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Diarrhea is messy. Diarrhea can be embarrassing. Watery stool. Runny stool. Multiple trips to the toilet. Fecal accidents. We’ve all experienced it at some point. For some, they have diarrhea every now and then. For others, this is a daily struggle. What is diarrhea? What are the causes of diarrhea? How can you stop diarrhea?
What is diarrhea?
Diarrhea is the passage of loose or watery stools. In general, it is an increase in the frequency of stool and usually more than four stools per day is considered diarrhea. In technical terms, diarrhea is more than 200 grams of stool per day. On the Bristol stool chart, diarrhea is type 6 and 7.
The Bristol Stool Chart
What are the different types of diarrhea?
- Acute Diarrhea: Diarrhea 14 days or fewer in duration.
- Persistent Diarrhea: Diarrhea that is more than 14 days in duration but less than 30 days.
- Chronic Diarrhea: Diarrhea that is more than 30 days in duration.
- Dysentery: Diarrhea with visible blood or mucus.
- Travelers’ Diarrhea: Diarrhea that develops during travel to a less developed country or within 10 days of returning.
- Osmotic Diarrhea: Diarrhea in which the stool osmotic gap is greater than 50 mosm/kg.
- Secretory Diarrhea: Diarrhea in which the stool osmotic gap is less than 50 mosm/kg.
What causes diarrhea?
- Infections: viruses( norovirus, rotavirus, adenoviruses, etc), bacteria (Campylobacter, Salmonella, Shigella, Clostridium difficile, Escherichia coli, etc), and protozoa (Entamoeba, Cryptosporidium, Giardia, Cyclospora, etc).
- Inflammation: Crohn’s disease, ulcerative colitis, microscopic colitis.
- Surgery that causes reduction of mucosal surface area: intestinal resection, colon resection.
- Congenital disease with absence of an ion-transport mechanism: congenital sodium diarrhea, congenital chloridorhea.
- Dysregulation: diabetes mellitus, postvagotomy diarrhea.
- Tumors that produce chemicals that cause diarrhea: Neuroendocrine tumors.
- Malabsorption: celiac disease, Whipple’s disease, short bowel syndrome, small bowel bacterial overgrowth, pancreatic exocrine insufficiency, inadequate bile acid in the gut.
- Ingestion of poorly absorbed ions: magnesium, phosphate, sulfate.
- Ingestion of poorly absorbed carbohydrates and sugar: lactose, fructose, mannitol, lactulose, sorbitol.
- Drugs and poisons: antibiotics, chemotherapy, some anti-hypertensive drugs, anti-inflammatory agents like NSAIDS, gold, 5-ASA, antacids, acid-reducing drugs, colchicine, anti-depressants, drugs for anxiety, heavy metals, theophylline, herbal supplements, vitamin supplements.
What tests do I need for diarrhea?
- No test in certain cases.
- Stool tests.
- Blood tests.
- Colonoscopy.
- Upper endoscopy.
- CT scan.
- Special X-Rays.
How can I stop my diarrhea?
- If your diarrhea is acute, non-bloody, non-mucoid and you can still eat and drink, wait to see if it will go away by itself.
- If your diarrhea is acute but associated with other symptoms like abdominal pain, nausea, vomiting, weakness, lightheadedness, dizziness, and other worrisome symptoms, contact your physician.
- If your diarrhea is bloody, contact your physician.
- If your diarrhea is chronic, contact your physician.
Over The Counter (OTC) medications for Diarrhea
- Loperamide (imodium). It usually comes as 2 mg tablet or capsule. You can use up to 8 tablets per day.
- Lomotil (diphenoxylate/atropine; 2.5 mg/0.025 mg). You can use up to 8 tablets per day.
- Pepto-Bismol (bismuth subsalicylate). You can use 2 tablets or 30 mL by mouth every 30 to 60 minutes. You can use up to 16 tablets or 240 mL a day.
How to stop diarrhea from infection
- Some will be self-limiting and only require adequate hydration.
- Some will require antibiotics.
- Contact your physician.
How to stop diarrhea from inflammation
- Contact your physician.
- The diagnosis usually require colonoscopy with biopsy.
- If you have ulcerative colitis or crohn’s disease, there are approved medications that can help. Get support from the crohn’s and colitis foundation.
How to stop osmotic diarrhea from ingested material
- Avoid ingestion of poorly absorbed carbohydrates and sugar like lactose, fructose, mannitol, lactulose, sorbitol.
- Avoid ingestion of poorly absorbed ions like magnesium, phosphate, sulfate.
- Contact your physician.
How to stop post-cholecystectomy diarrhea
- Try cholestyramine (Questran) or colestipol (Colestid).
- Try loperamide (imodium).
- Contact your physician.
How to stop diarrhea associated with irritable bowel syndrome (IBS)
- Contact your physician.
- Learn more about IBS HERE.
