Diarrhoea in adults

What is diarrhoea?

Image result for diarrhoea africaDiarrhoea means increased fluidity and frequency of stooling more than the normal for a particular individual. It is a common clinical problem. Acute diarrhoea (one of sudden onset and lasting for less than 2 weeks) is very common and usually requires no investigation or treatment. Chronic diarrhoea (one lasting more than one month) on the other hand, always needs investigation and appropriate treatment.

What causes it?

Diarrhoea can be caused by a large number of things. These may be broadly classified into infective and non-infective causes.

Infective causes include bacterial, viral, fungal and parasitic causes. These can be picked up from contaminated foods or drinks. Diarrhoea can also be got through contact with the stool of an infected person. This happens when you touch something that’s contaminated with traces of their stool (for example, the person’s hand) and then put your hand to your mouth (for example, when you eat).

Non-infective causes include bowel inflammation from inflammatory bowel disease, irradiation and reduced blood supply; cancers like that of the colon; surgery involving cutting off part of the intestines; drugs like laxatives, anti-cancer drugs and metformin (an anti-diabetic drug).

What are the symptoms?

In addition to the loose stools, vomiting and stomach cramps may also be present.

As a lot of water is lost in stool, one may get dehydrated. Dehydration makes one feel thirsty, have dark-coloured urine, feel irritable, or tired. If this becomes too severe and goes on for too long without proper intervention, one may enter into shock and their vital organs damaged.

Fever may also occur especially when there is an infective cause which has entered the blood stream.

There may also be blood in the stool.

What treatments work?

Acute diarrhoea

Acute diarrhoea usually requires no investigation or treatment because it often resolves on its own. Oral fluid and electrolyte replacement may be necessary. Usually, just feeding well and drinking as much water as one can is enough. However, special oral rehydration solutions are available for use in severe episodes of diarrhoea. These are useful especially in very old people who get dehydrated easily.

Anti-diarrhoeal drugs are thought to prevent the clearance of any organism responsible for the diarrhoea from the bowel but may be necessary for short-term relief. Your doctor should determine if you need to take these drugs, and prescribe them for you.

Anti-bacterial drugs are occasionally necessary depending on the organism causing the diarrhoea.

Chronic diarrhoea

When diarrhoea lasts more than a month, it must be investigated properly, and the cause treated accordingly if possible.

Prevention

You can help prevent diarrhoea by washing your hands after using the toilet, before preparing food, and before eating.

You should only drink water that is boiled or bottled and properly sealed.

Be careful when you eat salads. Always prepare them yourself if you can.

Avoid eating previously peeled fruits, raw foods, unpackaged condiments and sauces, and food from street vendors especially in unhealthy environments.