Diarrhoea can be unpleasant, but it’s very common. If you have the most common type – that is, acute diarrhoea – it doesn’t usually last for long. Medically speaking, acute (or short-term) diarrhoea is when you have the symptoms for four weeks or less. The symptoms usually start suddenly, but they often ease within a few days to a week.
Since it’s so common, most people are aware of the symptoms of diarrhoea, the main one being the frequent passing loose or watery stools. Some people are affected by other symptoms too, including stomach pain, nausea, vomiting, a high temperature and headache, not to mention a lack of appetite.
You may experience diarrhoea when fluid from the contents of your bowel cannot be absorbed or when your bowel contains extra fluid. There are several reasons why this may happen. For instance, you may have a tummy bug such as a virus (for example norovirus, the so-called winter vomiting bug) or food poisoning caused by bacteria such as E.coli or salmonella. There are parasites that can cause the symptoms of diarrhoea too, such as Giardia intestinalis. All of these infections are also common causes of illness when people travel abroad.
But there are other, perhaps less obvious, things that can cause acute diarrhoea, including stress and anxiety. These may cause diarrhoea because they make food waste pass too quickly through your intestines (i). Drinking too much alcohol can also bring on a bout.
Diarrhoea can be distressing enough in itself, but it rarely needs any medical treatment. However, it can lead to something potentially more serious, namely dehydration. This happens because diarrhoea causes a lack of fluid in the body. Mild dehydration is fairly common and can be easily treated by drinking plenty of fluids. Severe dehydration, on the other hand, is very serious and can even be fatal if left untreated.
If you have mild dehydration, you may feel tired, dizzy, weak and have a headache; plus your mouth and tongue may feel dry and you may not pass very much urine. But if you become severely dehydrated, you may feel confused and your heartbeat may quicken. And if you don’t get immediate emergency medical help, you may fall into a coma. You should also seek medical help in any of the following circumstances:
You have diarrhoea accompanied by persistent vomiting
You have diarrhoea accompanied by persistent or severe stomach pain
You notice blood in your stools
Your stools are very dark or black
Long-term diarrhoea (chronic)
Persistent or chronic diarrhoea means diarrhoea that lasts longer than acute diarrhoea (it’s usually defined as symptoms that last for four weeks or more, though some experts claim diarrhoea is chronic when it lasts for more than 14 days (ii)). It’s estimated around two to five per cent of people with diarrhoea have the chronic condition (ii).
Unlike acute diarrhoea, chronic diarrhoea is usually caused by one of many medical conditions, including the following:
Irritable bowel syndrome (IBS). Discover more about the symptoms of IBS on your body.
Chronic infection (including hookworm or giardiasis)
Other things that may cause diarrhoea – chronic and sometimes also acute – include taking certain medicines such as antibiotics, antacids, anti-inflammatory painkillers (NSAIDs), some types of antidepressants and cholesterol-lowering medicines called statins. Chronic diarrhoea is also a common side effect of alcohol abuse.
If you’re affected by persistent diarrhoea, see your GP, as you may have a more serious underlying condition.
How diarrhoea is treated?
Chronic (long-lasting) diarrhoea needs further investigation to rule out the various medical conditions that may be causing it. But if you have diarrhoea that only lasts for a few days – and your temperature is normal – you may not need any treatment, or you could take a simple over-the-counter remedy.
While you have diarrhoea, it’s really important to keep drinking fluids to replace those you’re losing. Taking frequent sips of fluids such as water or swuash will help to prevent dehydration. For instance, try drinking fruit juice diluted with water or some clear soup (don’t, however, give fruit juice to children with diarrhoea, as it can make their symptoms worse). One way to tell whether you’re getting enough fluid is to check the colour of your urine. If you’re sufficiently hydrated, it should be a very light yellow colour or almost clear.
Eat if you feel like it
Years ago, health experts used to advise people with diarrhoea to eat nothing for 24 hours. But these days starving isn’t recommended, and you should try to eat small amounts of solid foods if you can, but avoid anything that’s too rich, fatty or spicy at first, as it could make your symptoms worse. There again, if you don’t feel like eating, don’t force yourself (but don’t stop eating for more than a few days).
Try over-the-counter remedies
Most cases of acute diarrhoea pass without the need for any medicines. But there are instances when you may need to control your symptoms quickly – if you have an important appointment, for example, or your symptoms are affecting your day-to-day activities. Here are the most common remedies used to reduce diarrhoea symptoms and to shorten its duration:
Loperamide - This is a medicine in capsule form that helps to slow down the movement of muscles in the intestines. It can help to shorten the amount of time you have diarrhoea by around 24 hours. However, loperamide should not be given to children.
Bismuth subsalicylate - This is also used to control diarrhoea, but avoid taking it alongside other medicines, including aspirin and other salicylates.
Rehydration solutions - If you’re worried about dehydration, you can buy oral rehydration solutions over the counter. These replace not only water but also glucose, sodium and potassium, which your body loses when you have diarrhoea. However, they don’t help to relieve diarrhoea symptoms. The salts come in sachets, so follow the instructions of how to take them carefully. They are particularly recommended for older people and young children, who are more prone to diarrhoea-related dehydration than the rest of the population.
Lifestyle tips for diarrhoea
You may not always be able to prevent a bout of diarrhoea, but there are some things you can do that may help you avoid it whenever possible.
It may sound obvious, but if you know a certain type of food upsets your stomach and causes diarrhoea, the easiest way to prevent another bout is to avoid eating it. For instance, many experts believe rich and spicy foods are the most common dietary causes of diarrhoea. So try to choose something that will treat your digestive system more gently. Other foods you may want to consider eating less of include caffeine (tea, coffee, chocolate), dairy foods, wheat, red meat, fizzy drinks and alcohol. Some people find eating a lot of foods that are high in insoluble fibre – which includes fruit, vegetables, beans and pulses – can also cause digestive discomfort and diarrhoea. If you suffer from diarrhoea more than just occasionally, but you don’t know what’s causing it, try keeping a food and symptoms diary to find out if your diet is to blame.
These days, stress is a part of everyday life and very few people are immune to its effects. Since stress and anxiety are common triggers of diarrhoea, it therefore makes sense to try and find ways of coping with pressure that may result in fewer stomach upsets.
Listening to music
This is one way to feel calmer – as long as you listen to something soothing rather than stimulating. Taking a short nap is also thought to help lower your blood pressure, making you feel more relaxed. Or you could try watching or reading something that makes you laugh, as laughter is also thought to help you feel more calm. Click here to find out more about stress.
Practice good hygiene
If a diarrhoea-causing infection is doing the rounds, washing your hands thoroughly and frequently could help stop you from becoming infected. Indeed, regular hand washing is widely accepted as a way to significantly reduce your chances of developing infectious diarrhoea. Wash your hands with soap and water or use antibacterial gel or wipes every time you come into contact with someone who has diarrhoea, and don’t share towels, flannels, bedclothes, plates or crockery with them. Also wash your hands after you’ve been gardening and after playing with pets, as even healthy animals can carry harmful bacteria.
On the other hand, if you have diarrhoea caused by a viral or bacterial infection, you can help avoid spreading it to others by practicing the same hygiene measures too.
Meanwhile, the risk of getting diarrhoea caused by food poisoning can also be reduced by following good food hygiene practices.
Natural remedies for diarrhoea
Keeping your digestive system healthy is considered to be the best way to reduce your risk of having episodes of acute diarrhoea. And according to many experts, one of the ways of doing just that may be to take certain nutritional supplements.
Products containing live bacteria such as L acidophilus, L casei, S boulardii and B bifidus are thought to act as a barrier against any potentially harmful bacteria that pass through your digestive system and work to prevent the growth of harmful organisms, which helps to prevent intestinal infections.
These beneficial live bacteria are widely available in powder, liquid, capsule or tablet form, as well as in certain dairy-based food products. Indeed, many clinical studies suggest taking such supplements may be an effective way to protect against a variety of gut and intestinal problems, including diarrhoea (iii) and travellers’ diarrhoea (iv). Studies also show that certain live bacteria supplements may help prevent diarrhoea associated with antibiotics (v).
These are starches containing soluble fibre that the body cannot fully digest. Instead, the undigested parts provide nourishment for your intestinal bacteria, which can help to keep your digestive system healthy. There is some evidence that it may be useful for preventing traveller’s diarrhoea (vi), plus some experts believe it may help reduce diarrhoea and vomiting in young children (vii). FOS is available as a nutritional supplement – often in powder form – but you can also find it in foods such as asparagus, Jerusalem artichoke, leeks, onions and soya beans.
Managing diarrhoea can be a difficult task, but these steps should point you in the right direction. For more information on a range of other health conditions, please visit our health library.
Available online: https://patient.info/doctor/chronic-diarrhoea-in-adults
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Waligora-Dupriet AJ, Campeotto F, Nicolis I, et al. Effect of oligofructose supplementation on gut microflora and well-being in young children attending a day care centre. Int J Food Microbiol. 2006 Sep 20.
Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
Christine Morgan has been a freelance health and wellbeing journalist for almost 20 years, having written for numerous publications including the Daily Mirror, S Magazine, Top Sante, Healthy, Woman & Home, Zest, Allergy, Healthy Times and Pregnancy & Birth; she has also edited several titles such as Women’ Health, Shine’s Real Health & Beauty and All About Health.