Diarrhea

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Patient education: Diarrhea

DIARRHEA OVERVIEW

Diarrhea is defined as three or more loose or watery stools per day. Nearly everyone will have an episode of diarrhea at some point during their life, with the average adult experiencing it four times per year. Although most cases of diarrhea resolve within a few days without treatment, it’s important to know when to seek help.

CAUSES

Diarrhea can be caused by infections or a variety of other factors. The cause of diarrhea is not identified in most people, especially those who improve without treatment.

Diarrhea caused by infections usually results from eating or drinking contaminated food or water. Signs and symptoms of infection usually begin 12 hours to four days after exposure and resolve within three to seven days.

Treatment:

Drink adequate fluids — If you have mild to moderate diarrhea, you can usually be treated at home by drinking extra fluids. The fluids should contain water, salt, and sugar. Oral rehydration solution (ORS), a specific mixture of glucose and sodium, is the best first-line treatment. Commercial sports drinks (eg, Gatorade) are not optimal for fluid replacement, although they may be sufficient for a person with diarrhea who is not dehydrated and is otherwise healthy. Diluted fruit juices and flavored soft drinks along with salted crackers and broths or soups may also be acceptable.

One way to judge hydration is by looking at the color of your urine and monitoring how frequently you urinate. If you urinate infrequently or have urine that is dark yellow, you should drink more fluids. Normally, urine should be light yellow to nearly colorless. If you are well hydrated, you normally pass urine every three to five hours.

If you become dehydrated and are unable to take fluids by mouth, a rehydration solution can be given into a vein (intravenous fluids) in a healthcare provider’s office or in the emergency department.

Diet

There is no particular food or group of foods that is best while you have diarrhea. However, adequate nutrition is important during an episode of acute diarrhea. If you do not have an appetite, you can drink only liquids for a short period of time. Boiled starches and cereals (eg, potatoes, noodles, rice, wheat, and oats) with salt are recommended if you have watery diarrhea; crackers, bananas, soup, and boiled vegetables may also be eaten.

Antidiarrheal medications in Adults

Your provider may recommend these medications, These are used to reduce diarrhea are available, and are safe if there is no fever (temperature greater than 100.4°F or 38°C) and the stools are not bloody. These medications do not cure the cause of the diarrhea, but help to reduce the frequency of bowel movements.

Antibiotics

Antibiotics are not needed in most cases of acute diarrhea, and they can actually worsen diarrhea or cause further complications if used inappropriately.

Preventing spread

Adults with diarrhea should be cautious to avoid spreading infection to family, friends, and co-workers. You are considered infectious for as long as diarrhea continues.

Hand washing 

— Hand washing is an effective way to prevent the spread of infection. Hands should ideally be wet with water and plain or antibacterial soap and rubbed together for 15 to 30 seconds. Pay special attention to the fingernails, between the fingers, and the wrists. Rinse the hands thoroughly and dry with a single use towel.

If a sink is not available, alcohol-based hand rubs are a good alternative for disinfecting hands.

Go TO THE ER IF:

Profuse watery diarrhea with signs of dehydration. Early features of dehydration include sluggishness, becoming tired easily, dry mouth and tongue, thirst, muscle cramps, dark-colored urine, urinating infrequently, and dizziness or lightheadedness after standing or sitting up. More severe features include abdominal pain, chest pain, confusion, or difficulty remaining alert.

Many small stools containing blood and mucus

Bloody or black diarrhea

Temperature ≥38.5°C (101.3°F)

Passage of ≥6 unformed stools per 24 hours or illness that lasts more than 48 hours

Severe abdominal pain/painful passage of stool

In addition, if you have persistent diarrhea following antibiotics, are older than 69 years, have other medical illness or a weakened immune system, you should also consult your healthcare provider.

FOLLOW-UP CARE:

You should contact your private physician for follow-up care. If you are unable to get a timely appointment, or if you are worsening, call us. If you need assistance finding a primary doctor or gastroenterology specialist please call 410-601-WELL (9355)