GASTROINTESTINAL
Diarrhea
What is Diarrhea?
Diarrhea is a term we use to describe loose or watery stools (numbers 5-7 on the Bristol Stool Chart below). If you have diarrhea for too long, you can become dehydrated – this is particularly concerning in the very young (children) and in older adults. Diarrhea can happen for a variety of reasons but is often associated with either something you've eaten or acute illnesses like a viral or bacterial infection.
Acute Diarrhea
This is the type of diarrhea that doesn't last very long. It can be caused by infections (bacterial or viral gastroenteritis), food intolerance or eating greasy foods, reactions to medications or parasitic infections. Acute diarrhea usually last for a few days but less than 4 weeks.
Chronic Diarrhea
This is the type of diarrhea that lasts for weeks to months. It can be persistent or it can be intermittent (can come and go). This type of diarrhea is usually caused by other digestive problems like Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Diseases like Crohn's or Ulcerative Colitis. It could also be caused by something like Celiac disease, food intolerance (ex. Lactose), medications, hyperthyroidism and other medical conditions. People who have had their gallbladder removed can develop chronic diarrhea.
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It may sound silly, but severe constipation can also cause diarrhea. If you have a large amount of stool in your rectum, it can cause a fecal impaction. This is like a large brick of stool that creates a blockage. The stool behind this blockage seeps through and can come out as liquid stool "accidents".
Traveller's Diarrhea
Travelling to tropical or undeveloped countries can put you at risk for Traveller's Diarrhea. Consuming water or food that is contaminated with viruses or bacteria can cause profuse diarrhea and completely ruin your trip. This type of diarrhea is typically unrelenting and watery. There is an oral vaccine you can take to help protect you from Traveller's Diarrhea – plan ahead and speak to your doctor before you travel. You can also get a just-in-case prescription of antibiotics that might help if you get traveller's diarrhea on your trip.
Treating Diarrhea at Home
Most cases of acute diarrhea will resolve on their own within a couple days. Keep yourself hydrated with water and electrolyte drinks as much as you can. If you develop symptoms of dehydration (feeling more thirsty, having dark, concentrated urine), you should see a doctor. There are some over-the-counter remedies for diarrhea. Loperamide (Imodium) should not be used if you think you have diarrhea from food poisoning – in this case it is better to let it all out so the toxins can exit your body and stop making you sick.
Bulking agents like Metamucil can be helpful in slowing down diarrhea.
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Wait a minute? Didn't we tell you that Metamucil was for constipation?
Yes. Metamucil can work for both diarrhea and constipation!
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It bulks up your stool which can help you to go more regularly, but can also help slow down diarrhea.
Other things that may help your diarrhea:
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Avoid caffeine, milk products and greasy foods
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Stay away from artificial sweeteners and fruit juice
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Try a BRAT diet for acute diarrhea (bananas, rice, applesauce and toast)
When to See a Doctor
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Your diarrhea is accompanied by fever and lasts more than 2 days
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There is blood in your diarrhea stools
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Your diarrhea lasts more than 7 days
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You have signs of dehydration like excessive thirst, fatigue, dark coloured urine and/or feel lightheaded
Children may show different signs of dehydration:
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Fewer wet diapers through the day
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No tears when they cry
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Sunken looking eyes
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Dry mouth
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Lethargy
Diagnosing the Cause of Diarrhea
Our section on diarrhea in children is currently under construction, but here is a handout from the experts at CHEO:
CHEO Diarrhea in children
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HEAL – Vomiting and Diarrhea:
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For more information on diarrhea in children:
John Hopkins Medicine Diarrhea in Children
If you have acute diarrhea, no testing needs to be done. If your diarrhea is severe, causes dehydration or persists and/or becomes chronic, your doctor may want to do some tests including:
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Blood tests to rule out certain diseases and see if you are dehydrated
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Stool cultures to see if you have bacteria or parasites in your body that can be causing your diarrhea
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Your doctor may also ask you to keep a food diary to see if they can pinpoint patterns, like certain foods you are eating that could be causing your diarrhea. If you want to speed things up, you should fill out a food diary while you wait to see your doctor. The CDC has a simple one you can use:
There are also apps you can use to track your bowel movements, such as the Bowelle app: