Types, Causes, and Treatment of Diarrhea

Diarrhea Overview:

Diarrhea is a type of disorder affecting the lower part of the digestive system. It is characterized by increased bowel movements, loose stools, and abdominal pain. This condition can indicate both common food poisoning and more serious diseases. In this article, you’ll learn about the causes of diarrhea and the available treatment methods.

Diarrhea and its Symptoms:
Diarrhea is a type of intestinal disorder that is often misinterpreted. One of its main symptoms is an increase in stool volume. However, to diagnose diarrhea, the following conditions must be met:

• The weight of stool passed during the day exceeds 200 grams in adults, while it ranges from 100-200 grams for an adult (10 grams per kilogram of body weight for a child).
• The stool is liquid.
• Bowel movements occur more than three times a day. If bowel movements are frequent but complete, it is not considered diarrhea. It should not be confused with fecal incontinence, which is caused not by a change in stool consistency but by weak anal sphincter muscles. Adults usually pass through diarrhea without serious consequences. However, according to the World Health Organization, it is a significant secondary cause of child deaths worldwide.

Causes of Intestinal Disorders:
Normally, the fluid load of the stomach and intestines, when considering digestive secretions, is up to 10 liters. 99% of it is absorbed in the large and small intestines. If this ratio decreases, the water content in the intestinal cavity increases, resulting in loose stools and increased stool volume. The causes can be varied, but there are specific mechanisms for disease development:

• Increased osmotic load: In this case, water-soluble materials accumulate in the intestines.
• Increased intestinal secretion: If there is more secretion from an organ than it can absorb, diarrhea begins.
• Accelerated transit: Poor absorption of fluid due to the rapid movement of digested food in the lower part of the digestive system.

The disorder can be divided into three types: osmotic, secretory, and motility. Sometimes, each type of disease resulting from intestinal inflammation is dealt with separately.

Causes of Acute and Chronic Diarrhea:

The disease continues in its acute form from several hours to 10 days. It is often caused by intestinal infections such as:

• Viral infections (such as rotavirus or norovirus).
• Bacterial infections (such as Salmonella, Shigella, and Campylobacter).
• Salmonella bacteria (when food is not adequately processed).
• Clostridium bacteria (resulting from eating unclean food or not washing hands). Diarrhea can also be caused by parasitic infections such as amoebas, giardia, and cryptosporidium.

The disease progresses to its chronic form if it lasts for more than 14 days. It can result from irritable bowel syndrome, ascites, ulcerative colitis, or Crohn’s disease. Rarely, diarrhea can be caused by the presence of a tumor in the intestines or in the glandular organs of the digestive system.

Diagnosis and Treatment of Gastrointestinal Disorders

Diagnosis:
Gastrointestinal disturbances usually last up to three days without causing concern (exception – when it starts in children or the elderly). If self-care attempts fail to resolve the problem, it’s best to consult a doctor. Medical treatment is necessary if:

• Blood or pus is present in the stool.
• Fever is present.
• Low blood pressure occurs.
• Signs of poisoning or dehydration are observed.
• Rapid weight loss occurs.

The doctor performs a clinical examination of the abdomen, inquires about the circumstances of symptom occurrence, and any accompanying diseases. In necessary cases, general and biochemical blood tests, microscopic and culture examination of stool are requested. It’s also important to ensure there is no hidden fat or blood in the stool.

Interpretation of Diagnosis Results:
Specific symptoms and their presence together help identify the causes of diarrhea. The most common clinical cases include:

• Infection: The patient is healthy, and the disease appears acutely after eating or traveling to an unsanitary environment. Stool consistency – watery.
• Bacteria: The patient is healthy, and blood is observed in the stool along with a decrease in blood pressure.
• Malabsorption: The patient rapidly loses weight, and the stool contains fat particles.
• Food intolerance: The stool consistently becomes liquid after consuming certain foods.

If the volume of stool passed during the day exceeds one liter, it indicates laxative use or the presence of a tumor in the intestines or glandular organs.

Antidiarrheal Treatment:
Gastrointestinal disorders need timely treatment since the main risk of repeated watery stool leakage is dehydration. Antidiarrheal medications work comprehensively and solve several problems simultaneously:

• Reduce intestinal muscle tension.
• Slow down intestinal motility.
• Prolong stool transit time.
• Enhance fluid absorption processes.

Antidiarrheal medications containing loperamide are often used. However, it’s important to remember that diarrhea is just a symptom, and treatment requires addressing the infection or underlying disease causing it.

Antibiotics:

If diarrhea is watery – a symptom of bacterial infection, the doctor may prescribe antibiotics for treatment. This is done only after laboratory diagnosis. Treatment is often targeted, so it depends on the specific pathogen to determine the appropriate diarrhea treatment:

• Salmonella: In mild diarrhea cases, antibiotics are not prescribed. In severe cases, ciprofloxacin or azithromycin may be prescribed.
• Shigella: Ofloxacin or norfloxacin, and in case of intolerance – azithromycin.
• Cryptosporidium: In severe diarrhea cases, paromomycin may be prescribed, and in mild diarrhea cases, no antibiotic treatment is needed.

To avoid side effects of antibiotic intake, it’s important to protect beneficial bacteria in the intestines. Probiotics can help with that. They are also directly beneficial in cases of disorders, as diarrhea itself negatively affects the microbial environment in the digestive system.

Other Treatments:
Watery diarrhea, which increases in volume and recurs abnormally, is not the only form of problem faced in such cases. Other problems also need to be addressed.

Therefore, the list of treatments expands to:

• Relieving abdominal pain: If laxatives do not reduce pain, antispasmodics can be taken.
• Eliminating toxins that accumulate due to gastrointestinal disturbances: This is done by taking an intestinal absorbent substance.
• Replacing lost fluids: Intravenous solutions can help with this.

Since the body loses many important nutrients with fluids, it will need vitamins and minerals. Vitamin C accelerates toxin excretion, while vitamin E acts as a powerful antioxidant. Therefore, treatment should be supplemented with a set of appropriate vitamins and minerals.

Diarrhea and Dietary Characteristics

Merely taking antidiarrheal medications is not sufficient – correcting the diet is important. Some substances may exacerbate clinical symptoms, and it is recommended to avoid foods containing them.

It is also important to avoid foods that negatively affect the mucous membranes of the digestive system, including not only fried and spicy foods but also very hot foods. Solid food during diarrhea can be harmful, and it is important to drink an adequate amount of fluids.

A key point in the diet is eating intermittently, which helps reduce pressure on the digestive system and speeds up recovery. Small meals consumed 5-6 times a day are the optimal plan.

Potential Complications

When a person experiences diarrhea, the body loses a significant amount of fluids, and dehydration is the primary threat in such cases. In countries facing problems accessing drinking water, such cases often end fatally. At-risk groups include children under the age of five and adults with immune deficiencies.

In addition to dehydration, serious complications can occur such as:

• Electrolyte imbalance, which can lead to disruptions in cardiovascular function.
• Metabolic acidosis, causing irregular heartbeats, low blood pressure, and loss of consciousness.
• Potassium deficiency, which can lead to paralysis and respiratory distress.
• Magnesium deficiency, which can cause tetany (life-threatening involuntary muscle contractions).

Immediate fluid and electrolyte replacement (oral rehydration therapy) help avoid these complications. In cases of mild diarrhea, oral treatment is administered, while intravenous treatment is given in cases of severe diarrhea.

Prevention

As a preventive measure against gastrointestinal disorders, often of infectious nature, individuals can take the following measures to avoid exposure to disease-causing microbes:

• Thoroughly wash hands with soap, especially before eating.
• Handle food carefully (wash fruits and vegetables, cook or fry meats and fish thoroughly).
• Avoid consuming raw food, especially in environments with questionable hygiene.
• Drink boiled or bottled water only.
• Monitor expiration dates of products and beverages.

Commonly available hand sanitizers proved to be very useful outdoors in the past year. If there is no opportunity to wash hands before eating, sanitizing them with hand sanitizer can prevent potential poisoning.

For children, breastfeeding is considered a good preventive measure against any infectious disease and is recommended for at least six months. It is considered an effective protection against many infectious diseases.