Published on Oct 20, 2015 and last reviewed on Feb 28, 2023 - 3 min read
Did you know that watery diarrhea can be due to a severe condition called exocrine pancreatic insufficiency? Read the article to know more about this condition.
A person having watery diarrhea may think it is simply a tummy flu. But things can be even more serious than just a gastrointestinal tract infection. Exocrine Pancreatic Insufficiency (EPI) means indigestion of food caused by the lack of digestive enzymes that normally are produced by the pancreas. Exocrine Pancreatic Insufficiency causes indigestion leading to watery diarrhea and hence also known as pancreatic maldigestion.
EPI may also present with fat maldigestion, a condition known as steatorrhea. In steatorrhea, there are very foul smelling, pale and bulky stools that float on water in the toilet pan and is due to excess gas and undigested fat seen as oil droplets in the stools. In EPI induced steatorrhea, there may be an oily material leakage from the anal opening and there may also be mild to moderate levels of fecal incontinence (loss of control on feces). A lot of patients present with this oily leakage and fecal incontinence problems and they do not even know that they may be having a problem of exocrine pancreatic insufficiency induced steatorrhea.
For normal digestion to take place, we need normal secretions of the pancreas consisting of proteins (3%) and a lot of water and electrolytes (97%). If due to diseases like long history of the infection of pancreas, there is a damage to the parts of the pancreas, it causes loss of function of pancreas that is associated with the digestion of the lipids and other nutrients in food.
Fats, we know, make a lot of bulk of our food and the resulting energy from food is largely dependent on the digestion of this fat content properly. Pancreas does all this digestion of the fats in the small intestinal lumen through its well formed secretions. 1 gram of fats when metabolized yield 9 Calories of energy which is more than double produced by the metabolism of 1g of carbohydrates (which is 4 Calories for 1 gram).
So, it is obvious that patient will feel lack of energy and fatigue too, along with diarrhea if he has the EPI. People usually know only one condition associated with the pancreatic insufficiency and that is diabetes mellitus. It is our duty to inform and guide the patients regarding other diseases too. Because, a well informed patient will never go for self medication and will not become a prey of the quakes if he/she gets any indigestion issues.
If considerable damage to the tissues of pancreas occurs due to any reason, it may lead to EPI. The concomitant disorders may be hepatitis A, diabetes mellitus, SLE or lupus, previous surgery of the gastrointestinal tract, cystic fibrosis, celiac disease of the gut, Crohn's disease, hyperacidity in stomach due to any underlying disease, heavy smokers, chronic alcoholics, etc. So, if anyone has one of these diseases, and he also gets frequent indigestion, weight loss, lack of energy and some issues with the brain functioning, please do visit your primary care physician to rule out the chances of EPI.
It is diagnosed easily and is treated according to the cause of the disease that has lead to the problems with the pancreas or pancreatic secretions. Also we may supplement the pancreatic enzymes to aid in digestion even if the patient has completely lost functioning of the pancreas.
For any health issues, consult an internal medicine physician online for early diagnosis and good prognosis --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician
A person having watery diarrhea may think it is simply tummy flu. But things can be even more serious than just a gastrointestinal tract infection. Watery diarrhea is usually caused due to stomach infection, but it may also be symptomatic of other conditions. Watery diarrhea may also occur from lactose intolerance, caffeine, laxative foods, and alcohol use which other symptoms may not accompany.
Watery diarrhea usually occurs through food poisoning and may also be frequently caused by several underlying diseases that may or may not have been diagnosed. Certain side effects of drugs may additionally lead to an episode of diarrhea. Mentioned below are a few of them.
- Lactose intolerance.
- Celiac disease.
- Crohn's disease.
- Irritable bowel syndrome.
- Proton pump inhibitors.
- chemotherapeutic drugs.
Watery diarrhea is a short-term sickness that arises commonly from a gastrointestinal infection. Sometimes the gut biome may be sufficiently strong to neutralize the infectious cause, while the etiology may overpower the gut immunity in other cases. This imbalance in the reaction is responsible for the occasional occurrence of watery diarrhea.
Watery diarrhea lasting more than two days without any improvement can be worrisome. The condition may be accompanied by other clinical manifestations, such as those mentioned below.
- Skin rash.
- Abdominal pain.
- Rectal pain.
- Bloody stools.
A person having watery diarrhea may think it is simply stomach flu. But things can be even more serious than just a gastrointestinal tract infection. Letting diarrhea run its course makes the individual lose excess fluids and salts, resulting in weakness and tiredness. Hence, it is better to treat the condition if it does not improve within 2 to 4 days.
The following steps can be taken to treat diarrhea:
- Sufficient hydration.
- Semi-solid and low-fiber food.
- Avoid high-fiber, dairy, and highly seasoned foods.
- OTC antidiarrheal drugs (Loperamide, Bismuth subsalicylate, etc.).
Diarrhea is one of the most common conditions of the digestive system and can occur due to an array of causative agents which can be either harmful or merely an adverse reaction in the body. It is possible to have watery diarrhea without being sick from ingesting laxative foods or certain medications. Stress has also been associated with diarrhea.
The following conditions can mimic gastroenteritis:
- Campylobacter Infections.
- Clostridioides (Clostridium) Difficile Colitis.
- Escherichia coli (E coli) Infections.
- Food Poisoning.
- Peritonitis and Abdominal Sepsis.
- Salmonella Infection (Salmonellosis).
Yellow watery diarrhea can be an indication of several underlying diseases. Yellow watery diarrhea most commonly indicates the malfunctioning of the individual’s liver or gallbladder. On the other hand, bright yellow watery stool may be due to giardiasis. Yellow watery diarrhea almost always has mucus present.
Diarrhea may be resolved within 2 to 4 days. If the condition does not improve by then, it requires medical attention. Persistent diarrhea beyond four weeks is a sign of chronic diarrhea. The presence of symptoms mentioned below is another signal of a serious case of diarrhea.
- Excessive thirst.
- Decreased urinary output.
- Dark-colored urine.
- Rectal pain.
- Dry mouth.
- Scaly skin.
- Severe dehydration.
Diarrhea can occur between 30 minutes to 8 hours of consuming infected food. This time varies from person to person. Other factors that influence the time difference between ingestion of food and the beginning of an episode of diarrhea include the patient’s age, an underlying gastrointestinal condition, the onset of abdominal pain, the temperature of the environment, mental stress, and the amount of water intake.
Diarrhea refers to increased frequency of the bowels. To reset the gut to its normal condition, one can follow certain steps:
- Removing offending food from the diet.
- Take prebiotics.
- Sufficient diet and exercise.
- Follow a Mediterranean diet.
- Stress management.
- Diagnosis of the underlying cause and apt therapies.
The gut bacterial biome is seriously affected by infectious diarrhea. The population of good bacteria is depleted, along with a heavy loss of fluids, salts, and minerals. Dehydration is the immediate aftermath of diarrhea that requires correction as soon as possible. There must be a quick recovery of the gut biome as well.
Paradoxical diarrhea is caused due to hard impaction of stool in the colon around which leakage of watery diarrhea occurs. The hard impacted stool is an aftermath of long-standing and untreated constipation. There are several medications that can aid in dislodging the impacted stool and at times physical maneuvers may be required.
Last reviewed at:
28 Feb 2023 - 3 min read
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