Diarrhea

Several soft, semiformed stools each day or frequent, watery stools throughout the day and even the night is generally called diarrhea. For people in the Western World, the usual amount of water in stool each day is generally no more than 200 ml or 7 oz. (8 oz. = 1 cup). When it is consistently more than this, it is called diarrhea in the medical field.

There are many causes of diarrhea. Fortunately, in most instances, this change in bowel habits is short lived and clears up on its own. In these cases, it is assumed that it is a virus infection or even “something I ate.” Whenever diarrhea lasts more than two or three weeks, medical advice is generally recommended. Among the many known causes are:

Most people have certain foods that may be the main cause of diarrhea. For hot pepper lovers (the chemical in it is called capsaicin), diarrhea often occurs the morning after. Many people are intolerant of milk and milk products so that even small amounts of the milk sugar lactose can cause diarrhea. Large amounts of fatty foods cause the same problem in other people. The best treatment for diarrhea in all these instances is to avoid the offending agent.

Many prescription and OTC medication such as Maalox or Mylanta containing magnesium can cause diarrhea. Sorbitol is an artificial sweetener that is used in sugar free gum and prepared foods such as jams and jellies. If a change in bowel habit occurs after taking a new drug, the physician should be contacted. In particular, antibiotics are known to cause diarrhea, at times quite severe. Diarrhea can develop up to one month after taking antibiotics. Infection: There are over hundreds of different bacteria that normally live quietly and beneficially in the large intestine. There are also many viruses and other infectious agents that find their way into our bodies. Some of these can infect the intestinal tract and cause diarrhea. Many times these infections improve without treatment. Some bacterial infections, such as salmonella, E. coli and C. diff are serious and require medical evaluation. Salmonella commonly comes from contaminated poultry. There are parasites, such as amoeba and giardia, attack the intestines. Giardia may be found in wild animals and in contaminated streams and well water. Virus infection is probably the most common cause of short term diarrhea and, fortunately, it usually clears up on its own. There are certain intestinal diseases that can cause chronic diarrhea. These include ulcerative and microscopic colitis, Crohn’s disease, diverticulosis, and even colon cancer. These are all serious diseases that require careful medical attention and treatment. It is a major reason why the cause of chronic diarrhea should always be known. Stress and Irritable Bowel Syndrome (IBS): IBS is a problem that occurs when the intestines, especially the colon do not contract in a smooth, rhythmic manner. The contractions can be exaggerated in which case diarrhea occurs or they may be sluggish and result in constipation. Sometimes there is alternating constipation and diarrhea. Emotional stress often aggravates these symptoms. The cause and treatment of diarrhea may be very simple, such as discontinuing magnesium- containing antacids. Or it may be more difficult. Testing of blood and stool may be needed. X-rays and ultrasound may also be necessary. Colonoscopy and capsule endoscopy can reveal many causes of colonic and small bowel diarrhea. There are simple things that can be done at the beginning of a diarrheal episode which may help reduce symptoms. Taking only liquids by mouth and avoiding solid food and milk may be helpful. Over-the-counter constipating agents, such as Pepto-Bismol, Kaopectate, or Imodium can also be tried. For explosive or persistent condition, diarrhea treatment will obviously depend on the cause. The best medicine for diarrhea can be recommended depending on the patient’s condition. Fortunately, the cause of diarrhea can almost always be found and effective treatment is then usually available.

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