4 Causes of Diarrhea and Treatment

Causes of Diarrhea

Diarrhea is when someone has loose watery stools. Normally, diarrhea is self-contained and it goes away on its own. However, when diarrhea goes on for weeks at a time, a person can become very ill. In this article, we will discuss what diarrhea is and what causes it. We will also discuss how to treat diarrhea.

Food Poisoning

Food poisoning is an illness as a result of eating or drinking food that has been contaminated. It is usually caused by
germs (bacteria, such as E.coli and salmonella) that are present in food or within drinks, however, food poisoning
can also occur due to chemicals (such as lead or mercury), viruses (such as norovirus) or parasites.

How the infection is spread

Food can be contaminated during production, processing, storage, and cooking. There are a number of factors that result in food poisoning:

  • Not cooking food at the right temperature and/or for the right length of time
  • Not chilling food at the correct temperature
  • The food being handled by someone who has not washed their hands properly
  • People eating food after it has passed its ‘use by’ date, and cross-contamination.

Symptoms

The most common symptoms of food poisoning are:

  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach pains
  • Abdominal cramps
  • Chills
  • A high temperature

Treatment

Generally, there is no specific treatment for food poisoning and you don’t usually need to visit a doctor. However, it is important to: get plenty of rest, stay at home and drink plenty of fluids to prevent dehydration which is especially important in the very young and elderly.
Symptoms of dehydration
Dry mouth
Unable to pass urine
Dark, concentrated urine
Extreme thirst
Tiredness
Dizziness and headaches

To deal with the symptoms of dehydration you can take rehydration products or drinks. These solutions will replace the sugars, salts, and minerals that you have lost from your body and help restore the natural balance of body fluids. These rehydration solutions can be purchased from chemists, but please ask the advice of your pharmacist or GP.

Here are some further ways to cope with your symptoms and speed up your recovery time:

  • Eating smaller, more frequent meals is easier than trying to eat three large meals.
  • Stick to easily digested foods, such as toast, crackers, bananas, apple sauce and
    rice until you begin to feel better.
  • Avoid alcohol, cigarettes, caffeine and spicy and fatty foods because these will make
    you feel worse.
  • Take plenty of rest. Food poisoning can have a worse effect on your body than most
    people realize.


Irritable Bowel Syndrome

Irritable bowel syndrome (or IBS) affects the colon, or large bowel, which is the part of the digestive tract that stores stool (poo). People with IBS appear to have sensitive bowels that are easily ‘upset’. IBS is a very common problem. One in five Australians has unpleasant symptoms of IBS at some time.

It is more common in women, often comes
on in the late teens or early twenties and may come and go over a person’s life. Symptoms are often more troublesome before a woman’s period.

What are the symptoms of IBS?
The main symptoms of IBS are:
Abdominal pain or discomfort that is often relieved by passing gas or feces
• Stomach bloating
• Chronic diarrhea or constipation, or alternating between the two

What causes IBS?
No one knows the exact underlying cause of IBS. The symptoms may be due to increased sensitivity to
the function of the bowel. This can be responsible for discomfort, and abnormal contractions in the bowel muscle.
Certain factors can ‘trigger’ attacks in susceptible individuals. These include:

• Infection – An episode of gastroenteritis may result in persistent bowel symptoms. The cause is unknown but
may involve changes to nerve function in the bowel or changes in the normal bacterial population of the
bowel.
• Food intolerance – Impaired absorption of lactose (a sugar found in dairy and many processed foods),
fructose or sorbitol (an artificial sweetener) may trigger IBS.
• General diet – Low fiber diets can exacerbate constipation in some with IBS.
• Stress – Strong emotions, such as anxiety or stress, can affect the nerves of the bowel in susceptible people.
• Medications – Certain medications (such as antibiotics, antacids, and painkillers)

Treatment

• Anti-diarrhoeal agents (e.g. Imodium, Lomotil, fiber supplements) can be an essential part of management
in those with diarrhea-predominant IBS
• Pain-relieving medications (e.g. opiates such as codeine) can provide effective pain relief. One of their
most common side effects, constipation, may also relieve the diarrhea of diarrhea-predominant IBS. Pain relief may also be obtained from medications that reduce bowel spasms
• Constipation treatments (e.g. fiber supplements or laxatives) may provide relief for constipation-predominant IBS
• Antispasmodic agents (e.g. mebeverine, belladonna, hyoscine, and peppermint oil capsules) may ease
cramping
• Tricyclic antidepressants can be effective in treating the pain of IBS but are best prescribed for a trial period with the monitoring of symptoms. Use of these medications does not mean that IBS is caused by depression
• Establishing eating routines and avoiding


Bacterial Infections

Acute gastrointestinal illnesses rank second only to acute respiratory illnesses as the most common disease worldwide. In children less than 5 years old, attack rates range from 2-3 illnesses per child per year in developed countries to 10-18 illnesses per child per year in developing countries.

In Asia, Africa, and Latin America, acute diarrheal illnesses are a leading cause of morbidity (1 billion cases per year), and mortality (4-6 million deaths per year, or 12,600 deaths per day) in children. Most cases of acute infectious gastroenteritis are viruses (Rotavirus, Calicivirus, Adenovirus).

Prevention and Treatment

The most critical therapy in diarrheal illness is hydration. Ideally, an oral rehydration solution containing water, salt, and sugar is utilized.

Intestinal glucose absorption usually remains intact with diarrheal illnesses; therefore, the intestines can absorb water if glucose and salt are also present to assist in the transport of water from the intestinal
lumen.

Since most cases are self-limited, antibiotic therapy is usually not required. One situation in which antibiotics are commonly recommended is in cases of traveler’s diarrhea, in which ETEC or other bacterial pathogens are likely causes, and prompt treatment with fluoroquinolones can reduce the duration of illness from 3-5 days to <1-2 days.

One intervention that hospitals are started to adopt is to start patients in probiotic therapy. At my hospital, every patient that is started on IV antibiotics is also given probiotics.

Probiotics have been proven to help restore the natural gut bacteria that antibiotics kill. when the natural bacteria in the gut is disturbed, the person will develop all kinds of digestion problems. There is all kind of probiotics on the market.

Clostridium Difficile

clostridium difficile, Causes of diarrhea. IBS

Clostridium difficile

Another major cause of diarrhea is an infection called c-diff or Clostridium difficile. C-diff is an infection of the colon that can be life-threatening especially to the elderly. C-diff is highly contagious.

Each year in the United States, about a half-million people get sick from C. difficile, and in recent years, C. difficile infections have become more frequent, severe and difficult to treat. Recurrent C. difficile infections also are on the rise.

Signs and Symptoms of C-Diff Include:

  • Watery diarrhea 10 to 15 times a day
  • Abdominal cramping and pain, which may be severe
  • Rapid heart rate
  • Fever
  • Blood or pus in the stool
  • Nausea
  • Dehydration
  • Loss of appetite
  • Weight loss
  • Swollen abdomen
  • Kidney failure
  • Increased white blood cell count

The best way to prevent the transmission of C-diff to others is to thoroughly wash your hands.


Treatment for Diarrhea

The basic treatment for diarrhea is to determine the cause and to remain properly hydrated. If the diarrhea is caused by an infectious source.

 

References:

https://www.mayoclinic.org/diseases-conditions/c-difficile/symptoms-causes/syc-20351691

Talley N.J., Zinsmeister A.R., Van Dyke C., Melton L.J., III Epidemiology of colonic symptoms and irritable bowel syndrome. Gastroenterology. 1991;101(4):927–934. 
Talley N.J., Weaver A.F., Zinsmeister A.R., Melton L.J., III Self-reported diarrhea: what does it mean? Am J Gastroenterol. 1994;89(8):1160–1164. 

 

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