Diarrhoea: Types, Symptoms, Causes, Risk Factors, and Treatment

What is diarrhoea?

Diarrhoea causes abnormal and frequent bowel movements in a day. Diarrhoea can cause loose and liquid stools.

Diarrhoea is not the one that usually happens every morning. People tend to run to the restroom if they have diarrhoea. Diarrhoea is a common occurrence and can resolve without any intervention.

Usually, diarrhoea can last for about two to three days, and it will go away on its own. When you have diarrhoea, you will have a feeling of bloating and a loss of appetite.

If you tend to consume food, your stomach will not be able to digest it, and you will experience certain discomfort, nausea and abdominal cramps.

In most cases, diarrhoea can be cured without any medication and with certain home remedies. In rare cases, it can lead to dehydration. The electrolytes of the body will be sent out of the body through stools.

If dehydration is not treated properly, it can be fatal. When a person is affected by dehydration, it is important to drink adequate water and hydrate well. Since electrolytes are lost during the process, try ORS powder. They will help to restore the lost electrolytes.

Types of diarrhoea

There are three types of diarrhoea.

• Acute diarrhoea
• Persistent diarrhoea and
• Chronic diarrhoea

Acute diarrhoea

Acute diarrhoea lasts for about one to three days. This type of diarrhoea can cause loose and watery stools with an increase in frequency. Acute diarrhoea will not require any major treatment, and it will go away on its own.

Persistent diarrhoea

Persistent diarrhoea can last for about 14 days. It can cause loose stools three times a day and even more. It can be caused by certain small intestine disorders. Persistent diarrhoea can cause complications like growth failure.

According to NCBI, deaths of hospitalised persistent diarrhoea patients range from 10-12%, and most cases are recorded in the first 48 hours. Additionally, the stool samples of patients affected with persistent diarrhoea contained Escherichia coli.

Scientists have also found that persistent diarrhoea is caused when the small intestines allow the passage of dietary proteins. This can induce a hypersensitive reaction and cause damage to the small intestine and mucosa.

Chronic diarrhoea

Chronic diarrhoea causes loose stools more than three times within a day. It can last for more than four weeks.

The cause of chronic diarrhoea is quite wide, and they are categorised into inflammatory and secretory diarrhoea. Persistent bacterial infection can also lead to chronic diarrhoea. Mycobacterial and parasitic infections can also lead to chronic diarrhoea.

Diarrhoea symptoms

Some of the common symptoms of diarrhoea are:

• Abdominal cramps
• Nausea and Vomiting
• Bloating
• Fever
• Mucus in stools
• Frequent bowel movements
• Loose or watery stools
• Blood in stools
• Headache
• Flatulence
• Loss of appetite
• Dehydration
• Weakness.

Causes of diarrhoea

The cause of diarrhoea can be wide-ranging, and the prevalence can depend on a person’s food habits and personal hygiene practices. Some of the common causes of diarrhoea are discussed below.

Long term causes

Long-term causes of diarrhoea can be due to various health conditions, like

• Inflammatory bowel disease
• Irritable bowel syndrome
• Medicines
• Food allergy
• Malabsorption syndrome
• Encopresis
• Lactose intolerance
• Diverticulosis

Irritable bowel syndrome is a common cause of long-term diarrhoea. It can be caused by infections and other malabsorption disorders.

Inflammatory bowel disease is categorised into Crohn’s disease and ulcerative colitis. These are caused by autoimmune conditions when the body attacks its own cells.

Infections in the intestine can cause diarrhoea. This is common in people who travel a lot. Also, personal hygiene can play an important role in the cause of diarrhoea.

Allergies to food and hypersensitivity can cause diarrhoea. If people with lactose intolerance consume milk products, they will not be digested, leading to diarrhoea.

Medicines can also cause diarrhoea. Over-the-counter drugs and prescribed medicines can also lead to diarrhoea. In most cases, if you pause the medication, diarrhoea will stop. However, do not pause the medication without the doctor’s suggestion.

Short term causes

Short-term diarrhoea can be caused by various reasons, like parasitic infection and food poisoning caused by bacteria like E.coli. When you are allergic to certain foods, it can also lead to diarrhoea. When a person is too stressed, it can also lead to diarrhoea.

Virus

A certain type of virus can also cause diarrhoea. Some of the common viruses that can cause diarrhoea are

• Norwalk virus
• Enteric adenoviruses
• Astrovirus
• Hepatitis

According to NCBI, norovirus is responsible for 90% of viral diarrhoea caused worldwide. Diarrhoea caused by a virus can usually last up to 2 days. However, the symptoms can last a maximum of up to 14 days.

Bacteria and parasites

The common causes of diarrhoea can be bacteria and parasites. The parasite that causes diarrhoea is Giardia duodenalis. When the parasite affects the intestine of the person, it will be passed into the stools.

When the parasite is removed from the body, there are possibilities for the parasite to survive for weeks and even months.

Giardiasis is caused when you swallow the parasite through the mouth or from infected animal meat. It can also spread when

• Consuming foods that are infected with the parasite.
• Close contact with a person who has giardiasis.
• Poor self-hygiene.
• Sexual contact with a person who is affected with giardiasis.
• Contact with an environment that has been infected with giardiasis.

Some of the symptoms of giardiasis include

• Diarrhoea
• Foul-smelling poop
• Dehydration
• Gas
• Stomach pain or cramps

The symptoms can last up to 2-6 weeks. However, in people with a weakened immune system, the symptoms can last longer.

Medications

There are reports that state certain medications can induce diarrhoea. Some of the drug classes that can cause diarrhoea are

• Antibiotics
• Metformin
• Beta-blockers
• Antidepressants
• Acid reducers
• Digoxin
• Lithium
• Colchicine
• Fibrates
• Levothyroxine
• Nonsteroidal anti-inflammatory drugs

These types of diarrhoea are stopped when the medication is paused. Consult your doctor if diarrhoea is caused due to these medications.

Medication-induced diarrhoea lasts for about a few days. In some cases, they can last for a week.

Lactose intolerance

Lactose intolerance is one of the most common causes of diarrhoea. People affected with the condition of lactose intolerance will not be able to digest the milk, and this can lead to diarrhoea.

When they consume dairy products, it can lead to malabsorption and diarrhoea. This type of diarrhoea can last up to 48 hours. The severity of the symptoms can depend on the type and quantity of dairy product they consume.

Fructose

Fructose malabsorption can cause osmotic diarrhoea. Fermentation of fructose occurs in the colon, which leads to bloating and gas. A low-fructose diet can help reduce the occurrence of diarrhoea.

Surgery

Diarrhoea after surgery can be common. In most cases, nausea and vomiting are the common side effects of surgery. The surgeries that are performed on the organs that can lead to diarrhoea are

• Stomach
• Gall bladder
• Large intestine
• Liver
• Spleen
• Pancreas
• Small intestine.

Diagnosis of diarrhoea

The primary step in diagnosis is your symptoms. The symptoms you exhibit and a detailed medical history will help to find the cause of the diarrhoea. Some of the common tests used to diagnose diarrhoea are listed below.

Blood test

A blood test is usually used to test your general health. The blood test will indicate the presence of any pathogen. Blood tests are not perfect but have a higher accuracy rate. The blood test will also detect the presence of antibodies that are specific to certain yeasts, parasites and gluten.

The blood will be drawn, and the sample collected will be processed in the laboratory and will be analysed for the cause of diarrhoea. The doctor will be able to analyse the results and give proper medication.

Stool test

A stool test is usually used to diagnose diarrhoea. The test will require a sample of the infected person’s stool.

Other common tests a doctor can recommend are listed below.

• Stool culture
• Gastrointestinal pathogens
• Clostridioides difficile toxin test
• Ova and parasite tests
• Faecal occult blood test
• Faecal fat test
• Stool antigen tests
• Faecal elastase, and
• Faecal trypsin/chymotrypsin

The stool sample will look for the presence of bacterial, viral or parasitic infections or their proteins.

Colonoscopy

A colonoscopy can detect symptoms like bowel movement, abdominal pain and unintentional weight loss. A colonoscopy will help look inside the colon.

The colonoscope is the device used to perform a colonoscopy. The device will contain a long, flexible tube that contains a camera and light at the end of the tube. With the help of the flexible tube, the rectum will be examined.

During the procedure, the oxygen levels, pulse and blood pressure will be monitored. The procedure will take about 10-15 minutes. The colonoscope will be inserted gently, and you might feel a low range of discomfort.

Treatment of diarrhoea

In most cases, diarrhoea can be treated within a few days. The symptoms mostly last for 2 days. However, some people may require treatment, as diarrhoea can indicate an underlying health condition.

Oral rehydration solutions

Diarrhoea majorly causes dehydration. To balance the lost fluids, ORS (oral rehydration solutions) will be used.

The ORS powder is made of water, sodium, glucose and potassium. If the dehydration is not treated properly, it can be fatal. The primary use of oral rehydration powder will be to replenish the lost fluid and electrolytes.

When the ORS powder is administered, it will increase fluid absorption in the gastrointestinal tract.

The ORS powder can be mixed with water and consumed. It is usually safe to consume. However, consult your doctor before taking it.

Anti-diarrhoeal medicines

Anti-diarrhoeal drugs can help reduce the frequency of diarrhoea. In time, it slows and stops the diarrhoea.

After taking these drugs, the need to run to the restroom will reduce, and at this time, you can stop the drugs.

Some of the common medications used are

• Loperamide
• Bismuth subsalicylate
• Atropine.

Intravenous fluids

Intravenous fluids are used to treat people affected with severe diarrhoea. Cholera can cause severe dehydration. In such cases, intravenous fluids will be required to replace the lost fluids and the electrolytes.

According to CDC, people with these symptoms should be administered intravenous fluids.

• Severe dehydration
• Stupor
• Coma
• Extreme fatigue and
• Uncontrolled vomiting.

Additionally, for people with severe dehydration, intravenous fluids should be started immediately. The IV administration should be monitored, and the level should be decreased or increased.

Antibiotics

Diarrhoea will not require any antibiotics, and it will resolve on its own. However, antibiotics can help reduce the severity of the disease. The symptoms tend to worsen after three days. So, in such cases, antibiotics will be required to treat diarrhoea.

After treating diarrhoea for 3 days, if it does not stop, antibiotics should be administered immediately to avoid severe consequences.

Some of the common antibiotics that can be administered for diarrhoea are

• Azithromycin
• Fluoroquinolones
• Levofloxacin
• Ciprofloxacin
• Rifaximin

In some cases, diarrhoea can be caused by a disturbance in the stomach flora. So, antibiotics can help clear harmful bacteria. After taking antibiotics, it is important to consume probiotic foods, to replace the lost probiotic organism.

Dietary changes

After recovering from diarrhoea, certain dietary changes will be required. The tolerance to food can differ from one person to another. So, avoid foods that can cause cramping, diarrhoea and gas formation.

When you are affected by diarrhoea, consume foods that have a good potassium content. Diarrhoea can weaken and dehydrate you, so potassium-rich foods can strengthen you, and you will not feel weak.

Fluids can help replace lost electrolytes and water. Consume fluids like fresh juices and clear broths. The liquid will not put too much pressure on your bowel and will prevent any further irritation.  

Low-sugar fruit juices without pulp and salty broths can help with the symptoms of diarrhoea. Avoid drinks that have high sugar content, alcohol and drinks that contain sweeteners like sorbitol, xylitol and mannitol.

The caffeine in coffee and tea can trigger diarrhoea. So, consider drinking hot drinks with a decaffeinated option.

Complications associated with diarrhoea

The major complication caused due to diarrhoea is dehydration. If left untreated, it can also be fatal. Dehydration can be dangerous for children, adults and people with weakened immunity.

Repeated diarrhoeal instances can lead to urinary tract infections and kidney stones. Extreme thirst, dry mouth, body temperature and irregular blood pressure can also be complications of diarrhoea.

If diarrhoea is not treated properly, it can also lead to kidney damage, brain damage and, in extreme cases, death.

Prevention of diarrhoea

According to WHO, diarrhoea is the second leading cause of death in children. Diarrhoea can be avoided and prevented by following certain self-hygiene practices.

• Consume foods that are cooked properly at right temperature.
• After cooking, make sure they are covered properly.
• Wash hands with soap before eating.
• People with weakened immunity are the most affected. So, feed babies exclusively with breast milk for the first six months after birth.
• Practise proper self-hygiene practises.
• After using the restroom, wash your hands with soap properly.
• Proper education about how the infection spreads.
• Avoid drinking water from infected sources and only drink clean water.
• Avoid street foods.
• Do not consume undercooked and raw foods.
• Pre-packed foods are safe to eat. However, check for the expiry date.

When to consult a doctor?

Consult your doctor when you have symptoms like

• Diarrhoea that do not settle after three days.
• Severe dehydration.
• Abdominal pain or cramps.
• Blood or black stools.
• Fever with a temperature above 102 Fahrenheit for two consecutive days.

Conclusion

Diarrhoea is very common. It occurs mainly due to improper self-hygiene practices. Washing hands before consuming food can prevent diarrhoea.

Dehydration is a common symptom of diarrhoea, and if it is not treated properly, it can be fatal. When affected with diarrhoea, consume fluids to replace the lost electrolytes and fluids in the body.

If diarrhoea does not stop after three days, consult your doctor. If left untreated, it can lead to major consequences.

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