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Diarrhea

by Cynthia M. Johnson, MA
En Español (Spanish Version)
Definition
Causes
Risk Factors
Symptoms
Diagnosis
Treatment
Prevention

Definition

Diarrhea is more than three loose, liquid stools in one day. It causes the body to lose fluids and electrolytes. Diarrhea can be:

  • Acute—sudden and brief
  • Chronic—long term
  • Recurring—diarrhea that comes and goes over time

Fluid loss can lead to dehydration. This can be dangerous for babies, young children, and older adults.

Causes

Causes may be:

Risk Factors

Things that may raise the risk of this problem are:

  • Traveling to a developing country where the water and food supply may be contaminated
  • Taking certain medicines
  • Being in a hospital
  • Having a severely weakened immune system, such as with AIDS or after an organ transplant

Symptoms

Problems may be:

  • Frequent loose, liquid stools
  • Belly pain and cramping
  • An urgent need to have a bowel movement
  • Blood and mucus in the stool
  • Fever
  • Nausea and vomiting
  • Muscle aches and pains
  • Weight loss

When Should I Call My Doctor?

Call your doctor if you:

  • Have diarrhea that lasts longer than three days
  • Are not able to eat or drink to stay hydrated
  • Have a fever

Call your doctor if your young child:

  • Has diarrhea that lasts longer than a day
  • Has pus in his or her stool
  • Does not have wet diapers
  • Is crying without tears
  • Is unusually sleepy or irritable
  • Has a fever

When Should I Call for Medical Help Right Away?

Call for medical help or go to the emergency room right away if you or your child has:

  • Severe belly pain and cramping
  • Bloody or black stool

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. The doctor may insert a gloved finger into the rectum to examine it. This is called a digital rectal exam.

The doctor may ask these questions to find the cause of diarrhea:

  • Does anyone else in the family have diarrhea?
  • What kinds of food and drinks have you had?
  • Do your children attend daycare?
  • Have you traveled recently?
  • What is your sexual history?

Blood tests and stool tests may be done.

The rectum and colon may need to be examined. This can be done with:

A biopsy may also be taken.

Images may be taken of the colon. This can be done with:

Barium Enema
Radiology colon

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Treatment

Any underlying cause will need to be treated.

The goal of treatment is to ease diarrhea and prevent dehydration. Choices are:

  • An oral rehydration solution to replace lost fluids
  • Dietary changes, such as a clear diet and avoiding foods that trigger diarrhea
  • Antidiarrheal medicine
  • Probiotics

Prevention

The risk of diarrhea may be lowered by:

  • Practicing proper hand hygiene
  • Practicing safe food preparation and storage
  • Taking care when traveling, such as:
    • Drinking bottled water and avoiding drinks with ice
    • Avoiding foods from street vendors
    • Not eating raw vegetables or fruits
    • Cooking foods well
    • Only eating pasteurized dairy products

Rotavirus is a common cause of diarrhea in children under 5 years of age. The rotavirus vaccine can prevent it.

RESOURCES:

Family Doctor—American Academy of Family Physicians
http://familydoctor.org

National Institute of Diabetes and Digestive and Kidney Disorders
http://www.niddk.nih.gov

CANADIAN RESOURCES:

The College of Family Physicians of Canada
http://www.cfpc.ca

Health Canada
https://www.canada.ca

REFERENCES:

Acute diarrhea in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/acute-diarrhea-in-adults. Accessed February 9, 2021.

Diarrhea. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/diarrhea.html. Accessed February 9, 2021.

Diarrhea. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea. Accessed February 9, 2021.

Rotavirus vaccines. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccinesafety/vaccines/rotavirus-vaccine.html. Accessed February 9, 2021.

Shane AL, Mody RK, et al. 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):e45-e80.

Last reviewed December 2020 by EBSCO Medical Review Board James P. Cornell, MD  Last Updated: 2/9/2021