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What is Diarrhea? What's the Difference Between Mild, Moderate or Severe Diarrhea Cases?
Diarrhea is loose, watery stools. A person with diarrhea typically passes stools greater than 3-times a day. People with diarrhea may pass more than a quart of stool a day, much of it being liquid-like. Mild or moderate diarrhea is a common problem usually lasting 1 to 2-days and goes away on its own without special treatment. However, serious or severe diarrhea, ongoing for 3 days or more may be a sign of a serious problem and also has an elevated risk of Dehydration. Severe diarrhea sometimes indicates a chronic disease or medical condition.
Diarrhea can cause dehydration, which means the body lacks sufficient fluids to function properly. Dehydration is particularly dangerous in both young children and in older people (which is an elderly health issue a Geriatrician worries about), and must be treated promptly to avoid potential closely related serious health issues and concerns.
People of all ages can get diarrhea and the average adult has a bout of serious-diarrhea about 4 or more times a year. In the USA, each child will have from 8 to 16-cases of diarrhea (some episodes may be severe-diarrhea) by the age of 5.
What causes Chronic Diarrhea and Severe Diarrhea?
Severe cases of diarrhea are typically related to a bacterial, viral, or parasite infection. Chronic diarrhea is often related to other health and medical conditions or quite possibly attributable to fairly common functional disorders such as an irritable bowel for example, or a medical condition known as inflammatory bowel syndrome and disease.
A few of the more common causes of diarrhea include the following:
Bacterial infections - Several types of bacteria consumed thru contaminated water or food can cause the onset of moderate or severe diarrhea. Common causes include Campylobacter, Salmonella, Shigella and e-Coli).
Viral infections - Many viruses cause diarrhea, including rotavirus, Norwalk virus, cytomegalovirus, herpes simplex virus, and viral hepatitis.
Food intolerances - Some people are unable to digest food components such as artificial sweeteners and lactose—the sugar found in milk.
Parasites - Parasites can enter the body through food or water and settle in the digestive system. Parasites that cause diarrhea include Giardia lamblia, Entamoeba histolytica, and Cryptosporidium.
Reaction to medicines - Antibiotics, blood pressure medications, cancer drugs, and antacids containing magnesium can all cause diarrhea.
Intestinal diseases - Inflammatory bowel disease, colitis, Crohn’s disease, and celiac disease often lead to diarrhea.
Functional bowel disorders - Diarrhea can be a symptom of irritable bowel syndrome.
Some people develop severe diarrhea after stomach or stomach pacemaker surgery, or removal of the gallbladder. The reason may be a change in how quickly food moves thru the digestive system after stomach surgery, or an increase in bile in the colon after gallbladder surgery.
People who visit foreign countries are at high-risk for traveler’s severe diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or parasites. Traveler’s diarrhea can be a problem for people visiting developing countries. Luckily visitors to the United States, Canada, most European countries, Japan, New Zealand and Australia do not face much risk of getting traveler’s diarrhea.
In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes away on its own, a time-consuming search for diarrhea causes is likely not necessary.
What are the Symptoms of Diarrhea?
Diarrhea may be accompanied by cramping, abdominal pain, bloating, nausea, or urgent needs to use the bathroom, ASAP. Depending on the cause, a person may have a fever or bloody stools.
Severe or Chronic Diarrhea in Children is a Troubling Kids Health Issue
Children can have acute and chronic forms of serious diarrhea. Causes of diarrhea in young children include bacteria, parasites, virus or viral infections, medications, functional bowel disorders and forms of food sensitivities.
Infection with the rotavirus is the most common cause of acute or serious diarrhea in kids. Rotavirus diarrhea usually resolves in 3 to 9-days. Very young children who are 6 to 32-weeks old can be vaccinated against the virus with a vaccine called Rotateq.
If your child has diarrhea, do not hesitate to call the doctor for medical advice. Diarrhea is especially dangerous in newborn babies and infants, leading to rapid dehydration. A child can die from serious dehydration within a few days. The main treatment for diarrhea in children is re-hydration to replace lost body fluid quickly.
Take your child to the doctor if there is no obvious signs of improvement after 24-hours or so, or if any of the following conditions symptoms appear:
- stools containing blood or pus
- black looking stools
- a temperature above 102-degrees
- obvious signs of dehydration
Medications to treat diarrhea in adults can be dangerous for children and should only be given with a doctor’s guidance.
Dehydration from Diarrhea
Moderate or severe cases of diarrhea may cause dehydration, which means the body has lost too much fluid and electrolytes and can’t function properly. Dehydration is particularly dangerous in children and in older folks and must be treated promptly to avoid serious health problems.
Signs of Dehydration include
- excessive thirst
- less frequent urination
- dry skin
- dark-colored urine
Signs of dehydration in children include
- dry mouth and tongue
- no tears when crying
- no wet diapers for 3-hours or more
- sunken abdomen, eyes, or cheeks
- high fever
- listlessness or irritability
- skin that does not flatten when pinched and released
If you suspect that you or your child is dehydrated, call the doctor immediately. Severe dehydration may require hospitalization and IV fluid or IV vitamin therapy.
Dehydration Can Be Prevented
The fluid and electrolytes lost during diarrhea episodes need to be replaced ASAP because the body cannot function without them. Electrolytes are the salts and minerals that affect the amount of water in your body, muscle activity, and other important functions.
Although water is extremely important in preventing dehydration, it does not contain electrolytes. Broth and soups which have sodium, fruit juices, soft fruits, or vegetables that contain potassium, help restore electrolyte levels. Over-the-counter rehydration solutions such as Pedialyte, Ceralyte, and Infalyte are also good electrolyte sources and are especially recommended for children's consumption.
How is the cause of Diarrhea Diagnosed?
Diagnostic tests to find the cause of diarrhea may include the following:
Medical history and physical examination. The doctor will ask you about your eating habits and medication use and will examine you for signs of illness.
Stool culture. A sample of stool is analyzed in a laboratory to check for bacteria, parasites, or other signs of disease and infection.
Blood tests. Blood tests can be helpful in ruling out a specific disease.
Fasting tests. To find out if a food intolerance or allergy is causing the diarrhea, the doctor may ask you to avoid lactose, carbohydrates, wheat, or other foods to see whether the diarrhea responds to a change in diet.
Sigmoidoscopy. For this test, the doctor uses a special instrument to look at the inside of the rectum and lower part of the colon.
Colonoscopy. This test is similar to a sigmoidoscopy, but it allows the doctor to view the entire colon.
Imaging tests. These tests can rule out structural abnormalities as the cause of diarrhea.
How is Diarrhea Treated?
In most cases of diarrhea, replacing lost fluid to prevent dehydration is the only treatment necessary. Medicines that stop diarrhea may be helpful, but they are not recommended for people whose diarrhea is caused by a bacterial infection or parasite.If you stop the diarrhea before having purged the bacteria or parasite, you will trap the organism in the intestines and prolong the problem. Instead, most doctors usually prescribe antibiotics as an initial treatment procedure. Viral infections are either treated with medication or left to run their course, depending on the severity and type of virus.
Tips About Food and Food Sensitivity
Your doctor may ask you about the diet and foods the diarrhea patient has been eating. Until diarrhea subsides, try to avoid caffeine, milk products, dairy and ice cream, greasy foods, high fiber food, or very sweet treats. These foods tend to aggravate or cause diarrhea symptoms and contribute to its longevity.
As your digestive health improves, you can add soft, bland foods to your diet, including bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, tofu and other healthy light foods which are also non-spicy and plain, with low-fat. For children, the pediatrician may also suggest a bland or simple food diet. Once the diarrhea has stopped, the pediatrician will encourage kids to return to a normal but healthy diet, assuming the food will be well tolerated.
Preventing Traveler’s Diarrhea
Traveler’s diarrhea happens when you consume food or water contaminated with bacteria, viruses or parasites. You can take these precautions to prevent traveler’s diarrhea when you travel outside the United States and Canada:
- Do not drink tap water or use it to brush your teeth.
- Do not drink unpasteurized milk or dairy products.
- Do not use ice cubes made from tap water.
- Avoid raw fruits and vegetables, including lettuce, unless they are peelable and you do the peeling.
- Do not eat raw or rare meat and fish.
- Do not eat meat or shellfish is not hot when served.
- Do not eat food from street vendors.
You can safely drink bottled water—if you are the one to break the seal—along with carbonated soft drinks, and hot drinks such as coffee or tea.
Depending on where you are going and how long you will stay, your doctor may recommend you take antibiotics before leaving on your overseas trip to help protect you from possible infection.
Hope through Research
The Division of Digestive Diseases and Nutrition at the National Institute of Diabetes and Digestive and Kidney Diseases supports basic and clinical research into severe severe diarrhea and other gastrointestinal conditions. Among other areas, researchers are studying how the absorption and secretion in the digestive tract affects content and consistency of stool, the relationship between severe-diarrhea and Helicobactor pylori, motility in chronic diarrhea, and chemical compounds may be useful in treating cases of Severe Diarrhea.
Points to Remember about Diarrhea
Diarrhea is a common problem usually resolves on its own.
Diarrhea is dangerous if a person becomes dehydrated.
Causes include viral, bacterial, parasitic infections, food intolerance, reactions to medicine, intestinal diseases or a bowel disorder.
Treatment involves replacing lost fluid and electrolytes. Depending on the cause of the problem, diarrhea sufferers might need medications to stop the diarrhea, or treat an infection. Children may need an oral rehydration solution to replace lost body fluid and electrolytes.
Call the doctor if the person with diarrhea has severe pain in the abdomen or rectum, a fever of 102-degrees or higher, blood in the stool, signs of dehydration, or diarrhea for more than 3-days.
Home Health care to Treat Diarrhea
- Drink plenty of fluid to avoid becoming dehydrated. Start with sips of any fluid other than caffeinated beverages. Milk may prolong loose stools, but also provides needed fluids and nourishment. Drinking milk may be fine for mild diarrhea. For moderate and severe diarrhea, electrolyte solutions available in drugstores are usually best.
- Active cultures of beneficial bacteria (probiotics) make diarrhea less severe and shorten its duration. Probiotics can be found in yogurt with active or live cultures and in supplements.
- Foods like rice, dry toast, and bananas can sometimes help with diarrhea.
- Avoid over-the-counter anti-diarrhea medications unless specifically instructed to use one by your doctor. Certain infections can be made worse by these drugs. When you have diarrhea, your body is trying to get rid of whatever is causing it (contaminated foods, virus, etc.). The medicine can interfere with this process.
- Get plenty of rest.
If you have a chronic form of diarrhea, such as is caused by irritable bowel syndrome, try adding bulk to your diet to thicken your stool and regulate bowel movements. Such foods include fiber from whole-wheat grains and bran. Psyllium-containing products such as Metamucil or similar products can also add bulk to stools.
When to Contact a Medical Professional
Diarrhea is not usually harmful, but it can become dangerous or signal a more serious problem. You should consider seeing your doctor if you experience any of the following:
- Serious pain in the abdomen or rectum
- Signs of dehydration
- You have blood, pus, foul-smelling or oily-appearing stools
- Your stools are black
- You have abdominal pain which isn't improved by bowel movements
- You have symptoms of dehydration such as light-headedness when sitting or standing up
- You have a fever above 101°F, or your child has a fever above 100.4°F, along with diarrhea
- You have recently traveled to a foreign country
- You have eaten with other people who also have diarrhea
- You have started on a new drug or medication
- Your diarrhea does not get better in 5 days (2-days for infants or children), or worsens
- You or your child has been vomiting for more than 12-hours
- Your baby is affected; under 3-months. Then see a doctor ASAP upon diarrhea or vomiting onset
What to Expect at Your Doctors' Office Visit
Your doctor will take a complete medical history and examination, paying attention to your abdomen.
Questions the health professional may ask include these issues:
- When did your diarrhea start?
- What is the color and consistency of your stool?
- Do you have evidence of blood in your stool?
- Are you passing large amounts of mucus with your stool?
- What other conditions or symptoms do you have?
- Do you have abdominal pain or severe cramping with the diarrhea?
- Do you have a fever or the opposite; cold feelings?
- Are any other family members sick?
- Have you recently traveled out of the country?
- Have you possibly been exposed to unpurified water or spoiled food?
- What makes your pain worse? Stress? Specific foods?
- Have you had abdominal surgery?
- Have you taken anti-biotics recently?
- What medications do you take? Any recent changes to your meds?
- Do you drink coffee? How much? How often?
- Do you drink alcohol? How much? How often?
- Are you a smoker? How much per day?
- Are you exposed to ongoing and considerable second-hand smoke?
- Are you on a special diet or eating gas-causing foods?
Your doctor may ask you to obtain one or more stool samples in containers to test for signs of inflammation and infection and to identify those which may be causing infection.
If there are signs of dehydration in addition to the diarrhea, your doctor may order:
- A basic metabolic panel test to check blood electrolyte levels
- BUN and serum creatinine tests
- Urine specific gravity check