Diarrhea
Updated Aug. 15th, 2019
The definition of diarrhea is having three or more loose or liquid bowel movements per day. This uncomfortable condition has affected each and every one of us at some time or another. In fact, diarrhea is actually a symptom of a larger problem, and it can be triggered by a wide variety of causes. The cause of each case can be determined by any combination of stool testing, physical exam, and colonoscopy.
CAUSES OF DIARRHEA
There are a number of different types of diarrhea, and each may require slightly different approaches to treatment.
Malabsorption
If the intestines are not absorbing nutrients, minerals and sugars properly then they will draw water out of tissues inside of the gastrointestinal tract which causes loose, watery stools. The name for this process is called osmotic diarrhea since the water is collected by osmosis. Diseases such as Celiac disease and pancreatic disease can encourage this as well as food sensitivities and laxatives. Food intolerance is a common culprit as the body will be lacking in required digestive enzymes. The excessive intake of certain vitamins and minerals can also lead to diarrhea.
Infectious Diarrhea
There are a wide variety of microorganisms, viruses, and parasites in the digestive tract that can cause diarrhea. The most common causes of infectious diarrhea in North America are: E. coli, Salmonella, Giardia, and rotavirus. When it affects those travelling, the condition is called Traveller’s Diarrhea. Some infectious pathogens secrete toxins that trigger an osmotic effect like that of malabsorption. Others directly irritate the lining of the digestive tract causing an immune response and local damage. This can cause the leaking of fluid from the lining of the GI tract, which can further loosen the stool.
Inflammatory Bowel Disease (IBD)
When the digestive tract becomes inflamed, due to autoimmune activity, the cells lining the intestines can become damaged, and can leak protein-rich fluid that acts as an osmotic draw for water. At the same time, the migration of immune cells into the area will cause inflammation, the formation of mucous (pus) and the leaking of blood into the digestive tract. This can cause further irritation and increased digestive motility. For more information see our IBD article.
Irritable Bowel Syndrome (IBS)
The cause of irritable bowel syndrome (IBS) is not yet known, but it causes alternating bouts of constipation and diarrhea. In this condition, the bowel spasms painfully and occasionally mucous can be seen in the stools. It is considered a functional bowel disorder. For more information, please see our IBS article.
Increased Motility
Some cases of diarrhea are caused by an increase in the contractions in the intestinal walls. This speeds the movement of the food through the digestive tract such that it cannot be fully digested nor the nutrients properly absorbed. This results in loose stools with undigested food present. This cause is often present in conjunction with the other causes in this list.
Side Effects of Diarrhea
Because loose stools drain water from the body, diarrhea can quickly cause dehydration and electrolyte disturbances. The most commonly lost electrolytes are salts and zinc. For more information on dehydration, and replenishing, please see our Electrolytes article. It is extremely important to ensure adequate water intake during periods of diarrhea to prevent dehydration. Signs of dehydration are: thirst, dizziness, dark or absent urine, sallow complexion, and loss of elasticity in the skin.
TREATMENT OF DIARRHEA
It is generally recommended to try to promote continued eating whenever possible during diarrhea to help speed the return to normal GI motility. Foods that are easier on the digestive system include soft bland foods like: plain rice, boiled potatoes, toast, crackers, cooked carrots, and broths. Avoid dairy and spicy food as well as those containing grease or large amounts of fibre, particularly insoluble fibre as they can be difficult to digest. Drinking adequate fluids is also essential. A homemade electrolyte solution can be made and ingested as frequently as possible.
Conventional Treatment
Most cases of diarrhea are treated with over the counter medicines like Imodium, Pepto-Bismol, and Kaopectate. Those with blood and pus in their stool or those with a fever should not use these treatments as these are the signs of infection, and the diarrhea should be allowed to continue to help flush the infection. Some cases of diarrhea are treated with anti-motility agents, or antibiotics. In general, diarrhea tends to resolve itself in a few days with or without treatment.
When to seek medical attention
• Symptoms continue for longer than 2 days
• Accompanied by severe pain
• Fever of 102oF (39oC) or higher
• Stools containing pus or blood
• Black tarry stools
• Prolonged dehydration
Soluble Fibre
Although high doses of fibre should be avoided during bouts of diarrhea, some soluble fibre can often be beneficial for prolonged cases of non-infectious diarrhea to help bind excess nutrients or minerals and prevent them from drawing water into the intestines. This helps to bulk the stool and slow transit time. Apple pectin is a great source of soluble fibre. For more information, please see our Fibre article.
Probiotics
Lack of protective flora in the gastrointestinal tract can leave the body open to possible infection. Also, prolonged diarrhea can often deplete the naturally occurring symbiotic microorganisms in our gut. Supplementation with probiotics can help to reverse this effect and protect against future infection. For more information, please see our Probiotics article.
Oregano Oil
This strong essential oil fights harmful microbes, viruses, and parasites. This supplement can be used to directly kill infections and help to reduce certain cases of infectious diarrhea. For more information, please see our Oregano Oil article.
Bentonite Clay
Clay supplements can bind toxins and help to bulk the stools and reduce the symptoms of diarrhea. Like fibre, this should only be used if the diarrhea is non-infectious. For more information, please see our Bentonite Clay article.
zinc
Supplementation of zinc is extremely beneficial in cases of diarrhea as depletion is common. This is especially helpful in children suffering from prolonged diarrhea. For more information, please see our Zinc article.
Once the diarrhea has resolved, see our Leaky Gut article for ideas on how to repair the lining of your digestive tract.
Thank you for your quick response to my problem. It was very helpful.
While most people normally need to drink a minimum of 8 cups of liquid a day, you may need to increase that amount during or after diarrhea. Consume as much fluid as possible, but avoid dehydrating beverages with tons of sugar, caffeine, alcohol, or prunes, all of which can have a laxative effect and make diarrhea worse.
Instead of chugging your drink down at once, take frequent sips or suck on ice chips. Build up to 1 ounce an hour, then 2 ounces an hour, and so on until you can drink normally.
Hello Paul,
Thank you for your comment, we're glad you've been enjoying our articles. Indeed, this can cause dehydration; therefore extra fluids and electrolytes are important. You are correct, chugging fluids can cause them to flush through your system, rather than being properly absorbed. Here is more information about electrolytes and trace minerals to help replenish when dehydrated:
https://www.nationalnutrition.ca/articles/supplements/supplement-articles-electrolytes/
https://www.nationalnutrition.ca/articles/supplements/trace-minerals/
Have a healthy day!