeal episode, you should consume nutrient-rich foods to break this cycle.
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Crohn’s and Colitis UK – find out more about Crohn’s and Colitis UK by clicking on the following link: Crohn’s and Colitis UK
Guts UK! – click here to visit the website: Guts UK
BAD UK: Bile Acid Diarrhoea Support – you can visit BAD UK by clicking on this link: Bile Acid Diarrhoea Support
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Medical terms are often baffling and difficult to fully understand. To help, we have listed some frequently used terms below.
Electrolytes – electrolytes are the essential minerals found inside body tissues, blood, urine and sweat. Electrolytes possess an electrical charge. They help your body carry out important functions, such as the production of energy. Examples of electrolytes include sodium, chloride, potassium, calcium, magnesium, phosphate, and bicarbonate
Inflammatory Bowel Disease – Inflammatory Bowel Disease (IBD) is a group of inflammatory conditions affecting the digestive system. IBS consists of two chronic diseases, namely Crohn’s disease and Ulcerative Colitis (UC.) Ulcerative colitis can result in sores and ulcers inside the intestines
Pancreas – the pancreas is a gland found behind your stomach. It is responsible for the production of enzymes that help break down food. The pancreas also secretes very important hormones, such as insulin and glucagon
Rotavirus – rotavirus is a contagious virus of the Reoviridae family that causes diarrhoea mostly in infants and young children. Adults may also catch the virus however, they present with milder symptoms as compared to children
