Diarrhea

Definition: abnormally frequent discharge of fluid fecal material from the bowel

Causes: While most bouts of diarrhea are self-limiting requiring no cause for concern, if it continues the cause may need to be discovered to help treat it. Causes include nervousness, reactions to drugs, viral/bacterial/parasitic infections, food intolerances or lactose intolerance, problems with the liver or gallbladder, small bowel diseases such as celiac sprue, hyperthyroidism, and sometimes even cancers of the intestinal tract, among other causes. The presence of blood in the stools is cause for concern and a doctor should be consulted. If diarrhea lasts more than three days, a physician should also probably be consulted. Diarrhea alternating with constipation may be a sign of irritable bowel syndrome.

Signs and Symptoms:

In addition to the watery stools, a patient may experience fever if caused by infection, abdominal pain, cramping, vomiting, and nausea. See a physician if blood is present in the stools.

Treatment:
The first concern with diarrhea is to correct the changes produced by the diarrhea, meaning depletion of electrolytes and acid/base balance. Do not eat much for the first 24 hours, mainly ingesting clear liquids or broths and electrolyte solutions such as Gatorade or Pedialyte. If caused by an infection, antibacterials or antiparasitics may be required. If caused by other diseases, that disease may be treated. Sometimes the BRAT diet is advised: bananas, rice, apples, and toast.

For chronic diarrhea, changing the diet is important. Avoid irritating foods such as dairy products, sugar, wheat, chocolate, artificial sweeteners, and caffeine. Fiber is important also in alleviating chronic diarrhea. Vitamin A helps with the lining of the intestinal tract. An acidophilus supplement is very important in restoring the normal intestinal tract flora, as well as products such as Florastor.

Prevention:

Wash your hands well before preparing foods and clean the area where you prepare foods. Eat a good high fiber, low glycemic index diet. If you have been on antibiotics or are taking antibiotics, take an acidophilus supplement along with it. Be careful when you travel. Drink mainly bottled water when you travel to reduce exposure to infectious agents. Avoid dairy and wheat and other irritating foods.

Reference:

J Pediatr 2003 Mar;142(3):297-304