Diarrhea - Causes, Signs, Diagnosis, Treatment, Prevention, and Complications

Introduction:

Diarrhea is a common problem with loose, watery stools three or more times a day. Diarrhea presents alone or may be associated with nausea, vomiting, abdominal pain, or weight loss.

Usually, diarrhea is a temporary problem lasting a few days. However, if it is present for a long time, it indicates the presence of other conditions. Diarrhea is categorized as acute or chronic depending on the duration and infectious or noninfectious depending on the cause.

What Are the Causes of Diarrhea?

Many diseases and conditions can cause diarrhea, including:

• Bacterial and Parasitic Infections: Exposure to Escherichia coli or parasites through contaminated food or water can cause diarrhea. Traveler's diarrhea is caused by bacteria and parasites when traveling in developing countries. Clostridium difficile is another bacteria that causes diarrhea and occurs after using certain antibiotics or a hospital stay.

• Viral Infections: Viruses that can cause diarrhea include enteric adenovirus, astrovirus, norovirus, cytomegalovirus, and viral hepatitis. Rotavirus can cause diarrhea in children. The virus that causes corona disease is also associated with nausea, vomiting, and diarrhea.

• Medications: Many medications can cause diarrhea. Some antibiotics kill the good bacteria and disturb the intestine's normal bacterial flora, resulting in diarrhea or other infections. Anti-cancer drugs and antacids containing magnesium can cause diarrhea.

• Lactose Intolerance: Lactose is a sugar found in milk and other dairy products. People who find it difficult to digest lactose will have diarrhea after eating dairy products.

• Fructose: Fructose is a sugar found in fruits and honey. Fructose intolerance can also lead to diarrhea.

• Artificial Sweeteners: Sorbitol and mannitol are artificial sugars found in chewing gum and other sugar-free products. They can cause diarrhea.

• Surgery: Gallbladder removal and intestine surgery can cause diarrhea.

• Digestive Disorders: Crohn's disease, ulcerative colitis, celiac disease, and small intestinal bacterial overgrowth can cause diarrhea.

What Are the Signs and Symptoms of Diarrhea?

Signs and symptoms associated with loose, watery stools include:

• Nausea.

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  Vomiting and Diarrhea

• Vomiting.

• Abdominal pain.

• Bloating.

• Urge to have a bowel movement.

• Blood in stool.

• Mucus in the stool.

How Can We Diagnose Diarrhea?

A physician will gather all the medical history, and enquire for information about the medications prescribed or currently taken.

Followed by that the physical examinations and advises some tests including:

• Blood Test: A complete blood count test, kidney function test, and electrolytes measurement are done to determine the severity of diarrhea.

• Stool Test: A stool test finds bacterial or parasitic infections.

• Breath Test: This test helps to find out lactose intolerance. Breathing out hydrogen indicates lactose is not digested correctly.

• Flexible Sigmoidoscopy or Colonoscopy: The doctor uses a thin tube with a light to view the inside of the colon. Flexible sigmoidoscopy provides a view of the lower colon, whereas colonoscopy allows viewing the entire colon. The device is also used to take tissue samples for examination under a microscope.

• Endoscopy: A long thin tube attached with a camera is used to examine the esophagus, stomach, and small intestine. It is also used to take tissue samples for analysis in the laboratory.

How Can We Treat Diarrhea?

Mostly mild diarrhea resolves on its own within a couple of days. However, medications or other treatments are prescribed if lifestyle changes and home remedies do not improve the symptoms.

• Antibiotics or Anti-parasitics: Antibiotics or anti-parasitic medications are given if bacteria or parasites cause diarrhea. Antibiotics will not help in viral infections.

• Replacement of Fluids: Drinking water with electrolytes or juice can replace fluids. Drinking fruit juices can maintain potassium levels, and drinking soups can maintain sodium. However, apple juice can make diarrhea worse. In children, oral rehydration solution is given to prevent dehydration or replace lost fluids.

• Adjusting the Medications: If an antibiotic is causing diarrhea, another antibiotic is prescribed.

• Treating Underlying Conditions: If diarrhea is caused by underlying conditions such as inflammatory bowel disease, medications are given to treat the condition.

How Can We Prevent Diarrhea?

Washing hands properly can prevent the spread of infectious diarrhea. Proper washing should follow:

• Washing Frequently: Wash the hands before and after preparing food. Wash the hands after using the toilet, sneezing, coughing, blowing the nose, or changing diapers.

• Use Soap: Wash the hands with soap and water for at least 20 seconds.

• Use Sanitizer When Washing Is Not Possible: Use an alcohol-based hand sanitizer that contains at least 60% alcohol.

• Vaccination: Children should be vaccinated against rotavirus, the most common cause of viral diarrhea.

• Preventing Traveler's Diarrhea: Travelers' diarrhea occurs in people who travel to countries with poor sanitation.

To reduce the risk of traveler's diarrhea:

• Eat hot, well-cooked foods.

• Avoid peeled fruits and vegetables.

• Avoid undercooked meat and dairy foods.

• Drink bottled water.

• Avoid tap water and ice cubes.

What Are the Lifestyle Changes and Home Remedies for Diarrhea?

Some home remedies for diarrhea include:

• Drinking plenty of liquids and juices can reduce the symptoms.

• Avoid caffeine and alcohol.

• Avoid certain foods such as dairy products, fatty foods, and high fiber foods.

• Over-the-counter anti-diarrheal medications such as Loperamide and Bismuth salicylate help reduce the frequency of watery stools.

• Probiotics available in capsule or liquid form can be taken to restore the healthy bacteria in the intestinal tract.

What Are the Complications of Diarrhea?

If untreated, diarrhea causes dehydration which can be life-threatening.

Dehydration is dangerous in children, older adults, and those with weak immune systems.

Symptoms of dehydration in infants and children include:

• Fever above 39 degrees Celsius.

• Crying without tears.

• Not having a wet diaper for three or more hours.

• Dry mouth and tongue.

• The sunken appearance of abdomen, skin, and cheeks.

• Drowsiness or irritability.

Symptoms of dehydration in adults include:

• Excessive thirst.

• Dry skin and mouth.

• Little or no urination.

• Fatigue.

• Dizziness.

• Dark-colored urine.

Conclusion:

There are many causes of diarrhea, and mostly diarrhea can be prevented by maintaining good personal hygiene and handwashing. Therefore, treatment mainly focuses on hydrating the patient.

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