Diarrhea is one of the most common symptoms that people experience. It is defined as loose, watery stools occurring more than three times in one day. Diarrhea is not the occasional loose stool or the frequent passing of formed stools.
Anyone can get diarrhea. This common problem can last a day or two, or for months or years, depending on the cause. Most people get better on their own, but diarrhea can be serious for babies (
see Infant Diarrhea) and older people if lost fluids are not replaced. Many people throughout the world die from diarrhea because of the large volume of water lost and the accompanying loss of electrolytes (sodium and potassium).
The average adult has a bout of diarrhea about four times a year.
Understanding Bowel Movements, Stool, and Diarrhea
If you have diarrhea, there has been a change in your bowel movements -- you pass unusually loose stools. Stool is what is left after your
digestive system (stomach, small intestine, and
colon) absorbs nutrients and fluids from what you eat and drink. Stool passes out of the body through the rectum. If fluids are not absorbed, or if your digestive system produces extra fluids, stools will be loose and watery. Loose stools are larger than usual. People with diarrhea often have frequent bowel movements and may pass more than a quart of watery stool a day.
Diarrhea can cause dehydration, which means the body lacks enough fluid to function properly. Dehydration is particularly dangerous in children and the elderly, and it must be treated promptly to avoid serious health problems.
Acute Versus Chronic Diarrhea
There are two general types of diarrhea -- acute diarrhea and chronic diarrhea. Acute diarrhea is diarrhea that improves within two weeks. Chronic diarrhea is diarrhea that lasts longer than two weeks.
Diarrhea is a symptom, not a disease. There are many possible acute diarrhea causes. A few of the more common causes of acute diarrhea include:
Specific causes of chronic diarrhea include:
- Infections
- Medicines
- Certain medical conditions like:
Sometimes, the cause of chronic diarrhea remains unknown. As long as diarrhea goes away on its own, an extensive search for the cause is not usually necessary.
When to See Your Healthcare Provider for Diarrhea
Not everyone with diarrhea needs to see a healthcare provider. However, there are situations when it does make sense.
You should see your healthcare provider if any of the following is true:
- You have had diarrhea for more than three days
- You have severe pain in the abdomen or rectum
- You have a fever of 102 degrees Fahrenheit or higher
- You see blood in your stool or have black, tarry stools
- You have signs of dehydration (see below).
If your child has diarrhea, do not hesitate to call the healthcare provider for advice. Diarrhea can be dangerous in children if too much fluid is lost and not replaced quickly. Take your child to the doctor if any of the following symptoms appear (This is especially important if your child is six months old or younger.):
- Stools containing blood, mucus, or pus
- Watery diarrhea with repeated vomiting
- Temperature above 101.4 degrees Fahrenheit
- No improvement after 24 hours
- Signs of dehydration:
- No wet diapers for more than three hours
- Lack of tears when crying
- Lack of energy
- Frequent crying or irritability
- Sunken abdomen, eyes, or cheeks
- Listlessness or irritability
- Dry mouth and tongue
- Skin that does not flatten when pinched and released.
Treatment for diarrhea depends on the type (either acute or chronic) and what caused it.
In most cases, the only acute diarrhea treatment necessary is replacing lost fluid to prevent dehydration until symptoms improve. In some cases, diarrhea medicine may be recommended. Chronic diarrhea is more challenging to treat. Depending on the cause, treatment for chronic diarrhea may involve medications, such as antibiotics, or lifestyle and diet changes. Similar to acute diarrhea, chronic diarrhea treatment also involves replacing fluid and electrolytes.
When it comes to treating or preventing diarrhea, diet is an important factor to consider. Diet is important:
- During and after an acute diarrhea attack
- In helping to diagnose causes of chronic diarrhea
- In preventing traveler's diarrhea
- In treating conditions such as irritable bowel syndrome (IBS) and celiac disease.
(Click Diarrhea Diet for more information about diet and its impact on diarrhea -- both during and after an attack.)
Preventing Traveler's Diarrhea
Traveler's diarrhea occurs when you consume food or water contaminated with bacteria, viruses, or parasites. You can take the following precautions to prevent traveler's diarrhea when you go abroad:
- Avoid drinking tap water or using ice cubes made from tap water. Also, don't use tap water when brushing your teeth.
- Avoid drinking unpasteurized milk or eating dairy products made from it.
- Do not eat meat or shellfish that is not hot when served to you.
- Avoid all raw fruits and vegetables (including lettuce and fruit salad) unless they can be peeled and you peel them yourself.
- Do not eat raw or rare meat or fish.
- Do not eat food sold by street vendors.
You can safely drink bottled water (if you are the one to break the seal), carbonated soft drinks, and hot drinks like coffee or tea.
Depending on where you are going and how long you are staying, your doctor may recommend that you take antibiotics before leaving to protect you from possible infection.
Transmission and Prevention of Diarrhea
The viruses and bacteria that can cause diarrhea are highly contagious and can spread easily from person to person. The viruses that cause diarrhea are often found in the stool or vomit of infected people. Diarrhea transmission can occur in one of several ways, such as:
- Eating foods or drinking liquids that are contaminated with a diarrhea virus or bacteria
- Having direct contact with another person who is infected and showing symptoms (for example, when caring for someone with the illness, or sharing food or eating utensils with someone who is ill)
- Touching surfaces or objects contaminated with a diarrhea virus and putting your hands in your mouth.
People can spread diarrhea both before and after they become sick with it. They can sometimes pass a virus that causes diarrhea to other members of the family and to close contacts.
Better hygiene (washing your hands) and sanitation can help prevent the spread of diarrhea in a lot of cases; however, such prevention strategies have not significantly reduced the number of certain types of diarrhea outbreaks, such as those involving
rotavirus disease. A new, recently licensed vaccine (RotaTeq
®) is the best way to protect your child against rotavirus disease.
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