Diarrhea

Risk factors include: Traveling to a developing country where the water and food supply may be contaminatedHaving a severely weakened immune system, such as with AIDS or after an organ transplantTaking certain medications Symptoms Symptoms include: Frequent, loose, liquid stoolsAbdominal pain, crampingUrgent need to defecateBlood and/or mucus in stoolFeverDehydrationNausea, vomitingMuscle aches and painsWeight lossMalnutrition Diagnosis The doctor will ask about your symptoms and medical history, and perform a physical exam. To determine the cause of your diarrhea, the doctor will ask questions, such as: Does anyone else in your family have diarrhea?What kinds of food have you eaten recently?Do you drink well water?Do your children attend daycare?Have you traveled recently?Do you use laxatives?What medications do you take?Do you have any symptoms other than diarrhea (eg, fever, rash, aching joints)?What is your sexual history?Have you ever had abdominal surgery? Tests may include: Laboratory analysis of a stool sampleBlood testsFasting or food elimination testsDigital rectal examexamination of the rectum with the doctor's gloved finger inserted into your rectumFlexible sigmoidoscopy a thin, lighted tube inserted into the rectum to examine the rectum and the lower colon. Colonoscopy a thin, lighted tube inserted through the rectum and into the colon to examine the lining of the colon Biopsy removal of a sample of colon tissue for testing. This may be performed as part of a flexible sigmoidoscopy or colonoscopy Upper GI Series a series of x-rays of the upper digestive system taken after drinking a barium solution (also called barium swallow) Barium enema insertion of fluid into the rectum that makes the lining of your colon show up on an x-ray Barium Enema 2008 Nucleus Medical Art, Inc.

TreatmentIf a medical condition is causing your diarrhea, treating it may help relieve your diarrhea.General recommendations for treating diarrhea include: Drink Lots of FluidsPlain water will not replace the electrolytes lost through diarrhea. Consider drinking sports drinks or specially balanced rehydration solutions. Ask Your Doctor If You Should EatSome doctors suggest that you consume only clear fluids during the most severe phase of diarrhea. Avoid Certain Foods Avoid the following foods: Very spicy foodsFatty foodsGreasy foodsHigh-fiber foodsDairy products in large amountsCaffeinated drinks Encourage Certain FoodsComplex carbohydratesYogurtFruits and vegetablesLean meats Treat Abdominal Pain With HeatUse a hot water bottle or heating pad on your abdomen to relieve cramps and pain. Medications Depending on why you have diarrhea, your doctor may recommend medications, such as: Bismuth subsalicylateCodeine phosphateLoperamide hydrochlorideParegoricPsyllium or methylcellulose compoundsKaolin or pectin productsAntibiotics may be indicated for certain bacterial causes of diarrhea. Probiotics (eg, lactobacillus , bifidobacterium) may be beneficial. Zinc supplementation may be recommended in certain cases. HospitalizationIf your diarrhea causes severe dehydration or you have other chronic conditions, you may need to be hospitalized to receive fluids through an intravenous line.

Prevention To reduce your chance of getting diarrhea: Practice good handwashing.Practice safe food preparation and food storage.If you have diarrhea, don't prepare food for others. If you're traveling: Drink bottled water.Use bottled water when brushing your teeth.Avoid drinks that contain ice.Don't eat food purchased from street vendors.Don't eat raw vegetables or fruits (all produce should be peeled and/or cooked).Make sure meats are cooked thoroughly.Eat only pasteurized dairy products.If you eat seafood, make sure it's very hot. RESOURCES: American Gastroenterological Associationhttp://www.gastro.org National Institute of Diabetes and Digestive and Kidney Diseaseshttp://digestive.niddk.nih.gov/index.htm CANADIAN RESOURCES: Alberta Health and Wellnesshttp://www.health.gov.ab.ca/ Communicable Disease Control Unithttp://www.gov.mb.ca/health/publichealth/cdc/index.html References: American Gastroenterological Association website. Available at: http://www.gastro.org . Kleigman RM, Jensen HB, Behrman RE, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/diarrhea/index.htm .

Primary Care Medicine . 4th ed. Lippincott, Williams, and Wilkins; 2000. Last reviewed November 2007 by Kari L. Kassir, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.