What is diarrhea?
Diarrhea—loose, watery stools occurring more than three times in one day—is a
common problem that usually lasts a day or two and goes away on its own without
any special treatment. However, prolonged diarrhea can be a sign of other
problems. People with diarrhea may pass more than a quart of stool a day.
Diarrhea can cause dehydration, which means the body lacks enough fluid to
function properly. Dehydration is particularly dangerous in children and the
elderly, and it must be treated promptly to avoid serious health problems. (See
"What is dehydration?")
People of all ages can get diarrhea. The average adult has a bout of diarrhea
about four times a year.
What causes diarrhea?
Diarrhea may be caused by a temporary problem, like an infection,
or a chronic problem, like an intestinal disease. A few of the more common
causes of diarrhea are:
Bacterial infections. Several types of bacteria, consumed through
contaminated food or water, can cause diarrhea. Common culprits include
Campylobacter, Salmonella, Shigella, and Escherichia coli.
Viral infections. Many viruses cause diarrhea, including rotavirus,
Norwalk virus, cytomegalovirus, herpes simplex virus, and viral hepatitis.
Food intolerances. Some people are unable to digest some component of
food, such as lactose, the sugar found in milk.
Parasites. Parasites can enter the body through food or water and settle
in the digestive system. Parasites that cause diarrhea include Giardia lamblia,
Entamoeba histolytica, and Cryptosporidium.
Reaction to medicines, such as antibiotics, blood pressure medications,
and antacids containing magnesium.
Intestinal diseases, like inflammatory bowel disease or celiac disease.
Functional bowel disorders, such as irritable bowel syndrome, in which
the intestines do not work normally.
Some people develop diarrhea after stomach surgery or removal of the
gallbladder. The reason may be a change in how quickly food moves through the
digestive system after stomach surgery or an increase in bile in the colon that
can occur after gallbladder surgery.
In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes
away on its own, an extensive search for the cause is not usually necessary.
People who visit foreign countries are at risk for traveler's diarrhea, which is
caused by eating food or drinking water contaminated with bacteria, viruses, or,
sometimes, parasites. Traveler's diarrhea is a particular problem for people
visiting developing countries. Visitors to the United States, Canada, most
European countries, Japan, Australia, and New Zealand do not face much risk for
traveler's diarrhea. (See "Preventing Traveler's Diarrhea.")
What are the symptoms?
Diarrhea may be accompanied by cramping abdominal pain,
bloating, nausea, or an urgent need to use the bathroom. Depending on the cause,
a person may have a fever or bloody stools.
Diarrhea can be either acute (short-term) or chronic (long-term). The acute
form, which lasts less than 4 weeks, is usually related to a bacterial, viral,
or parasitic infection. Chronic diarrhea lasts more than 4 weeks and is usually
related to functional disorders like irritable bowel syndrome or inflammatory
bowel diseases like celiac disease.
Diarrhea in Children
Children can have acute or chronic forms of diarrhea. Causes
include bacteria, viruses, parasites, medications, functional disorders, and
food sensitivities. Infection with the rotavirus is the most common cause of
acute childhood diarrhea. Rotavirus diarrhea usually resolves in 3 to 9 days.
Medications to treat diarrhea in adults can be dangerous to children and should
be given only under a doctor's guidance.
Diarrhea can be dangerous in newborns and infants. In small children, severe
diarrhea lasting just a day or two can lead to dehydration. Because a child can
die from dehydration within a few days, the main treatment for diarrhea in
children is rehydration. (See "Preventing Dehydration".)
Take your child to the doctor if any of the following symptoms appear:
- stools containing blood or pus, or black stools
- temperature above 101.4 degrees Fahrenheit
- no improvement after 24 hours
- signs of dehydration (see below)
What is dehydration?
General signs of dehydration include:
- less frequent urination
- dry skin
- dark colored urine
Signs of dehydration in children include:
- dry mouth and tongue
- no tears when crying
- no wet diapers for 3 hours or more
- sunken abdomen, eyes, or cheeks
- high fever
- listlessness or irritability
- skin that does not flatten when pinched and released
If you suspect that you or your child is dehydrated, call the
doctor immediately. Severe dehydration may require hospitalization.
When should a doctor be consulted?
Although usually not harmful, diarrhea can become dangerous or
signal a more serious problem. You should see the doctor if any of the following
- You have diarrhea for more than 3 days.
- You have severe pain in the abdomen or rectum.
- You have a fever of 102 degrees Fahrenheit or higher.
- You see blood in your stool or have black, tarry stools.
- You have signs of dehydration.
If your child has diarrhea, do not hesitate to call the doctor
for advice. Diarrhea can be dangerous in children if too much fluid is lost and
not replaced quickly.
What tests might the doctor do?
Diagnostic tests to find the cause of diarrhea include the
- Medical history and physical examination.
The doctor will need to know about your eating habits and medication use and
will examine you for signs of illness.
- Stool culture. Lab technicians analyze a sample of
stool to check for bacteria, parasites, or other signs of disease or
- Blood tests. Blood tests can be helpful in ruling
out certain diseases.
- Fasting tests. To find out if a food intolerance
or allergy is causing the diarrhea, the doctor may ask you to avoid lactose
(found in milk products), carbohydrates, wheat, or other foods to see
whether the diarrhea responds to a change in diet.
- Sigmoidoscopy. For this test, the doctor uses a
special instrument to look at the inside of the rectum and lower part of the
- Colonoscopy. This test is similar to sigmoidoscopy,
but the doctor looks at the entire colon.
What is the treatment?
In most cases, replacing lost fluid to prevent dehydration is
the only treatment necessary. (See "Preventing Dehydration" below.) Medicines
that stop diarrhea may be helpful in some cases, but they are not recommended
for people whose diarrhea is caused by a bacterial infection or
parasite—stopping the diarrhea traps the organism in the intestines, prolonging
the problem. Instead, doctors usually prescribe antibiotics. Viral causes are
either treated with medication or left to run their course, depending on the
severity and type of the virus.
Dehydration occurs when the body has lost too much fluid and electrolytes (the
salts potassium and sodium). The fluid and electrolytes lost during diarrhea
need to be replaced promptly—the body cannot function properly without them.
Dehydration is particularly dangerous for children, who can die from it within a
matter of days.
Although water is extremely important in preventing dehydration, it does not
contain electrolytes. To maintain electrolyte levels, you could have broth or
soups, which contain sodium, and fruit juices, soft fruits, or vegetables, which
For children, doctors often recommend a special rehydration solution that
contains the nutrients they need. You can buy this solution in the grocery store
without a prescription. Examples include Pedialyte, Ceralyte, and Infalyte.
Preventing Traveler's Diarrhea
Traveler's diarrhea happens when you consume food or water
contaminated with bacteria, viruses, or parasites. You can take the following
precautions to prevent traveler's diarrhea when you go abroad:
- Do not drink any tap water, not even when brushing your
- Do not drink unpasteurized milk or dairy products.
- Do not use ice made from tap water.
- Avoid all raw fruits and vegetables (including lettuce
and fruit salad) unless they can be peeled and you peel them yourself.
- Do not eat raw or rare meat and fish.
- Do not eat meat or shellfish that is not hot when served
- Do not eat food from street vendors.
You can safely drink bottled water (if you are the one to
break the seal), carbonated soft drinks, and hot drinks like coffee or tea.
Depending on where you are going and how long you are staying, your doctor may
recommend that you take antibiotics before leaving to protect you from possible
Points to Remember
- Diarrhea is a common problem that usually resolves on its
- Diarrhea is dangerous if a person becomes dehydrated.
- Causes include viral, bacterial, or parasitic infections;
food intolerance; reactions to medicine; intestinal diseases; and functional
- Treatment involves replacing lost fluids and
electrolytes. Depending on the cause of the problem, a person might also
need medication to stop the diarrhea or treat an infection. Children may
need an oral rehydration solution to replace lost fluids and electrolytes.
- Call the doctor if a person with diarrhea has severe pain
in the abdomen or rectum, a fever of 102 degrees Fahrenheit or higher, blood
in the stool, signs of dehydration, or diarrhea for more than 3 days.
Tips About Food
Until diarrhea subsides, try to avoid milk products and foods that are greasy,
high-fiber, or very sweet. These foods tend to aggravate diarrhea.
As you improve, you can add soft, bland foods to your diet,
including bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots,
and baked chicken without the skin or fat. For children, the pediatrician may
recommend what is called the BRAT diet: bananas, rice, applesauce, and toast.
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Nutritional and Herbal Therapy for Diarrhea
According to the
Tao of Nutrition, you can consume the following to help relieve
diarrhea, especially chronic diarrhea:
- Make a rice porridge with lotus seed and yam or barley
- Eat burnt rice or bread
- Eat 2 tablespoons of dried apples three times a day with
water and on an empty stomach
- Drink a tea from ginger, fennel, basil and Chinese Black
- Drink black tea
It's important to eat foods that are rich in potassium since
diarrhea tends to cause lowered potassium levels in the body. Potassium is a
mineral that plays an important role in fluid balance, nerve conduction and
muscle contraction. The following potassium-rich foods are:
It is also recommended that you take a lactobacillus
supplement to help balance the flora in your gut.
For chronic diarrhea, the Chinese herbal formula,
Bloat by Traditions of Tao, is an excellent choice. It's safe and
gentle for long-term use. Another effective formula for chronic diarrhea,
especially loose stools, is
by Traditions of Tao.
Tao of Nutrition, by Maoshing Ni, Ph.D., C.A., and Cathy McNease,