DIARRHEA, ACUTE

General Information

DEFINITION--The passage of many loose, watery or unformed bowel movements. This is a symptom, not a disease.

BODY PARTS INVOLVED--Colon; small intestine.

SEX OR AGE MOST AFFECTED--Both sexes; simple diarrhea is common among all age groups.

SIGNS & SYMPTOMS

• Cramping abdominal pain.
• Loose, watery or unformed bowel movements.
• Lack of bowel control (sometimes).
• Fever (sometimes).

CAUSES--There are many causes including infections (viral, parasitic or bacterial).

RISK INCREASES WITH

• Emotional upsets or acute stress.
• Food poisoning or food allergy.
• Infections (viral, parasitic or bacterial) or other recent illness.
• Regional enteritis.
• Malabsorption syndromes.
• Disease or tumor of the pancreas (malignant or benign).
• Diverticulitis.
• Foods, such as prunes or beans.
• Use of drugs, such as laxatives, antacids, antibiotics, quinine or anticancer drugs.
• Radiation treatments for cancer.
• Excess alcohol consumption.
• Crowded or unsanitary living conditions.
• Immunosuppression due to illness or drugs.
• Travel to foreign country.
• Ingestion of water from streams, springs or untested wells.
• Lactose or sorbitol intolerance.

HOW TO PREVENT

• If diarrhea is recurrent and a cause can be identified, treatment or avoidance of the cause should prevent recurrence.
• Everyone is likely to have bouts of diarrhea occasionally from insignificant causes that disappear and leave no lasting effects. Most cases of acute diarrhea last a short time and a search for the cause may not be necessary.
• Avoid undercooked or raw seafood, buffet or picnic foods left out several hours and food served by street vendors.
• Wash hands frequently, especially after using the toilet.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Laboratory stool studies (for prolonged diarrhea).

APPROPRIATE HEALTH CARE

• Self-care. Diarrhea is a symptom. If possible, the underlying disorder should be treated.
• Doctor's treatment (if symptoms persist longer than 2 to 3 days).

POSSIBLE COMPLICATIONS--Dehydration if diarrhea is prolonged, especially in infants.

PROBABLE OUTCOME--Spontaneous recovery in 24 to 48 hours.

How To Treat

GENERAL MEASURES--

• If you think a prescription drug is causing the diarrhea, consult with the doctor before discontinuing it.
• If cramps are present, place hot compresses, a hot-water bottle or an electric heating pad on the abdomen.
• Maintain fluid intake. Severe diarrhea may require urgent fluid and electrolyte replacement to correct dehydration.

MEDICATION--For minor discomfort, you may use non-prescription drugs such as bismuth subsalicylate (Pepto-Bismol).

ACTIVITY--Decrease activity until diarrhea stops.

DIET--

• Replace lost fluids and electrolytes with a commercial rehydration product (e.g., Gatorade). There are special products for infants (Pedialyte, Ricelyte, etc.). Follow package instructions.
• After 12 hours with no diarrhea, try a diet of clear soup, salted crackers, dry toast or bread.
• Avoid alcohol, caffeine, milk and dairy products, spicy, fried and junk foods.
• Resume a normal diet 2 or 3 days after the diarrhea stops. Avoid alcohol and highly seasoned foods for several more days.

Call Your Doctor If

• Diarrhea lasts more than 48 hours, especially in a child.
• Mucus, blood or worms appear in the stool.
• Fever rises to 101F (38.3C) or higher.
• Severe pain develops in the abdomen or rectum.
• Dehydration develops. Signs include: dry mouth; wrinkled skin; excess thirst; little or no urination.