Diarrhea

Diarrhea means passing watery, loose and frequent stools (stool weight > 200 g/day).
Chronic diarrhea (long-term) means loose or frequent stools for more than 3-4 weeks.
Acute diarrhea is usually related to a bacterial, viral, or parasitic infection. Chronic diarrhea is usually related to functional disorders such as irritable bowel syndrome or inflammatory bowel disease.

Common causes of diarrhea

Viral gastroenteritis( stomach flu)

Rotavirus, Norwalk virus, cytomegalovirus are the common culprits. Viral gastroenteritis can cause mini-epidemics.

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Bacterial infections

. Shigella causes dysentery ( blood passes in stools with abdominal cramps),

. Salmonella causes typhoid, and

. Escherichia coli (E. coli).

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Parasites

Entamoeba histolytica (amebiasis), Giardia lamblia (Giardiasis)

. Irritated bowels due to infection or bacterial toxins secrete more electrolytes and water.

Intestinal diseases.

. Colitis - Either infective or ulcerative

. Celiac disease

. Inflammatory bowel disease,

. Crohn’s disease

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Diarrhea as a side effect

. Antibiotics ( ampicillin)

. Anticancer drugs, and

. Antacids containing magnesium

• Lactose intolerance — (Lactose the sugar found in milk.)

. Postcholecystectomy Diarrhea -
Cholecystectomy is a surgery in which gallbladder is removed.
After gallbladder removal, some patients will have diarrhea.

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Signs and symptoms

• Blood or pus in your stools or your stool is black.

• Stools containing blood or pus.

• Black stools.

• Abdominal pain.

• Bloating.

• Nausea

Dehydration in children

This can occur earlier and can prove really dangerous. Parents should know how to monitor for hydration.

Signs of dehydration in children include

. Depressed fontanelle

• No tears when crying or scanty tears

• Not passing urine for 3 hours or more

• Dry mouth and tongue due to decreased saliva

. Decreased sweating

• Sunken abdomen, eyes, or cheeks

. Rapid breathing

• Fever

• Irritability

• Skin that does not flatten when pinched and released

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Traveler’s diarrhea

People who travel a lot are at a risk for traveler’s diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or parasites. Traveler’s diarrhea can be a problem for people from developed nation visiting developing countries.

How to avoid Traveler’s diarrhea?

. Avoid eating food on footpath stalls ( panipuri, bhelpuri, etc). Eat in a good hotel.

. Drink mineral water / boiled water.

. Give rotavirus vaccine to children.

. Avoid raw fruits, salad.

. Oral typhoid vaccine should be given to adults.

Laboratory tests to be done

. Stool examination for ova.

. Stool culture. Stool is examined in a laboratory to check for bacteria, parasites, occult blood or other signs of disease and infection.

• Sigmoidoscopy.

Examination of the rectum and lower part of the colon.

. Colonoscopy.
This test is similar to a sigmoidoscopy, but it allows the examination of colon.

. Imaging tests like X-ray and USG -. These tests can rule out structural abnormalities.

Read -

Irritable-bowel-syndrome

Severe diarrhea can lead to dehydration. Dehydration can lead to fatigue, hypovolemia and its complications.
Oral rehydration solution ( ORS) has an important role in management of dehydration. Read next resource.