What is Diarrhea?

By strict medical definition, diarrhea refers only to the passage of abnormally frequent bowel movements. In general use, however, it has come to mean loose watery stools. By either definition, the causes of diarrhea are legion. Some of them—inflammatory bowel problems and sprues (see Crohn's Disease, Ulcerative Colitis, and Celiac Sprue)—cause ongoing problems with diarrhea over many years.
Diarrhea Other causes arise from infections by viruses (the stomach "flu"), from food or drink contaminated with bacteria (the spectrum on these runs from traveler's diarrhea, or "Montezuma's Revenge," to life-threatening cholera), and from parasites (amoebic dysentery). Some people develop diarrhea because of food allergies or sensitivities, such as milk intolerance. And finally, diarrhea can develop because of overconsumption of antibiotic medications, chemical "laxatives" such as Milk of Magnesia and fiber, and sorbitol (a sugar substitute used to sweeten diabetic candies and gum). This kind of diarrhea usually stops readily when you stop taking the medication or chemical.

The specific treatment you would need to stop the other kinds of diarrhea would depend, naturally, on what had caused it. We have discussed inflammatory bowel disorders fully under the listings given on page 301, and food allergy causes and treatments under the listings Ulcerative Colitis and Celiac Sprue. In this listing, we will briefly describe each basic type of infectious diarrhea and then, at the end, address genera! nutritional support during and immediately after the problem.

Viral diarrhea

Many viruses—and there are quite literally hundreds—that afflict you with sore throats, colds, rashes, and fever can also cause diarrhea. Once the virus enters your intestinal tract, it causes a sudden and dramatic increase in motility (bowel contraction) and in secretion (production of mucus and lack of water reabsorption). Those two activities result in the waves of cramping in your belly, a bloated feeling, and finally the passage of stools every 30 minutes to an hour that become progressively looser and finally watery. Fortunately, most bouts of viral diarrhea last only a few days, but it's sometimes a miserable few, and then you're left feeling wrung out and weak for several more days. If your symptoms last only a day, the best advice is to try to ride them out and not interfere with medicines to stop the diarrhea. Doing so may prolong the symptoms. However, frequent watery stools for a longer period really have to be stopped because of lost fluid, loss of electrolytes, and the risk of irritating your colon/rectum to the point of bleeding.

Bacterial diarrhea

When you eat or drink food contaminated with foreign bacteria—at home or abroad—severe symptoms can occur. Treatment depends on the bacterium involved and the severity of symptoms. Anytime you have diarrhea that fails to clear in 48 to 72 hours, you should see your personal physician.

DiarrheaTypical "food poisoning" caused usually by a staphylococcus bacterium results in sudden onset of both vomiting and diarrhea with severe stomach cramping, but usually with no fever or other body symptoms. The symptoms may begin as quickly as 1 hour after eating the "bad" food, although a delay of 4 to 8 hours is not uncommon. Other bacteria (Salmonella, Shigella, E. coli, Vibrio cholerae, Clostridium botulinum) can also cause the diarrhea, but the delay in onset of the symptoms may be from a day and a half to 3 days, and the symptoms can be much more severe and even lifethreatening. The bacteria contaminating the food produce a toxic chemical that, when eaten, causes a sudden increase in motility and secretion. The bacteria themselves don't cause the symptoms, and therefore this kind of diarrhea truly is a "poisoning" and not an infection. Antibiotic medications usually are not needed in mild cases; however, let us stress a couple of points. See your doctor right away if you develop: bloody diarrhea, fever, double vision, difficulty swallowing, difficulty talking, or difficulty breathing, or if the diarrhea continues for more than 48 to 72 hours. Do not ignore or attempt self-treatment of these kinds of symptoms.

Parasitic diarrhea

Parasites are living creatures that live off of other living creatures. They can range in size from the tiny (Amoeba and Giardia are but a single cell in size) to the huge (fish tapeworms can grow up to 60 feet in length). Infestation by a parasite can cause sudden severe bloody diarrhea with fever (amoebic dysentery) or many weeks of daily diarrhea without many other symptoms {Giardia, roundworm, pinworm). All cases of parasitic diarrhea ultimately will require treatment with prescription medications to kill the parasite.

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