Diarrhea

 

Diarrhea can be described as an increase in the frequency of bowel movements or loose watery bowel movements. Although both changes in frequency of bowel movements and looseness of stools can occur separately, they are usually seen together. This looseness in stools which can vary from slightly soft to watery occurs due to an increase of water content in the stool, most commonly due to an infection of the digestive tract. This medical condition is a common reason for people to seek emergency medical advice.

 

 

A number of factors can cause diarrhoea such as:

1. Viruses: These include Norwalk virus, cytomegalovirus, and hepatitis virus. Rotavirus is the most common cause of diarrhoea in children.

2. Bacteria, protozoa and parasites: These can be spread through contaminated food and water, e.g., typhoid, cholera, etc.

3. Medications: A number of commonly prescribed medications including antibiotics can cause diarrhoea.

4. Lactose intolerance: People who lack enzyme lactase are unable to digest milk protein lactose that is present in dairy products, leading to diarrhoea after eating such foods.

5. Surgery: After an abdominal surgery or gall bladder surgery.

6. Chronic bowel infection: Chronic diarrhoea can occur due to chronic bowel infection e.g., tropical sprue, inflammatory bowel disease (Crohn’s disease and ulcerative colitis) and bowel cancer.

 

 

These include:

1. Loose watery stools occurring many times in a day

2. Abdominal pain and cramps

3. Fever

4. Blood in stool

5. Bloating

6. Nausea and vomiting

7. Weakness

8. Cold, moist skin

 

 

To come to a diagnosis, apart from a complete physical examination and history, following tests may also be advised by your physician.

1. Blood tests: Like Widal, Typhidot, CBC (complete blood count) to find out the cause of diarrhoea.

2. Stool test: To determine whether a bacteria or parasite is causing the diarrhoea.

3. Colonoscopy: In cases of persistent diarrhoea your physician may advise colonoscopy to view the internal lining of colon and also conduct biopsies if required.

 

 

Mild cases of diarrhea usually subside without any treatment apart from slight modification in diet. Chronic persistent cases will require tests and other treatment according to the cause.

Standard protocol for treatment of diarrhoea:

1. Drink more fluids to prevent dehydration and compensate for water loss. Severe cases will require fluids intravenously.

2. Oral rehydration salts (ORS) which are simple sugars and salts should be given to patients of diarrhoea. ORS sachets are inexpensive and available widely in all pharmacies.

3. Antidiarrhoeal medications

 

 

Most cases of acute and mild diarrhoea are self-limiting and respond within 5 days of treatment. Infectious diarrhoea responds well to antibiotic therapy; however, most deaths from diarrhoea occur due to dehydration. This is common in small children and elderly due to already compromised immune system and proneness to dehydration.

The best way to prevent diarrhoea is to effectively wash hands especially after using the toilet, changing nappies, and before eating/cooking/serving meals. Drinking water should be boiled or purified using popular methods and stored in hygienic conditions. Food should also be prepared and stored in a neat and hygienic manner.

Home tips to treat and prevent diarrhoea:

1. Consume foods high in fiber such as bananas, rice, and oatmeal to restore nutrition.

2. Restrict foods that aggravate diarrhoea such as sugary and fried foods.

3. Consume high potassium foods such as diluted fruit juices, tomatoes, potatoes, and bananas.

4. Drink more fluid between meals not during.

 

 

Did you know that artificial sweeteners like mannitol or sorbitol can also cause diarrhoea? In fact, one artificial sugar called lactulose induces diarrhoea and is used as a medicine for relieving constipation.