Clinical Manifestation Of Diarrhea
General Findings.Diarrhea is usually defined as the passage of 3 or more abnormally loose or liquid stools per day. Frequent passage of formed stools is not diarrhea, nor is the passing of loose, pasty stools by breastfed babies. Clinical clues to the possible etiology of gastroenteritis are noted inTable 366.9.
In the past, many guidelines divided patients into subgroups for mild , moderate , and severe dehydration. However, it is difficult to distinguish between mild and moderate dehydration based on clinical signs alone. Therefore most guidelines now combine mild and moderate dehydration and simply use none, some, and severe dehydration. The individual signs that best predict dehydration are prolonged capillary refill time > 2sec, abnormal skin turgor, hyperpnea , dry mucous membranes, absent tears, and general appearance . As the number of signs increases, so does the likelihood of dehydration. Tachycardia, altered level of consciousness, and cold extremities with or without hypotension suggest severe dehydration.
Viral Diarrhea. Symptoms of rotavirus AGE usually begin with vomiting followed by frequent passage of watery nonbloody stools, associated with fever in about half the cases . The diarrhea lacks fecal leukocytes, but stools from 20% of cases contain mucus. Recovery with complete resolution of symptoms generally occurs within 7 days. Although disaccharide malabsorption is found in 1020% of episodes, it is rarely clinically significant.
E.A. Shaffer, in, 2014
Can I Prevent Diarrhea
Trying a bulking agent such as psyllium may be helpful. Bulking agents help hold water in the stool and add bulk which may slow your bowel movements down. Don’t be confused by labels that say bulking agents are for constipation. These products can be helpful for both diarrhea and constipation.
You may also try to avoid foods that have a tendency to aggravate your diarrhea. These include caffeine, milk products, and foods that are greasy, high in fibre and/or very sweet.
How Can I Prevent Diarrhea
Although diarrhea can occur for various reasons, there are actions that you can take to prevent it:
- You can avoid developing diarrhea from food poisoning by washing the cooking and food preparation areas more frequently.
- Serve food immediately after preparing it.
- Refrigerate leftovers promptly.
- Always thaw frozen food in a refrigerator.
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How Do You Diagnose Diarrhea
For the majority of mild diarrhea cases, you wont need medical attention. These cases are self-limited and get better without medical intervention. The key to mild diarrhea is supportive therapy staying hydrated and eating a bland diet.
More serious cases of diarrhea may require medical attention. In these situations, there are a few diagnostic tests that your provider may order. These tests can include:
- Discussing a detailed family history, as well as physical and medical conditions, your travel history, and any sick contacts you may have.
- Doing a stool test on a collected stool sample to check for blood, bacterial infections, parasite and inflammatory markers.
- Doing a breath test to check for lactose or fructose intolerance, and bacterial overgrowth.
- Doing blood work to rule out medical causes of diarrhea such as a thyroid disorder, celiac sprue and pancreatic disorders.
- Doing endoscopic evaluations of your upper and lower digestive tract to rule out organic abnormalities .
How Can I Relieve Discomfort In The Rectal Area Caused By Diarrhea
Diarrhea often means frequent trips to the bathroom. This can cause discomforts like:
- Itching.
- Burning.
- Pain during bowel movements.
If youre experiencing any of these discomforts, there are a few things you can do to help, including:
- Sitting in a few inches of lukewarm water in a bathtub.
- Patting your rectal area dry with a clean soft towel after getting out of the tub or shower. Dont rub the area dry because that will only make the irritation worse.
- Applying petroleum jelly or a hemorrhoid cream to your anus.
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Causes Of Chronic Diarrhea
Chronic diarrhea is sometimes caused by an underlying medical condition. See your doctor if diarrhea doesnt respond to at-home care. If youre concerned about your diarrhea and dont already have a primary care provider, you can view doctors in your area through the Healthline FindCare tool.
During your appointment, your doctor may conduct a physical examination and ask about your symptoms. For example, how often do you have loose stools? Do you have any other symptoms? Is there a personal or family history of digestive problems? Based on your physical exam and your symptoms, your doctor may order a complete blood count or a stool sample to check for infections or inflammation.
Inflammatory conditions that can cause loose, watery stools include ulcerative colitis and Crohns disease. These conditions can also cause bloody stools and abdominal pain.
A stool sample, which examines feces, may reveal elevated white blood cells. This can be a sign of inflammation in your body or bacteria or parasites in your stool. The latter can also cause loose stools. This sample may also reveal fat in your stool, which can indicate chronic pancreatitis or celiac disease.
Your diet can also play a role in chronic diarrhea. Certain ingredients speed up the rate of digestion, causing food to pass rapidly through the colon. Common culprits include milk and artificial sweeteners .
Other causes of chronic diarrhea may include:
Treatments For Diarrhea Vs Dysentery
To treat diarrhea and dysentery, doctors take different approaches. You can treat diarrhea by drinking lots of fluids and eating solid foods. Youll need to build your electrolytes back up, so the doctor might tell you to drink some rehydrating sports drinks or Pedialyte.
Treatments for diarrhea
If you have diarrhea, doctors recommend eating normally when your appetite returns, if youve lost it. Avoid the following foods and beverages when returning to your regular diet so that diarrhea doesnt come back:
- Alcoholic drinks
- Drinks, snacks, or sweets with artificial sweeteners like mannitol, sorbitol, and xylitol
Treatments for dysentery
If you have dysentery, the doctor will prescribe antibiotics such as ciprofloxacin or azithromycin to treat the intestinal infection.
Along with the antibiotics, the doctor will want you to drink a generous amount of fluids to flush your system and build your electrolytes up. Similar to treatments for diarrhea, Pedialyte or rehydrating sports drinks will work, as will eating solid foods.
Untreated, both conditions can be life-threatening. Severe dehydration can occur if you dont see a doctor in time or if your diarrhea persists and wont go away. If you experience any dysentery symptoms or have diarrhea that doesnt go away, see your doctor immediately.
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Acute And Persistent Diarrhea
The most common causes of acute and persistent diarrhea are infections, travelers diarrhea, and side effects of medicines.
Infections
Three types of infections that cause diarrhea include
-
Viral infections. Many viruses cause diarrhea, including norovirus and rotavirus. Viral gastroenteritis is a common cause of acute diarrhea.
-
Bacterial infections. Several types of bacteria can enter your body through contaminated food or water and cause diarrhea. Common bacteria that cause diarrhea include Campylobacter, Escherichia coli , Salmonella, and Shigella.
- Parasitic infections.Parasites can enter your body through food or water and settle in your digestive tract. Parasites that cause diarrhea include Cryptosporidium enteritis, Entamoeba histolytica, and Giardia lamblia.
Infections in the digestive tract that spread through foods or drinks are called foodborne illnesses.
Infections lasting more than 2 weeks and less than 4 weeks can cause persistent diarrhea.
Travelers diarrhea
Travelers diarrhea is caused by eating food or drinking water contaminated with bacteria, viruses, or parasites. Travelers diarrhea is most often acute. However, some parasites cause diarrhea that lasts longer. Travelers diarrhea can be a problem for people traveling to developing countries.
Side effects of medicines
Many medicines may cause diarrhea. Medicines that may cause diarrhea include antibiotics, antacids containing magnesium, and medicines used to treat cancer.
Diarrhea As A Symptom Of The Coronavirus
Diarrhea. You know if youhave THIS digestive condition. People who suffer from diarrhea experienceloose, watery stools more frequently than normal and often experience a senseof urgency to go. Generally, there are two types of diarrhea, acute and chronic.Acute diarrhea lasts a short time, about three to 5 days. Chronic diarrhea isusually related to other digestive disorders such as irritable bowel syndromeor inflammatory bowel disease and may last for as long as you have the illness.Most recently, diarrhea has been added as a symptom of the coronavirus .
According to the World Health Organization, the most common symptoms of COVID-19 are:
- Fever
With some patientsexperiencing the following:
- Aches and pains
- Diarrhea
Some people become infectedbut dont develop any symptoms or feel unwell at all!
Weve seen the most common listof COVID-19 symptoms repeatedly on the TV, in news articles, and from ourfriends and family. However, as doctors learn more about COVID-19, a new study hasshown that digestive symptoms, in particular diarrhea, could be a symptom forpeople who have a mild form of COVID-19 . In this study publishedin the American Journal of Gastroenterology, patients in this unique sub-groupshowed that diarrhea can be the initial presentation of COVID-19, and patientsmay only later or never present respiratory symptoms or a fever.
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What Symptoms Relate To Diarrhoea
As well as the loose and watery stools of diarrhoea, you may sometimes have other symptoms, including:
- bloating and flatulence
- abdominal cramps, with a colicky pattern
- dehydration
You may feel an urgent need to go to the toilet.
How Is Diarrhea Treated
In most cases, you can treat mild and uncomplicated diarrhea at home. By using an over-the-counter product like bismuth subsalicylate youll usually feel better very quickly.
However, over-the-counter medications arent always the solution. If your diarrhea is caused by an infection or parasite, youll need to see a healthcare provider for treatment. A general rule is not to use over-the-counter medications for diarrhea if you also have a fever or blood in your stool. In those cases, call your healthcare provider.
When diarrhea lasts for a long period of time , your healthcare provider will base your treatment on the cause. This could involve a few different treatment options, including:
How should I take over-the-counter medications for diarrhea?
Its important to always follow the instructions on the packaging when you take an over-the-counter medication for diarrhea. The rules for managing diarrhea in an adult are different than in children. Always call your childs healthcare provider before giving your child any type of medication for diarrhea.
A tip for managing diarrhea in an adult with over-the-counter medication includes:
- Taking two tablespoons of Kaopectate® or two tablespoons of Pepto-Bismol® after each loose stool. Do not take more than eight doses in 24 hours.
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How To Diagnose Diarrhea Vs Dysentery
Diagnosing diarrhea
Your doctor will talk to you about your diet and any recent trips you may have taken. They might want to know the type of foods you have been eating or where you might have eaten them. They will perform a physical exam, ask about any medicines youre taking, and take a stool sample for testing.
Diagnosing dysentery
Diagnosing dysentery is similar to diarrhea, but the doctor will take a sample of your stool and test it for bacteria.
What Other Symptoms Might I Have With Diarrhea
Other possible symptoms of diarrhea include:
- Cramps or pain in the abdomen
- An urgent need to use the bathroom
- Loss of bowel control
If a virus or bacteria is the cause of your diarrhea, you may also have a fever, chills, and bloody stools.
Diarrhea can cause dehydration, which means that your body does not have enough fluid to work properly. Dehydration can be serious, especially for children, older adults, and people with weakened immune systems.
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What Complications Are Associated With Diarrhoea
Diarrhoea may cause dehydration. More fluids are lost from the body when you have diarrhoea than normally. Dehydration can lead to a loss of electrolytes minerals your body needs to function properly. This is why rehydration is so important.
Diarrhoea causes food to move quickly through your body. If this is ongoing it makes it difficult for you to absorb nutrients and can lead to malnutrition.
Some people may develop temporary lactose intolerance after an episode of diarrhoea or gastroenteritis. See your doctor if the symptoms continue for more than a couple of weeks.
What Are The Treatments For Diarrhea
Diarrhea is treated by replacing lost fluids and electrolytes to prevent dehydration. Depending on the cause of the problem, you may need medicines to stop the diarrhea or treat an infection.
Adults with diarrhea should drink water, fruit juices, sports drinks, sodas without caffeine, and salty broths. As your symptoms improve, you can eat soft, bland food.
Children with diarrhea should be given oral rehydration solutions to replace lost fluids and electrolytes.
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When Should I Call My Doctor About Diarrhea
If you have diarrhea that fails to improve or resolve completely, you should call your healthcare provider. Keep track of any other symptoms you may be experiencing this includes fever, vomiting, rash, weakness, numbness, lightheadedness, dizziness, weight loss and blood in your stool. If you have any concerns, its always best to call your healthcare provider.
Infants Toddlers And Young Children
The parent or caretaker of an infant, toddler, or young child with diarrhea and any of the following symptoms should seek a doctors care right away:
- diarrhea lasting more than 24 hours
- fever of 102 degrees or higher
- severe pain in the abdomen or rectum
- stools containing blood or pus
- stools that are black and tarry
- symptoms of dehydration
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How Can I Feel Better
Your rectal area may become sore because of all the bowel movements that diarrhea brings. You may have itching, burning, or pain when you go to the bathroom.
For relief, take a warm bath or sitz bath. Afterward, pat the area dry with a clean, soft towel. You may also try using a hemorrhoid cream or petroleum jelly on the affected area. If this continues for several days, you should contact your doctor.
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Can I Manage Diarrhea Without Taking Any Medication
When you have an acute case of diarrhea, you can often take care of it without needing any medication. Several things you can do to care for diarrhea include:
- Drinking plenty of water and other electrolyte balanced fluids and caffeine-free sodas). Make sure to hydrate throughout day. Your body loses water each time you have diarrhea. By drinking plenty of extra fluids, you are protecting your body from dehydration.
- Changing your diet. Instead of picking greasy, fatty or fried foods, go for the BRAT diet:
- B: Bananas.
- A: Applesauce.
- T: Toast .
Sometimes, diarrhea can also make you lactose intolerant. This is usually temporary and it means that you need to avoid items with lactose until your diarrhea is gone.
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What Are The Treatments For Diarrhea And Loose Stools
Treatments for diarrhea and loose stools depend on the cause. In many cases, home remedies and diet changes are sufficient and diarrhea will go away on its own with rest, hydration, and a bland diet. If treatment is needed it may include:
- Intravenous fluids to treat and prevent dehydration
- Antibiotics if the diarrhea is caused by certain bacterial infections
What Can I Do To Prevent Diarrhea
Proper handwashing can reduce the spread of bacteria that may cause diarrhea.
A rotavirus vaccine can prevent diarrhea caused by rotaviruses. Ask your child’s healthcare provider which vaccines are right for your child.
When you travel, make sure anything your child eats and drinks is safe. This is even more important if you travel to developing countries.
Travel safety tips for drinking and eating include:
-
Not drinking tap water or using it to brush teeth
-
Not using ice made from tap water
-
Not drinking unpasteurized milk
-
Not eating raw fruits and vegetables unless you wash and peel them yourself
-
Not eating raw or undercooked meat or fish
-
Not eating food from street vendors or food trucks
Talk with your child’s healthcare provider before traveling.
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What Are The Symptoms Of Diarrhea
The symptoms you can experience when you have diarrhea can vary depending on if its mild or severe and what the cause of the diarrhea happens to be. Theres a link between severe cases of diarrhea and a medical condition that needs to be treated.
When you have diarrhea, you may experience all of these symptoms or only a few. The main symptom of diarrhea is loose or watery stool.
Other symptoms of mild diarrhea can include:
- Bloating or cramps in the abdomen.
- A strong and urgent need to have a bowel movement.
- Nausea .
If you have severe diarrhea, you may experience symptoms like:
- Fever.
- Vomiting.
- Blood.
Severe diarrhea can lead to significant complications. If you have these symptoms, call your healthcare provider and seek medical attention.