Diarrhoea: Symptoms, Diagnosis, Treatment, Prevention

Diarrhoea is a condition characterised by the frequent passage of loose, watery stools, which may result in you needing to go to the bathroom more frequently. 

There are a few types of diarrhoea:

• Acute diarrhoea (short-term): Persists for one or two days and goes away on its own. 
• Persistent diarrhoea: Persists beyond two weeks and less than four weeks.
• Chronic diarrhoea: Persists for at least four weeks. Symptoms may be continual or may come and go.

What are the symptoms of diarrhoea? 

Symptom may vary from individual to individual. Symptoms of diarrhoea may include:

• Belly (abdominal) pain
• Bloating 
• Nausea and vomiting
• Fever
• Blood or mucus in the stool
• Frequent, loose, or watery stools
• Urgent need to have a bowel movement
• Dehydration (dry mouth, thirst, reduced urination, dizziness due to loss of fluids)
• Fatigue

A person with diarrhoea can range from being mildly to severely ill. Someone with a mild case might experience a few loose bowel movements but generally feel fine otherwise.

On the other hand, a person suffering from severe diarrhoea might endure 20 or more bowel movements in a day, occurring as frequently as every 20 to 30 minutes.

What are the causes? 

There are a few causes you should be aware of that may lead to diarrhoea:

Infections

• Diarrhoea is a symptom of infections caused by various bacterial, viral, and parasitic organisms, majority of which are spread through contaminated water. When there is a lack of adequate sanitation, hygiene, along with safe drinking, cooking, and cleaning water, the risk of developing an infection is unfortunately common.

Medications

• Certain medications can cause diarrhoea, such as antacids, antibiotics, chemotherapy medicines, and nonsteroidal anti-inflammatory drugs (NSAIDs).

Food intolerance

• Lactose intolerance

Digestive tract diseases and conditions

• Irritable bowel syndrome (IBS): A chronic condition that affects the large intestine.
• Inflammatory bowel disease (IBD): Including Crohn’s disease and ulcerative colitis.
• Celiac disease: An autoimmune disorder triggered by gluten.

How is diarrhoea diagnosed?

Diarrhoea is typically diagnosed through a combination of medical history, physical examination, and, if necessary, additional tests to determine the underlying cause.

• Laboratory tests: Stool sample analysis to check for bacteria, viruses, parasites, and the presence of blood or mucus, and blood tests to look for signs of infection, inflammation, or other underlying conditions.
• Additional tests: Colonoscopy or sigmoidoscopy to examine the inside of the colon and rectum, especially if chronic or severe diarrhoea is present.
• Imaging tests: Abdominal X-rays, CT scans, or ultrasounds to identify any abnormalities in the digestive tract.

How is it treated?

The treatment for diarrhoea depends on its cause, severity, and the patient’s overall health. Common approaches to treating diarrhoea include:

Rehydration

• Oral rehydration solutions (ORS): To replace lost fluids and electrolytes. These solutions are especially important for children and the elderly.
• Drinking plenty of fluids: Water, clear broths, and oral rehydration drinks. Avoid caffeinated, alcoholic, and sugary beverages as they can worsen dehydration.

Medications

• Anti-diarrheal medications such as loperamide.
• Antibiotics for bacterial infection or antivirals for viral infection.
• Probiotics to help restore the natural balance of gut bacteria.

Intravenous (IV) fluids

• Hospitalisation might be necessary in severe cases where dehydration is significant.

What to eat after diarrhoea?

If you are experiencing severe diarrhoea, you may need to stop consuming dairy products for a couple of days.

Include bread products made from refined, white flour in your diet. You can also consume pasta, white rice, and cereals such as cream of wheat, farina, oatmeal, and cornflakes.

Vegetables are beneficial for your diet, including carrots, green beans, mushrooms, and beets. Remember to cook them before consumption.

How to prevent diarrhoea?

Food safety plays an important role in preventing diarrhoea.

• Avoid drinking raw (unpasteurised) milk.
• Thoroughly wash raw fruits and vegetables before consumption.
• Consume precooked, perishable, or ready-to-eat food promptly.
• Separate raw foods (meat, fish, and poultry) away from other foods.
• Make sure to wash your hands, knives, and cutting boards after handling uncooked food and raw produce.
• Ensure that raw animal sources are cooked thoroughly to reach a safe internal temperature.
• Seafood should be cooked thoroughly to lower the risk of food poisoning. Eating raw fish (e.g., sushi) can appear as a risk due to the possibility of parasitic worms (along with the risks associated with organisms carried by food handlers). Freezing can kill some, but not all, harmful microorganisms. Raw fish labelled “sushi-grade”, or “sashimi-grade” are some examples of food that has been frozen.
• Chicken eggs should be cooked thoroughly until the yolk is firm.
• Refrigerate food as soon as possible. Do not leave cooked food at room temperature exceeding two hours (one hour if the room temperature is above 32°C).

When to see a doctor?

• Severe or persistent diarrhoea that lasts more than two days for adults or 24 hours for young children and infants.
• Signs of dehydration such as excessive thirst, dry mouth, little or no urination, severe weakness, dizziness, light headedness.
• Severe abdominal or rectal pain.
• High fever especially 38°C or higher.
• Blood or pus in the stool, which can indicate a more serious infection or condition.
• Black or tarry stools, which can indicate potential bleeding in the gastrointestinal tract.
• Frequent vomiting that makes it difficult to keep fluids down.
• Recent travel to areas with poor sanitation, which might expose you to different infections or parasites.
• Underlying health conditions such as a weakened immune system, diabetes, or inflammatory bowel disease (IBD).
• Diarrhoea in infants or young children (they can become dehydrated more quickly than adults).

Make an appointment at Pantai Hospitals

Consult our doctors if you are experiencing symptoms of diarrhoea A dedicated and expert team of Gastroenterologists at Pantai Hospitals is available for consultation to provide the best care and assistance.

Get in touch with us to book an appointment today if you have concerns or questions regarding diarrhoea. We assure you the best possible care tailored to your specific needs.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.