| Subscribe online or by calling the toll free, |
| Multimedia Library | Upcoming Issues | Place an Ad |
 |
Diarrhea: Diarrhea Common Causes and Remedies for Diarrhea A serious bout with diarrhea leaves most people wondering what caused it in the first place. Was it something you ate? Was it a virus? If you have diarrhea frequently, you may even suffer from a chronic digestive disorder. But how often is frequent? Join DH&N as we find the answers to these questions and explore treatment options. By Gina Rollins Diarrhea is not a popular thing to talk about, but it happens to just about everyone from time to time. The average adult suffers from diarrhea about four times a year. For most people, it’s not serious, lasts only a day or two and ends on its own without treatment. For some — especially children and the elderly — diarrhea may pose a serious health threat. And for still others, it can be a very frustrating, long-term side effect of certain gastrointestinal problems and other chronic conditions. Bowel habits vary among people, so what one person considers diarrhea may be different from another. "To some, one loose stool is diarrhea; others think that five stools in a day where the stool is not loose and still formed is diarrhea. But most clinicians define it as loose, watery stools that occur frequently," explains AGA member Jerome Waye, MD, a gastroenterologist in private practice and clinical professor of medicine at the Mt. Sinai School of Medicine in New York City. The loose stools may come with abdominal cramps, nausea, vomiting, bloating and an urgent need to have a bowel movement. Fever and stools with blood, mucus or pus may also be present. Diarrhea has many causes, ranging from infections and food intolerances to chronic digestive disorders such as Crohn’s disease and irritable bowel syndrome. Simple things like greasy, high-fat meals can overload the digestive tract. Even stress can send some people on repeated trips to the bathroom. Some of the most common causes of acute (temporary), diarrhea include:
Most cases of acute diarrhea can be treated at home, even when the exact cause isn’t known. Curing What Ails You The first thing some people do is reach for a bottle of over-the-counter anti-diarrhea medication, such as Lomotil®, Imodium A-D®, Kaopectate® or Pepto-Bismol®. In many cases, these products do help alleviate symptoms and ease suffering. However, some physicians believe that Lomotil® and Imodium A-D®, should not be used for at least the first day of your symptoms if you are unsure about what is causing your diarrhea. For two common causes of diarrhea — bacterial and viral infections — loose, frequent stools are the body’s way of getting rid of the offending bug. Some physicians believe these products slow that process and can keep the germs around, actually making the problem last longer; however, there is little scientific data to support this theory. One of the most important things a person experiencing diarrhea should do is drink plenty of fluids. This helps prevent dehydration, which is the excessive loss of fluid and electrolytes, such as sodium and potassium, that the body needs to function properly. Water refills fluid levels, but it doesn’t replace electrolytes. Salty liquids like chicken and beef broth, and athletic replenishment drinks such as Gatorade® and Exceed® are better choices, according to Dr. Waye. Very hot or very cold liquids, coffee, caffeinated soft drinks and alcohol can further irritate the intestine, so they are best avoided until after the diarrhea ends. How much one should drink to rehydrate depends on the frequency of bowel movements, but a good rule of thumb is at least two cups of fluid each hour. Dehydration can be very serious — even life-threatening — especially in children. (See Kid’s Corner, p. 31.) It [dehydration] can also come on suddenly in children and adults. That’s what happened to Thomas Toscano, of Colstrip, Mont. A bout of diarrhea landed him in the hospital with severe dehydration. "It had already happened when I went to the doctor, but even a flu bug can cause it. It’s a real problem, and it can mess you up bad," he says. Symptoms of dehydration in adults include:
Another good thing to do while experiencing diarrhea is to go easy on the intestinal tract by eating bland, non-fatty foods that are easily digested. Adults who want more variety may try soft foods like baked or boiled potatoes, cooked carrots, crackers and baked chicken without skin. Diarrhea temporarily disrupts the body’s ability to digest lactose, so it’s best to stay away from dairy products — especially milk — for a few days. Red meats and highly seasoned foods are also better left alone. Although high-fiber foods like whole-grain breads, fresh fruits and vegetables are part of a normal healthful diet, they can be difficult for irritated and tender intestines to absorb. Diarrhea can be an embarrassing problem to discuss with others, but it’s important to seek medical attention when you need it. Not doing so can not only unnecessarily disrupt your life, but it can also have serious consequences for your health. Gina Rollins is a freelance writer who specializes in health care. A former health-care administrator, she counts numerous health-care associations and organizations among her clients. She resides in Silver Spring, Md. Combating Traveler’s Diarrhea Traveler’s diarrhea is the unwelcome guest that sometimes returns home with people who visit developing countries. It is often caused by ingesting food or water that has been contaminated with bacteria, viruses or parasites. The best way to avoid it is by adhering to the saying "boil it, peel it, cook it or don’t eat it." Precautions include:
When Is Some Enough? How do you know whether diarrhea is serious enough that you should see a doctor? According to the National Institute of Diabetes, Digestive and Kidney Diseases, you should seek medical attention when you experience any of the following symptoms:
Black stools may be a sign of gastrointestinal bleeding, a serious condition that should be attended to promptly. However, they can also be a harmless side-effect of taking Pepto-Bismol®. Consider, as well, the number of times you have bowel movements. "Multiple, unremitting diarrhea can be a sign of a serious infection and requires immediate attention," explains Dr. Waye. Another factor in determining whether or not you should see a physician is recent travel abroad or camping out. If you have done either of these, you may have contracted parasitic, bacterial or viral infections that need prompt treatment. (See Combating Traveler’s Diarrhea, above right). Likewise, if you are experiencing diarrhea and recently started a new medication, you should consult with your doctor right away. "Reactions to medications usually happen within 24 hours of starting [them] and they can be severe. Rarely do reactions happen long after you’ve been on the medication," says Dr. Waye. Even without severe symptoms, if the diarrhea doesn’t respond to home treatments within 24 hours, then you may want to contact your physician, Dr. Waye advises. Thomas Toscano sought help because of the dramatic change in his stools. "They stayed watery and real loose, and they had a foul odor. The stool color was also pale yellow. I knew something was totally wrong," he says. A visit to the doctor for treatment of diarrhea conjures lots of unpleasant images of painful, embarrassing procedures, but it shouldn’t. Depending on the likely cause of your case, after conducting a physical examination and gathering a medical history, your physician may only order a few blood tests. When a cause is not immediately known, further diagnostic tests may be necessary. You may undergo fasting tests to identify food intolerances. Your doctor may also need to examine your rectum and colon through either a flexible sigmoidoscopy or colonoscopy procedure. Treatment for acute diarrhea ranges from antibiotics for bacterial infections to changes in diet for food intolerances. Most cases clear up within three weeks. A Lasting Problem Sometimes, however, diarrhea persists because it is caused by a long-term gastrointestinal problem or other chronic illness. A long list of conditions causes chronic diarrhea. Some of the most common are:
Pinpointing the exact cause can be difficult and may require the expertise of a gastroenterologist. The process can be very unsettling and emotionally draining. "Their life is very disrupted by chronic diarrhea. They may become homebound and afraid they can’t go out. They have to know where the bathroom is at all times," explains AGA member John Fordtran, MD, a gastroenterologist and president of the Baylor Research Institute at Baylor University Medical Center in Dallas. Determining the cause of chronic diarrhea may involve a bit of detective work. A careful history is essential to understanding the problem, according to Dr. Fordtran. Your physician will probably ask detailed questions about the nature and timing of your diarrhea. When and how often does it occur? What does your stool look like? When and where do you experience pain? Do you only have diarrhea, or do you also experience constipation? Sometimes there’s not a clear cause of chronic diarrhea, and there may also not be a total cure. However, with persistence by both doctor and patient, combinations of drug therapy, dietary changes and even stress management can probably be found to better control the diarrhea and enable the patient to have a more normal life. "Most all can get some improvement. The degree of improvement depends on their condition," says Dr. Fordtran. Drug therapy and dietary changes, for example, helped John Arnold of Liberty, Mo., have better control over lifelong diarrhea. "I can do stuff and go places I couldn’t go before. I have a whole different life," he says. Finding the best treatment for any particular case of chronic diarrhea may take several attempts over an extended period. It’s easy to become discouraged and lose hope during this time. However, try to fight the feeling that your condition will never improve, Arnold advises. "Don’t ever give up. You never know what doors will open up for you," he says.
|
||
|
