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What is Diarrhea?

Diarrhea is loose, watery stools (bowel movements).  If you have loose stools three or more times in one day it is considered having diarrhea. Acute diarrhea is an increased number of stools or looser form than is customary for the patient, lasting less than 2 weeks, and often associated with abdominal symptoms such as cramping, bloating, and gas.  Diarrhea lasting more than a few days may be a sign of a more serious problem.  Chronic diarrhea lasts at least four weeks and can be the symptoms of a more serious disease.


What Are The Causes of Diarrhea?

The most common causes of diarrhea include

  • Parasites
  • Contaminated food or water
  • Viruses such as the flu, norovirus, or rotavirus
  • Food intolerances and sensitivities
  • Problems with how the colon functions, such as irritable bowel syndrome
  • Medicines such as antibiotics, cancer drugs, and antacids that contain magnesium
  • Diseases that affect the stomach, small intestine, or colon, such as Crohn’s disease


Causes of Acute Diarrhea

Acute, watery diarrhea is usually caused by a virus (viral gastroenteritis).  Medications such as antibiotics and drugs that contain magnesium products are also common offenders. Recent dietary changes can also lead to acute diarrhea. These including intake of coffee, tea, colas, dietetic foods, gums or mints that contain poorly absorbable sugars. Acute bloody diarrhea suggests a bacterial cause like Campylobacter, Salmonella or Shigella. Eating contaminated foods such as ground beef or fresh fruit can cause diarrhea due to E.coli 0157:H7. Diarrhea associated with recent antibiotic use suggests an infection with Clostridium difficile.


Causes of Chronic Diarrhea

There are many causes of chronic diarrhea, including carbohydrate malabsorption such as lactose, sorbitol, and fructose intolerance, intestinal infections or Irritable Bowel Syndrome. Certain medications such as NSAIDs, antacids, antihypertensives, antibiotics, and antiarrhythmics can cause diarrhea in some people.

Symptoms of abdominal bloating and excessive gas after consuming dairy products suggest lactose intolerance. This condition is more common in African-Americans and Asian-Americans. Certain soft drinks, juices, dried fruits, and gums contain sorbitol and fructose, which can lead to chronic diarrhea in people with sorbitol and fructose intolerance.

Intestinal infections such as giardiasis, opportunistic infections in someone with HIV can cause chronic diarrhea. Diabetes mellitus may be associated with diarrhea due to nerve damage and bacterial overgrowth; this occurs mainly in patients with long-standing, poorly-controlled diabetes.

Irritable Bowel Syndrome (IBS) is a condition often associated with frequent stools, alteration in bowel habits, and abdominal pain. These symptoms are key features of this syndrome, though many with IBS have constipation rather than diarrhea. Emotional or physiologic distress can worsen IBS symptoms. IBS is recognized as a motility disorder where no anatomic or organic diseases are found to account for the symptoms.


What Are The Signs and Symptoms of Diarrhea?

If your diarrhea is caused by a virus or bacteria, you may have a fever and chills. Other possible symptoms of diarrhea include:

  • Cramps or pain in the abdomen
  • An urgent need to use the bathroom
  • Loss of bowel control


What Are The Risk Factors of Diarrhea?

People of all ages can get diarrhea. But, people who visit developing countries are at risk for traveler’s diarrhea caused by consuming contaminated food or water.


How is Diarrhea Diagnosed?

To find the causes we would take these steps to find the root of your issue…

  • Do a physical exam
  • Ask about medications
  • Test your stool or blood to look for bacteria, parasites, or other signs of disease or infection
  • Ask you to stop eating certain foods to see whether your diarrhea goes away


Are There Preventative Steps To Avoid Diarrhea?

Rotavirus diarrhea can be treated and prevented in two or three doses of the rotavirus vaccine.  Traveler’s diarrhea can be prevented by being careful about what you ingest when you are in developing countries.  Do NOT use tap water, use bottled water for drinking and brushing teeth. Eat hot, fully cooked foods and avoid unwashed fruits and vegetables.


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Meet Jennifer Bonheur, MD

Dr. Jennifer Bonheur is a board-certified gastroenterologist who loves her work and values her relationships with her patients. As a female gastroenterologist, she strives to connect and treat the patient and not simply the illness. Dr. Bonheur offers specialized care in gastroenterology and therapeutic endoscopy. Together with her staff, she is committed to providing the highest quality medical care in a comfortable, professional and personalized environment. Learn More »