Diarrhea

Table of Content

Diarrhea

Diarrhea: Around the World

  • Diarrhea is usually no more than a minor discomfort and is rarely fatal in developed countries. However, in countries without adequate hygiene and sanitation, diarrhea is a cause for concern. In Asia, Africa and Latin America, diarrhea claims the lives of 12,600 children every day.
  • Worldwide, diarrheal diseases are second only to cardiovascular diseases as a cause of death.

 

Describing Diarrhea

  • Our digestive system has a remarkable capacity to absorb fluids. Each day, around 9-10 liters of fluid enter the digestive system, but it is estimated that only a liter reaches the far end of the digestive system and, of this, only one-tenth is thrown out of the body. A loss in our digestive system's ability to absorb this fluid will result in wetter stools.
  • Many medicines, toxins, infectious microorganisms and even food can affect the absorption of fluid and electrolytes. This leads to diarrhea.

 

Causes of Diarrhea

  • It is not always possible to identify the cause of diarrhea in most people. Often, people will improve without treatment.
  • Diarrhea can be caused by infections that enter the body through food or water that is contaminated with a harmful organism. Usually, signs and symptoms appear within 12 hours to 4 days after consuming something that may contain harmful organisms.
  • Diarrhea is also a common side effect of medications used to treat other health conditions. More than 700 medicines are known to cause diarrhea, and common drugs associated with this problem include antibiotics, antihypertensives and antidepressants.
  • Sometimes, food allergies may also be a cause of diarrhea for some people.

 

Symptoms of Diarrhea

  • Nausea
  • Abdominal pain
  • Fever
  • Bloody stools
  • Urgency to pass stools
  • Change from normal stool consistency to soft or watery stools

 

Important Things your Doctor Needs to Know From you

  • When did the symptoms start?
  • For how long have the symptoms been there?
  • How frequent are the symptoms?
  • Approximate amount of stool passed
  • Description of stool, e.g., floating, offensive smelling, has oil droplets, blood, mucus, pus
  • Have you been recently hospitalized?
  • Are you taking any other medication?
  • Any changes in your diet?
  • Have you lost weight recently?
  • Is there stomach pain?

 

Diagnosis

Most of the time, no tests are required to diagnose the cause of diarrhea since this condition usually goes away by itself within 5 days. However, sometimes, your doctor may recommend the following tests to rule out other conditions that may be present or to narrow down the cause of your symptoms:

  • Full blood count,
  • Urea and electrolytes
  • Liver function tests
  • C-reactive protein
  • Erythrocyte sedimentation rate

 

Treatment of Diarrhea

Fluid and Electrolytes Replacement

This is the first step recommended as, often, patients with diarrhea will be dehydrated from the excessive loss of fluid. It is important to replenish this loss by using oral rehydration fluids.

Anti-Diarrheal Drugs

You may be given medications that reduce the diarrhea. They are safe if the diarrhea occurs without fever and the stools are not bloody.

Antibiotic Therapy

If an infection is suspected to be the cause of diarrhea, a doctor may prescribe antibiotics. It is important to note that not all diarrheas are caused by infections and the unnecessary use of antibiotics can cause harm.

Diet

There is no particular food or group of foods that is best while you have diarrhea. However, adequate nutrition is important during an episode of acute diarrhea. If you do not feel like eating solid foods, you can drink only liquids for a short period of time. Boiled starches and cereals (e.g., potatoes, rice and wheat) with salt are recommended if you have watery diarrhea. You may also have bananas, soups and boiled vegetables.

Preventing the Spread of Diarrhea

Preventing Spread

Diarrhea is infectious for as long as it lasts. It's important to be careful so as not to spread diarrhea to people around you.

Diarrhea is spread by touching contaminated surfaces and then touching the mouth. To prevent its spread, thorough hand washing, taking care while changing diapers and staying away from work or school are important points to consider.

Hand Washing

Throughout the day we interact with our surroundings coming in contact with people, surfaces and objects, this tends to let germs accumulate on our hands. These germs can infect us when we touch our eyes, nose or mouth. It's not possible to be completely germ free all the time, but washing hands frequently will help reduce the transfer of bacteria, viruses and other microbes.

How to Wash your Hands?

Soap and water is usually sufficient for hand washing. These simple steps will ensure your hands are clean:

  • Wet your hands with running water.
  • Apply liquid, bar or powder soap.
  • Lather well.
  • Rub your hands vigorously for at least 20 seconds. Remember to scrub all surfaces, including the backs of your hands, wrists, between your fingers and under your fingernails.
  • Rinse well.
  • Dry your hands with a clean or disposable towel or air dryer.
  • If possible, use your towel to turn off the faucet/tap.

Reducing the Risk of Diarrhea

The following precautions can reduce the risk of diarrhea:

  • Do not drink raw (unpasteurized) milk or eat foods that contain unpasteurized milk.
  • Wash raw fruits and vegetables thoroughly before eating.
  • Keep the refrigerator temperature at 40°F (4.4°C) or lower; the freezer at 0°F (-17.8°C) or lower.
  • Use pre-cooked, perishable food as soon as possible.
  • Keep raw meat, fish and poultry separate from other food.
  • Wash hands, knives and cutting boards after handling uncooked food, including produce and raw meat, fish or poultry.
  • Thoroughly cook raw food from animal sources.
  • Seafood should be cooked thoroughly to minimize the risk of food poisoning.
  • Cook eggs thoroughly, until the yolk is firm.
  • Refrigerate foods promptly. Never leave cooked foods at room temperature for more than two hours (one hour if the room temperature is above 90°F/32°C).

 

Keep Yourself Safe

  • The best way to prevent diarrhea caused by an infection is to keep your hands clean and stay away from people who are sick.
  • Always wash your hands before you eat and after you use the toilet.
  • Always wash your hands after you touch pets or come in contact with their waste.
  • Practise proper hand washing (as given above in Hand washing) Wash hands with water and soap for about 20 seconds.
  • Whenever you can't wash your hands, use a hand sanitizer that contains alcohol.
  • Don't let your children put toys or other potentially contaminated objects in their mouths. Also, make sure your children wash their hands frequently as they can easily pick up and pass along germs.

 

When to Seek Help for Diarrhea?

Sometimes, the diarrhea may be severe and you will need to consult a doctor. The presence of any of the following signs should prompt you to be evaluated by a doctor:

  • Profuse watery diarrhea with signs of dehydration. Early signs of dehydration include sluggishness, becoming tired easily, dry mouth and tongue, thirst, muscle cramps, dark-colored urine, urinating infrequently, and dizziness or lightheadedness after standing or sitting up. More severe signs include abdominal pain, chest pain, confusion, or difficulty in remaining alert.
  • Many small size stools containing blood and mucus.
  • Bloody or black stools.
  • Temperature ≥38.5°C (101.3°F).
  • Passage of unformed stools for six or more times in 24 hours, or illness that lasts more than 48 hours.
  • Severe abdominal pain.

 

References

  1. Dis Mon. 1999; 45:268-299
  2. Nutrition. 1998; 14:758-762
  3. Medicine 2009; 37:23-27
  4. World J Gastroenterol 2009 July 21; 15(27):3341-3348
  5. http:// www. uptodate .com /contents/approach-to-the-adult-with-acute-diarrhea-in-developed-countries?source=search_result&search=diarrhea&selectedTitle=1 ∼ 150 as accessed on April 2012
  6. http:// www. mayoclinic. com as accessed on April 2012

The above information is not comprehensive and does not deal with all the aspects of this condition. This is not intended as a substitute for a doctor 's advice and care. Please refer to your doctor for any further queries.

 

 

 

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