Diarrhea

Diarrhea, the frequent passage of very loose or watery bowel movements, is a symptom of an underlying disorder, which may have been caused by stress, dietary indiscretion, travelers diarrhea, flu, food poisoning, or any one of numerous conditions. Although most episodes are minor and temporary, a prolonged bout can lead to dehydration and an upset in body chemistry that could be life threatening, especially in children and the elderly.

You should call a doctor if diarrhea lasts for more than one day in a child under the age of two or two days in an older child or an adult. Consult him even sooner if the diarrhea worsens or is accompanied by other symptoms such as severe abdominal pain, vomiting, fever, or the appearance of blood, mucus, or worms in the stool. Persistent or intermittent mild diarrhea also warrants medical investigation.

Diagnostic Studies and Procedures

The nature of the diarrhea is an important factor in the process of diagnosis. For example, diarrhea that alternates with constipation and periods of normal bowel function may be caused either by irritable bowel syndrome or stress. Blood in the stool can point to the possibility of an infection, cancer, polyps, or an inflamed colon.

After a physical examination, certain tests may be called for, including a stool analysis. X-rays, and colonoscopy, an examination of the entire colon with a special fiberoptic instrument.

Medical Treatments

The choice of anti-diarrheal medication depends upon the underlying cause. Most diarrhea resolves itself in a day or two of self-treatment with nonprescription drugs. Diarrhea accompanied by intestinal cramps and spasms may be treated with phenobarbiial, paregoric, opium, or other prescription substances to reduce intestinal motility. Antibiotics will be prescribed if a bacterial infection is present. Other drugs called anthelmintics are given if there are intestinal worms.

Even mild diarrhea in a baby or young child poses a danger of dehydration, especially if there is also vomiting, which makes it more difficult to replace fluids and body salts. In severe cases, hospitalization may be necessary to administer intravenous replacement of water and salts. Giving a special rehydration formula such as Pedialyte, which is available at pharmacies, usually can prevent dehydration and the need for intravenous therapy.

Alternative Therapies

Depending on the cause of the diarrhea, alternative therapies may be your sole remedy or may supplement medical or self-treatment.

Acupressure. A Shiatsu technique for relieving diarrhea involves applying pressure to the index finger a fraction of an inch from the corner of the nail, on the side facing your thumb. Use the thumb of the opposite hand to apply pressure for five to seven seconds several times an hour until diarrhea subsides.

Herbal Medicine. Herbalists often recommend blackberry root bark. Prepared tinctures are available in health food stores, or the bark can be boiled in water for 20 minutes and then strained and taken as a tea. Other herbal remedies include chamomile tea, raspberry leaf tea, and cayenne capsules. Ginger tea may alleviate any accompanying abdominal cramps and nausea; slippery elm bark capsules may also be recommended.

Nutrition Therapy. Sometimes taking antibiotics leads to diarrhea because they kill certain bacteria that live in the intestines and help maintain normal functioning. Eating yogurt with live acidophilus cultures helps repopulate the colon with these beneficial bacteria.

Self-Treatment

When stress brings on a bout of diarrhea, relaxation can help prevent it. If it is caused by an excess of certain fibrous foods such as bran, dietary modification may be necessary.

Occasional mild diarrhea can be self-treated with an over-the-counter medication that contains bismuth (Pepto-Bismol), attapulgite (Kaopectaie), or loperamide (Imodium A-D), although doctors disagree about their value. Do not use such products for more than a day or two without consulting a physician.

During an attack of diarrhea, avoid all solid foods, coffee, milk products, and spices. Take frequent sips of fluids such as flat sodas (ginger ale or cola allowed to fizz out at room temperature), tea, or clear soup. You can also try rice water, made by boiling 1/2 cup of brown rice in 3 cups of water for 30 to 45 minutes, then straining out the rice; drink about 1/2 cup of this liquid every hour.

As the diarrhea subsides, add bland foods; for example, the BRAT diet of bananas, rice, applesauce, and toast. Avoid other fruits and raw vegetables until normal bowel function returns.

Other Causes of Diarrhea

Diarrhea also can be caused by serious digestive problems, including colorectal cancer, Crohns disease, diverticulitis, and ulcerative colitis.