Diarrhea is a common problem that can occur to people of all genders and ages. Although it can generally be self-treated, everyone should still be careful and have a good understanding of the condition. However, if the symptoms are severe, you need to seek a doctor’s advice promptly as they, in certain cases, can become fatal.
What is diarrhea?
Diarrhea is a condition when your stools are loose as well as watery, and occurs more than 3 times within a 24-hour period; or you have blood mixed in your excrements more than once in 24 hours.
How many types of diarrhea are there?
There are 3 types of the condition according to their symptoms:
- Acute Diarrhea is the most common condition. It can last for 1-3 days before the symptom improves and is healed by itself.
- Persistent Diarrhea lasting about 2-4 weeks. Patients should note the symptoms and consult a doctor as soon as possible.
- Chronic Diarrhea that continues for 4 weeks or more, and can be intermittent. Patients need to see a doctor for a thorough diagnosis.
What causes diarrhea?
Diarrhea is caused by an ailment of the intestines, and can be categorized as infectious and non-infectious. In the case of acute diarrhea, it is usually caused by an infection – such as a virus or bacteria – and depends on several factors: reginal epidemiology, the person’s health condition (e.g., comorbidity, medication that may affect the immune system), etc. For the non-infectious group, the condition can also be caused by several factors which can be subdivided as functional diarrhea and abnormalities of the intestines. Examples of the latter include chronic inflammation of intestine, an abnormal growth in the intestine, etc. In any case, you should consult a doctor before it becomes too late.
How to treat diarrhea
Treatment depends mainly on the severity of your dehydration and comorbidities.
- Mild diarrhea – 5% of weight loss with mild dehydration but patient can still eat normally. This is usually caused by a mild infection or food poisoning, and will last no more than 2-3 days. You can self-treat the condition by taking oral rehydration salt (ORS) and medicines to relieve the symptoms – such as stomachache, nausea, or vomiting, etc. When the symptoms improve, you can stop the medication. However, if they do not improve after 3-5 days, it is recommended that you see a doctor to determine the actual cause.
- Moderate Diarrhea – 6-9% weight loss along with moderate dehydration and beginning to experience difficulty eating. The symptoms may also include dizziness, dry mouth, palpitations, decreased urination. When vital signs are measured, heart rate increases – over 100 beats per minute – while blood pressure remains normal. It is recommended that you take oral rehydration salt to prevent severer dehydration before seeing a doctor for evaluation and further treatment.
- Severe Diarrhea – over 10% weight loss. In addition, you may experience fainting spells, unconsciousness, palpitation, severe dizziness, little or no urination, abnormal vital signs (e.g., over 120 per minute heart rate, or fallen blood pressure to less than 90/60 mm Hg), and rapid breathing. If the blood pressure is low and the condition very severe, you need an immediate emergency treatment with prompt rehydration. It is recommended that you not wait until the condition has become severe, and that you seek medical advice as soon as you begin to experience even moderate diarrhea.
Which diseases are associated with diarrhea?
Since there are several causes of diarrhea, below is a list of common conditions which require additional examination:
- Irritable Bowel Syndrome. Though it is not a serious disease, irritable bowel syndrome is considered a “chronic” condition. Its common symptoms consist of knotted pain during a bowel movement but will improve soon afterwards, bloating and flatulence. There are many variations of irritable bowel syndrome including diarrhea, constipation, alternating diarrhea and constipation, excrements without bloody mucus, and is not accompanied by a fever. The condition will eventually subside by itself. However, if you experience these symptoms intermittently for more than 6 consecutive weeks, you may suspect that you have irritable bowel syndrome and should consult a doctor to determine the actual cause. If you indeed have the condition, the main treatment will include taking medication and lifestyle modification – such as avoiding FODMAPs food group which contains carbohydrate as well as various monosaccharides and disaccharides that will trigger the symptoms (e.g., milk, wheat, honey, variety of nuts, onion, garlic, mushrooms, etc.) You should also manage your stress, worries, and insomnia – all of which can also aggravate the condition.
- Colon Cancer. Patients may be experiencing many different symptoms – such as chronic diarrhea lasting more than 4 weeks, bloody mucus mixed in stools, alternating constipation and diarrhea – that may also be intermittent. Other symptoms include rapid weight loss and unusual loss of appetite. For some patients, they may have persistent low fever as well. Further, some people may have propensity for the disease – such as a family history of colon cancer, smoke cigarettes or drink alcohol, consume low fiber diets or grilled food too often after the age of 50.
- Hyperthyroidism. The condition also causes diarrhea, watery stools, and chronic loose stools that may be intermittent. The over-production of thyroid hormone can prompt the intestines to become abnormally active. The situation is usually found accompanying other conditions such as palpitation, extreme weight loss, heat hypersensitivity, or irregular menstruation in women, etc.
- Some types of antibiotic medication. As their own side-effect, some antibiotics can indeed cause diarrhea. In other cases, the medication may unintentionally destroy healthy bacteria in the intestines but allows unhealthy ones to overly increase. If you take antibiotics and experience chronic diarrhea that persists, you need to see a specialist for a thorough examination.
How to prevent diarrhea?
Primarily, diarrhea is only a “symptom” and, therefore, difficult to prevent. However, you can avoid infectious acute diarrhea by eating clean, cooked and hot food, as well as using serving spoons and washing your hands before and after eating. In terms of protection or treatment, it is necessary to first determine the root cause. The prevention may be that you alter some activities to avoid the trigger or the risks. This includes “habits modification” – such as stop drinking alcohol and smoking cigarettes – in order to reduce your risk of colon cancer, etc.
When should I see a doctor about diarrhea?
If the condition is not too severe, chronic or accompanied by other symptoms which may be considered high risk, you can self-treat it according to the initial symptoms. Nevertheless, if you experience moderate dehydration, and the condition does not improve after 3-5 days or it is accompanied by other symptoms (e.g., high fever, shivering, stools with mucus or blood mixed in), you need to consult a doctor as soon as possible.
Moreover, if you are in the high-risk category – i.e., those who are over 65 years of age, have comorbidities (such as heart disease or stroke), are taking immunosuppressive medication, or are pregnant – you must consult a doctor promptly and do not wait until the condition reaches the moderate level; as you risk allowing the condition to further deteriorate. Similarly, certain types of medication, or a combination among them, may be ineffective or react against one another.
Doctor Specialized in Diarrhea Treatment
Dr. Pakawat Thearapati, Internist, Internal Medicine Clinic, Bangkok Hospital.
Hospital Specialized in Diarrhea Treatment
Internal Medicine Clinic at Bangkok Hospital provides treatments for all severity levels of diarrhea. Our specialized and experienced medical experts together with multidisciplinary team of supporting professionals are ready to alleviate your pain and restore your quality of life.
