Diarrhoea - causes, symptoms and treatment (1 of 2)

What is diarrhoea?

Diarrhoea is having more frequent, loose, watery poo, which may be referred to as 'stools'.

You may get diarrhoea after being in contact with someone else who has it, or you may get it from food poisoning - after eating contaminated food or drinking contaminated water.

Almost everyone has diarrhoea at some point in his or her life, including on holiday abroad, called traveller's diarrhoea.

Diarrhoea that comes on suddenly and lasts for no longer than a couple of days is usually referred to as "acute diarrhoea". Most people with acute diarrhoea recover on their own. Diarrhoea that lasts more than two weeks is thought of as "chronic diarrhoea". Typically, chronic diarrhoea requires medical care to find the underlying cause and treat complications, such as dehydration.

What causes diarrhoea?

Many different problems can cause diarrhoea. Here are the major causes:

You are most likely to come down with diarrhoea after coming into contact with these infectious organisms and agents:

• A virus, such as rotavirus, winter vomiting disease (Norwalk virus or norovirus), enterovirus, or a hepatitisvirus.
• A bacterium, such as E. coli, salmonella,shigella, C.diff (clostridium), or cholera(Vibrio cholerae).
• A parasite, such as those that cause giardiasis and amoebiasis.

The length of time diarrhoea lasts often depends on what caused it. Diarrhoea from norovirus lasts around two days, for rotavirus, the duration is three to eight days, Campylobacter and salmonella infections may last two to seven days and diarrhoea from giardiasis can last several weeks.

Other medical conditions

A number of non-infectious medical conditions may cause diarrhoea, too. These include:

• Inability to digest certain foods, including a lactose intolerance (difficulty digesting the type of sugar found in dairyproducts); coeliac disease (a reaction togluten in wheat and some other grains); and pancreatic problems, such as those caused by cystic fibrosis, which interfere with production of important digestive substances.
• Surgery to remove part of your intestine. A shortened intestine may be unable to absorb all the substances you eat. This is referred to as short-bowel syndrome.
• The after-effects of surgery to remove the gallbladder. An increase in bile in thecolon may result in watery stools.
• Certain diseases of the endocrine (hormonal) system, including thyroiddisease, diabetes, adrenal disease, and Zollinger-Ellison syndrome.
• Certain rare tumours (including carcinoid tumour and pheochromocytoma) that produce diarrhoea-causing substances.
• Inflammation in the intestinal tract, which can result in chronic diarrhoea. If you have inflammatory bowel disease(such as ulcerative colitis or Crohn's disease), you will have bouts of diarrhoea during flare-ups of your disease.
• Pouches of the intestinal wall in diverticular disease can lead to diarrhoea, especially if they become infected and inflamed (diverticulitis)
• Irritable bowel syndrome, which may cause alternating bouts of diarrhoea andconstipation.
• Bowel cancer produces a change in bowel habit that may include diarrhoea or alternating diarrhoea and constipation.

Medication and other substances

Many medications can cause diarrhoea. Some of the most common include antacids containing magnesium, laxatives, digitalis, diuretics, a number of antibiotics, chemotherapy drugs, cholesterol-lowering agents, lithium, theophylline, thyroidhormone and colchicine.

Radiotherapy for prostate cancer or cancers in the abdomen can damage the intestine and cause diarrhoea.

Toxins such as insecticides, psychedelic mushrooms, and arsenic can cause diarrhoea, and overuse of caffeine or alcohol may contribute to diarrhoea.

What are the symptoms of diarrhoea?

• Increased frequency of bowel movements
• Loose, watery stools
• Urgency (having to go right away)
• Incontinence (leakage of stools)
• Bloating, wind
• Rectal pain
• Lower abdominal pain or cramping
• Nausea, vomiting
• Fever
• Blood or flecks of mucus in the stool
• Loss of appetite, weight loss

Seek medical advice

Seek medical advice if you have diarrhoea for more than three to four days, or if you have diarrhoea with any of the following:

• Blood in your stool
• Dark-black stool that looks like tar (but tell your doctor if you have been taking over-the-counter medications, which also can make the stool look darker than usual)
• Mucus passed with no stools
• Abdominal pain
• Rectal pain
• Fever
• Dehydration
• Recent travel abroad
• Recent seafood consumption
• Reason to believe that you have food poisoning
• Family members who have similar illness
• Colleagues, associates or friends who have similar symptoms after eating in the same venue

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