What is diarrhea?
Diarrhea is the passage of loose, watery stools and/or having bowel movements more frequently than usual. Diarrhea is a common digestive symptom of a wide variety of mild to serious diseases, disorders and conditions.
Diarrhea occurs in all age groups and populations. Depending on the cause, diarrhea can be short term (acute) and disappear relatively quickly, such as when it occurs with viral gastroenteritis. Diarrhea can also be continuous or recurring over a longer period of time (chronic), such as when it occurs with inflammatory bowel disease and irritable bowel syndrome. Diarrhea can range in severity from mild and self-limiting to serious and life-threatening.
Diarrhea that is associated with bloody stool, rectal bleeding, vomiting blood, dizziness, fainting, or severe pain can be a symptom of a serious, potentially life-threatening condition. Call 911 if you, or someone you are with, are exhibiting any of these symptoms. If your diarrhea persists for more than five days or otherwise causes you concern, contact a medical professional to discuss your symptoms.
What other symptoms might occur with diarrhea?
Diarrhea may be accompanied by other symptoms, depending on the underlying disease, disorder or condition. Symptoms frequently affect the digestive tract but may also affect other body systems.
Digestive symptoms that may occur along with diarrhea
Diarrhea may accompany other symptoms affecting the digestive tract including:
- Abdominal cramping or pain
- Abdominal swelling, bloating or distention
- Fecal incontinence
- Mucus or undigested food in feces
- Nausea and vomiting
- Rectal pain or burning
- Urgent need to pass stool
Other symptoms that may occur along with diarrhea
Diarrhea may accompany symptoms related to other body systems including:
- Change in level of consciousness
- Fever and chills
- Rapid heart rate (tachycardia)
- Shortness of breath or rapid breathing (tachypnea)
- Weight loss
Serious symptoms that might indicate a life-threatening condition
In some cases, diarrhea may occur with other symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting.
Seek immediate medical care or call 911 if you, or someone you are with, are exhibiting any of these symptoms:
- Bloody or black stools
- Confusion and disorientation
- Difficulty breathing
- Fainting, change in level of consciousness, or lethargy
- High fever (higher than 101°F)
- Rapid pulse or rapid breathing
- Rectal bleeding (large amount, not just a few drops)
- Rigid, board-like abdomen
- Severe abdominal pain
- Vomiting blood or black material (resembling coffee grounds)
- Yellow skin and eyes (jaundice)
What causes diarrhea?
Diarrhea occurs when fluid you take in by mouth, or fluid produced in your gastrointestinal tract, is not properly absorbed. Normally, the intestines absorb excessive water from food during the digestive process. When food moves too fast, the intestines cannot absorb water, resulting in loose stools. Diarrhea can also occur when excessive water moves into the bowel from the body.
Conditions that can cause diarrhea include infection, malignancy, inflammation, abdominal trauma, obstruction, and the use of certain medications, such as antibiotics, stool softeners, and laxatives.
Diarrhea can result from a wide variety of gastrointestinal or digestive conditions. The most common cause of diarrhea is a viral infection of the intestines, called viral gastroenteritis (stomach flu or intestinal flu). Inflammatory bowel disease (Crohn’s disease and ulcerative colitis) and irritable bowel syndrome are other common causes of diarrhea.
Gastrointestinal causes of diarrhea
Diarrhea may arise from problems in the digestive tract including:
- Bacterial or parasitic infection of the gastrointestinal tract
- Digestive tract surgery
- Food intolerances or allergies (lactose, fructose or gluten intolerance)
- Inflammatory bowel disease (Crohn’s disease, ulcerative colitis)
- Irritable bowel syndrome
- Laxative use or abuse
- Malabsorption syndromes
- Traveler’s diarrhea
- Tumors of the small or large intestine (benign or malignant)
Medications causes of diarrhea
Drug-induced diarrhea is a common side effect of several medications including:
- Alzheimer’s cholinesterase inhibitors, such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon)
- Antibiotics, which are one of the most common causes of drug-induced diarrhea
- Heartburn drugs, including magnesium-containing antacids, H2 blockers, and PPIs (proton pump inhibitors)
- Laxatives, including osmotics, such as milk of magnesia, and stimulants, such as bisacodyl (Dulcolax)
Many other drugs can cause diarrhea, such as NSAIDs (nonsteroidal anti-inflammatory drugs), antidepressants, and immune system suppressants. Check the warnings section of prescription patient information or over-the-counter labeling for more information.
Other causes of diarrhea
Diarrhea can also be caused by problems in body systems other than the digestive tract including:
- Alcohol abuse
- Low-fat diet
- Medication side effects (often antibiotics)
- Nutritional deficiency (zinc)
- Stress or anxiety
Life-threatening conditions associated with diarrhea
In some cases, diarrhea may accompany a serious or life-threatening condition including:
- Perforated peptic ulcer
- Bleeding esophageal varices
- Severe abdominal trauma
When should you see a doctor for diarrhea?
Call your doctor if you think a drug may be causing diarrhea. It can be a sign of toxicity for some medicines. For others, there are strategies your doctor may recommend for minimizing the problem.
When an adult should see a doctor for diarrhea
For a healthy adult, diarrhea is not usually an urgent medical problem. It will typically clear up in about 1 to 3 days. An adult should seek medical care if diarrhea persists for longer than three days or if it is not improving within three days with self-care.
In certain cases, you should seek prompt medical care without waiting for three days:
- If you are elderly, pregnant, or have a weakened immune system due to a medical condition or medication
- If you have recently traveled outside the country
When your baby, toddler or child should see a doctor for diarrhea
Knowing what is normal for your baby, toddler or child can help you decide when to call the doctor. For exclusively breastfed babies, soft and loose stool is very common. Otherwise, it’s important to contact your doctor right away for diarrhea in a baby less than six months old. They can become dehydrated very quickly. For children, toddlers, and babies older than six months, check with your doctor if diarrhea lasts for more than 24 hours.
When to seek emergency medical care for diarrhea
Dehydration is the biggest danger with diarrhea because it can lead to life-threatening complications. Call 911 or go to your nearest emergency room for diarrhea when:
- You have symptoms of dehydration, including excessive thirst, dark-colored urine, urinating less than normal, headache, skin that remains raised after pinching it, or dizziness, lightheadedness or fainting
- Your child has signs of dehydration, including dry mouth and tongue, irritability, no tears with crying, no wet diapers for three hours, skin that stays tented when pinched, or sunken eyes cheeks, or soft spots
You should also see a doctor immediately for the following:
- If you or your child are vomiting blood or bloody material
- If you or your child have a fever higher than 102°F
- If you or your child have blood or pus in the stool or the stool is black and tarry
- If you or your child have severe abdominal or rectal pain
How do doctors diagnose the cause of diarrhea?
To diagnose the cause of diarrhea, your doctor will ask you several questions related to your symptoms including:
- When did your diarrhea start?
- How often are you having loose or watery stool?
- Is it constant or does it come and go?
- What, if anything, makes your diarrhea better or worse?
- Are you experiencing other symptoms, such as abdominal pain or nausea?
- Do you see blood on the toilet paper or in the toilet?
- Is your stool black?
- Have you recently been out of the country or around someone with diarrhea?
- What medications do you take? Have you started any of them recently?
Your doctor will also likely perform a physical exam. After reviewing your exam and medical history, your doctor may order several tests or exams including:
- Blood tests to check blood cell counts and electrolytes
- Stool tests to check for blood, bacteria or parasite
- Hydrogen breath test, which can detect lactose intolerance
- Fasting tests, which systematically eliminate foods to identify food sensitivities and intolerances
It is not always possible to diagnose an underlying cause or condition. If the problem persists and your provider is unable to find a cause, seeking a second opinion may give you more information and answers.
How do you treat diarrhea?
The goal of treating acute diarrhea is to prevent dehydration. This involves drinking plenty of fluids to replace what you lose in the stool. Chronic diarrhea treatment will depend on the underlying cause, such as a food intolerance or IBD (inflammatory bowel disease).
Diarrhea treatments for adults
To prevent dehydration in adults, drink water as consistently as possible. To get electrolytes, choose sports drinks, salty broths, or electrolyte solutions in place of water. If nausea or vomiting also occur, take small sips every few minutes as tolerated.
When adults have viral diarrhea, an over-the-counter anti-diarrheal medicine may help. This includes:
- Bismuth subsalicylate (Kaopectate, Pepto-Bismol)
- Loperamide (Imodium)
Do not use these products if you have bloody diarrhea or a high fever. These symptoms can be signs of a bacterial or parasitic infection. Taking an anti-diarrheal can make your condition worse when bacteria or parasites are to blame.
Diarrhea treatments for children
To prevent dehydration in infants, offer formula or breast milk frequently. Toddlers and older children can drink water, but pediatric electrolyte solutions are most helpful. Children who want to drink milk can do so. But limit juices, which can make diarrhea worse. If your child will only drink juice, dilute it with water as directed by your doctor.
Children should not use over-the-counter anti-diarrheal medicines.
What to eat and drink for diarrhea?
Many people lose their appetite when they have diarrhea. If this is the case, there’s no need to force food. As the diarrhea subsides, you will likely regain your appetite and return to your normal diet. In the meantime, there are some foods you definitely want to avoid and some that may ease your digestion.
Foods to avoid when dealing with diarrhea
When you have diarrhea, certain foods and drinks can make the problem worse. This includes:
- Dairy products
- Drinks containing caffeine or alcohol
- Food and drinks containing fructose or sweeteners, such as sorbitol, mannitol and xylitol
- Greasy, fried or fatty foods, including fast food and processed foods like potato chips
- High-fiber foods, including fruits, fresh vegetables, beans, and whole-grain products
- Spicy or highly-seasoned foods
Foods to treat diarrhea in adults
If you aren’t vomiting, you may feel like having something to eat. Foods that are generally okay for adults with diarrhea include:
- Carbohydrates, such as rice, plain pasta, plain crackers, pretzels, bread, toast, and baked or boiled potatoes without the skins. As opposed to normal nutritional guidelines, stay away from whole-grain products.
- Cooked vegetables
- Gelatin, ice pops, or non-dairy frozen desserts, such as sorbet
- Lean proteins, such as cooked eggs and baked or broiled meats, fish, or skinless poultry
You should try to return to a normal or near-normal diet within 24 to 48 hours. At first, continue to avoid foods that can worsen diarrhea. Gradually add them back into your diet.
Foods to treat diarrhea in children
In most cases, a child or infant with diarrhea can continue a normal diet if they aren’t vomiting. This includes formula, breast milk, and dairy products. Call your doctor if formula or cow’s milk seems to make the problem worse or triggers gassiness. Your doctor may recommend a temporary change.
The foods a child with diarrhea can eat are generally the same as what adults can eat. Your child may want smaller portions until they feel better.
What are the potential complications of diarrhea?
In some cases, diarrhea can lead to serious complications, especially if the diarrhea is severe, continues for a long time, or the underlying disease or condition is untreated or poorly managed.
Diarrhea that contains blood can lead to anemia and shock in some cases. Other complications of diarrhea include: