Diarrhoea - Acute and chronic diarrhoea
Diarrhoea is defined as the evacuation of loose, liquid or unformed stools and usually due to an abnormally rapid passage of food residue through the intestinal canal.
Diarrhoea is a very common symptom with many possible causes. The term is used to describe an increase in frequency of bowel motions, or increased stool liquidity, or sometimes a sense of faecal urgency.
Diarrhoea may be acute (sudden onset and short duration) or chronic (gradual onset and long duration).
Diarrhoea occurs when the micro-organisms irritate the mucous membrane of the small or large intestine resulting in an abnormally large quantity of water in the motions. The irritated gut becomes very active, contracting excessively and irregularly (colic). This can be accompanied by nausea, vomiting, and cold sweats. In some cases the motions may include some blood.
Symptoms of Diarrhoea
The symptoms of diarrhoea include:
- Abdominal cramps
- Abdominal pains
- Urgency to go to the toilet
- Frequent passing of loose, watery faeces
- Nausea
- Vomiting.
Serious symptoms of Diarrhoea
In most cases, acute diarrhoea is self-limiting and will resolve by itself within a day or two.
However, contact your doctor immediately if you experience serious symptoms including:
- Blood in the faeces
- Pus in the faeces
- Painful passage of faeces
- Repeated vomiting
- Inability to increase fluid intake
- Reduced or absent urination
- Fever (temperature greater than 38ºC).
If you have a serious chronic medical condition, such as kidney or heart failure, even one day of diarrhoea can be dangerous. It's safer to see your doctor as soon as possible.
What are the warning signs?
- Blood in the motions.
- Pus in the motions (yellow mucus).
- Inability to drink liquids because of vomiting.
- Dehydration - symptoms include excreting small amounts of dark urine, drowsiness, dry mucous membranes and thirst. Dehydration as a result of diarrhoea is a particular risk for young children and the elderly.
- Pronounced drowsiness due to dehydration or intoxication.
- Acute diarrhoea in infants.
- Acute diarrhoea in very old people.
Causes of acute diarrhoea
A bout of diarrhoea can be caused by a wide range of disorders, infections and events including:
- Food poisoning
- Gastroenteritis
- Tropical diseases, such as typhoid and cholera
- Anxiety or emotional stress
- Overconsumption of alcohol
- Medications, particularly antibiotics.
Common infectious agents
Contaminated food and water are common causes of acute diarrhoea. Some of the infectious agents known to cause diarrhoea include:
- Viruses - such as calici virus, adenovirus and rotavirus.
- Bacteria - such as E. coli , Campylobacter, V. cholerae, Shigella , Salmonella and Staphylococcus aureus .
- Parasites - such as Giardia lamblia , Cryptosporidium parvum and tapeworm.
Causes of chronic diarrhoea
Some of the causes of chronic diarrhoea include:
- Coeliac disease - which reduces the intestine's ability to absorb food.
- Chronic constipation - the bowel is blocked by hard, impacted faeces but some liquids manage to seep past the blockage. This condition, called 'spurious' or 'overflow' diarrhoea, is more common in the elderly.
- Hormone disorders - such as diabetes or hyperthyroidism (overactive thyroid gland).
- Cancer - such as bowel cancer.
- Inflammatory bowel disease - including ulcerative colitis and Crohn's disease.
- Irritable bowel syndrome - symptoms include abdominal pain, bloating, and alternating constipation and diarrhoea.
- Lactose intolerance - the inability to digest the milk sugar lactose.
- Medications - including antibiotics, antacids that contain magnesium, laxatives, and drugs for treating hypertension (high blood pressure) and arthritis.
More Causes of Chronic Diarrhoea
Diarrhoea persisting for weeks or months whether constant or intermittent may be a serious disease.
1. Intestinal diseases-Chronic infections like amoebiasis, bacillary dysentery.
2. Parasitic disease-Worm infestations.
3. Ulcerative disease-Tuberculosis, ulcerative colitis.
4. Pancreatic disorders-Chronic inflammation.
5. Endocrine disorders-Thyroid over activity, diabetes, hormone producing tumors.
6. Cancer colon.
Diagnosis methods
Successful treatment depends on diagnosing the cause. Investigations may include:
- Medical history.
- Physical examination.
- Blood tests.
- Laboratory analysis of stool sample.
- Colonoscopy (the insertion of a slender instrument into the anus so that the doctor can look at the bowel lining).
Treatment options for Diarrhoea
Always see your doctor if you experience serious symptoms. Babies and young children with diarrhoea need prompt medical attention.
Treatment for diarrhoea depends on the cause but may include:
- Plenty of fluids to prevent dehydration.
- Oral rehydration drinks to replace lost salts and minerals. These drinks are available from pharmacies. An alternative is one part unsweetened pure fruit juice diluted with four parts of water.
- Intravenous replacement of fluids in severe cases.
- Medications such as antibiotics and anti-nausea drugs.
- Anti-diarrhoeal medications, but only on the advice of your doctor. If your diarrhoea is caused by infection, anti-diarrhoeal drugs may keep the infection inside your body for longer.
- Treatment for any underlying condition, such as inflammatory bowel disease.
Do consult a doctor without fail.
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