Diarrhea: how to prevent and treat it

a person holding a baby

Dehydration can occur very quickly in young children

We’ve all experienced it at one time or another: abdominal pain and cramping – and then diarrhea. For most of us, acute diarrhea, which lasts for less than two weeks, is an occasional event possibly caused by a virus, eating something that didn’t agree with us or even a reaction to stress. But chronic diarrhea, too, affects many people. Chronic diarrhea could last for months and be caused by illness, medication side effects, or food intolerances.

food, how to, diarrhea: how to prevent and treat it

What is diarrhoea?

Normal stool (feces) is about 25 per cent solid and 75 per cent water. When this balance is thrown off, the fecal matter can become hard and dry, making it hard to eliminate. Or it can become too watery, resulting in diarrhea. Your intestinal wall first pushes your food and then fecal matter through your intestines by contracting and releasing the muscles. This is called peristalsis. When you have diarrhea, your muscles usually contract harder and this – along with gas and bloating – can cause pain and cramping.

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Some people have diarrhoea more often than others

Adults who work with children, especially those who are still in diapers, are more likely to experience bouts of diarrhea than other adults. If you work in a daycare, for example, you may be exposed to more viruses from the children, causing you to have diarrhea, so frequent hand washing is a must. Other adults more prone to acute diarrhea are those with weakened immune systems, and people who travel to tropical destinations or areas where they may be exposed to contaminated water or food.

food, how to, diarrhea: how to prevent and treat it

Acute diarrhoea versus chronic diarrhoea

Doctors say you have acute diarrhea if you have three or more loose stools a day for up to two weeks. If you have diarrhea for two to four weeks, this is classified as persistent diarrhea. However, if you continue to have loose stools for more than a month, this is considered to be chronic diarrhea. Acute and chronic diarrhea usually have different causes.

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There are many causes of acute diarrhoea

Viruses, most often the norovirus, are the most common cause of gastroenteritis, what many people call the “stomach flu.” Norovirus is highly contagious. The virus can live on solid objects like doorknobs and elevator buttons, so frequent and thorough hand washing is key to avoiding contamination. Other causes of acute diarrhea are bacterial infections (often consumed through contaminated food or drinks), side effects from a drug, or parasites. Anxiety or stress can also trigger stomach upset and diarrhea.

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Drink water

We’ve all heard warnings not to drink non-bottled water or uncooked foods when travelling to certain parts of the world and it’s for good reason. Consuming food or drink contaminated by viruses, bacteria, or parasites you may not normally be exposed to can cause travellers’ diarrhea. If you are travelling to an area known for travellers’ diarrhea, speak with your doctor before you leave. Some doctors recommend short-term use of OTC drugs such as Pepto-Bismol to reduce the risk.

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Diarrhoea is a common drug side effect

One of the most common side effects associated with prescription drugs, such as antibiotics, is diarrhea. While antibiotics are usually short-term prescriptions, other medications taken for extended periods, like chemotherapy or pain medications, could cause longer-term diarrhea. If this happens to you, speak with your pharmacist and doctor to see if you can make any adjustments to your medications. However, don’t stop taking your medications without speaking with your doctor first.

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Common causes of chronic diarrhoea

Chronic diarrhea is often a symptom of a health condition, such as irritable bowel syndrome, inflammatory bowel disease, dietary intolerance (such as lactose intolerance), malabsorption disorders (such as celiac disease), certain types of cancer, or hyperthyroidism, among others. If you have had a gastric reduction surgery, you may also develop chronic diarrhea.

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C. difficile, an increasingly common infection

Clostridium difficile, or C. difficile, is an increasingly common infection, often contracted by patients or people who visit health-care facilities. People taking high-dose or prolonged antibiotics are at highest risk of contracting C. difficile. The infection can cause severe diarrhea and can be difficult to treat. If you are in the hospital or visiting someone in a health-care facility, be sure to wash your hands frequently and thoroughly during and after your stay or visit to prevent spread of the infection.

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Diseases that affect your gastrointestinal (GI) system

Diseases or conditions such as Crohn’s disease, celiac disease, irritable bowel syndrome, and inflammatory bowel disease (to name a few) cause chronic diarrhea. Treatment for these illnesses varies, even between people who have the same illness. Watching your diet is vital if you have a GI disease, because eating a food that triggers diarrhea could worsen your condition overall.

food, how to, diarrhea: how to prevent and treat it

Certain foods may be the culprit

If you have frequent bouts of diarrhea, it could be caused by something you’re consuming. For example, if you’re lactose intolerant, you cannot properly digest food or liquids that contain dairy products. Other foods known to cause diarrhea in some people include sugars, artificial sweeteners, gluten, fatty or fried foods, spicy foods, and food or drinks that contain caffeine. An elimination diet, where you remove a certain type of food from your diet, may help you find the food that is causing your discomfort.

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How can stress cause diarrhoea?

Your gut has millions of nerve cells in its wall lining. These nerve cells communicate with your brain and can react negatively when you are feeling stressed or anxious. This can cause diarrhea. This can also trigger a cycle – the more anxious you become, the more diarrhea you have, and then you become anxious about having diarrhea. Meditation, exercise, or speaking with a counsellor may help reduce this diarrhea trigger.

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Diarrhoea: We’ve all experienced it

The abdominal pain from diarrhea and other possible symptoms (cramping, feeling the strong need to move your bowels, and perhaps nausea and bloating) can make us feel very sick and uncomfortable. With acute diarrhea, these usually go away in a few days. But severe or chronic diarrhea, bowel movements that are frequent or continue over a long period, can cause weight loss, malnutrition, and dehydration, and can be life threatening, particularly among children or older people.

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Preventing dehydration is vital

The most important part of treating people with acute diarrhea is to prevent dehydration or provide rehydration. While you may not have much of an appetite when you have diarrhea, you need to take in fluids and salts to replace what you’re losing. Most doctors recommend water, fruit juice, or broth. If your child has acute diarrhea, your doctor may recommend an oral rehydration solution, such as Pedialyte. Some are sold in frozen Popsicle forms, making them more appealing for children.

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Avoid certain types of drinks

When you’re feeling thirsty or dehydrated, it may seem that any type of fluid will do the trick, as long as it quenches your thirst. But this isn’t always the case and some fluids will actually dehydrate you even more. So if you are experiencing diarrhea, it may be best to avoid consuming liquids that contain caffeine or alcohol, as well as carbonated drinks (sodas). Dairy products may increase diarrhea in some people.

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Dehydration can occur very quickly in young children

Infants and toddlers can become dehydrated very quickly if they have diarrhea. Watch for these signs and symptoms: not wetting a diaper for 3 or more hours, no tears when crying, dry mouth, fever (over 39C or 102F), drowsiness, irritability, unresponsiveness, or “sunken” appearance (eyes, cheek, abdomen seem to sink into the body). Seek medical help immediately if these symptoms appear. Also report diarrhea that lasts longer than a day, or if the stool looks dark, tarry, or bloody.

food, how to, diarrhea: how to prevent and treat it

When it comes to equality, the little details matter, too

When babies have diarrhea, they can develop severe diaper rash where their skin comes in contact with the stool. If your baby does have diarrhea, change their diaper as soon as possible after each bowel movement and clean their skin with mild soap and water. Pat dry gently – don’t rub, and whenever possible, allow their bottom to air dry. A diaper cream provides a bit of a barrier on their skin once a diaper is back on.

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Adults with diarrhoea may need to see a doctor too

While most cases of acute diarrhea will go away, older children and adults should see their doctor if they have any of these symptoms: fever (above 39C or 102F), six or more liquid/loose stools within 24 hours, blood or pus in the stool, stool that looks “tarry” or black, frequent vomiting, more than two days of diarrhea, or signs of dehydration. If this is happening to you, you may need intravenous (IV) fluids and medications to treat the cause of the diarrhea.

food, how to, diarrhea: how to prevent and treat it

Probiotics may help ease diarrhoea

In addition to drinking extra fluids and avoiding foods that you might know trigger diarrhea, you might want to try avoiding foods with artificial sweeteners, including chewing gum. Yogurt with probiotics helps some people, and if you experience frequent bouts of diarrhea, you may want to speak with your doctor about taking probiotics on a regular basis.

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Over-the-counter drugs for diarrhoea

If you are experiencing acute diarrhea and you don’t have any symptoms of an infection, such as a fever, your doctor may recommend that you try an over-the-counter (OTC) anti-diarrheal medication, such as loperamide (Imodium) or bismuth subsalicylate (Pepto-Bismol). However, if you have a bacterial or parasitic infection, stopping your body from expelling the stool may prevent your body from getting rid of the infection. So check with your doctor or nurse practitioner.

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Preventing diarrhoea

Since most cases of acute diarrhea are caused by contamination with a virus, bacteria, or parasite, good hygiene is your best protection. Wash your hands frequently and thoroughly. When travelling, ensure your food is well cooked (and hot), and avoid raw or unpackaged items. Get recommended vaccinations. Rotavirus, which spreads quickly among young children, can cause severe diarrhea. There is an oral vaccine that can reduce the risk.

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