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Symptoms & Causes

Diarrhea

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What is Diarrhea?

What is Diarrhea?

Diarrhea is defined as frequent bowel movements of loose, watery stool. Diarrhea is a common issue; it can be the sole symptom of a problem or occur with other symptoms such as nausea, vomiting, gastrointestinal (GI) pain, and unexplained weight loss.

Diarrhea can be mild or severe and typically resolves itself within a few days. However, diarrhea that lasts longer than a week or two could be a sign of a more severe condition such as IBS (irritable bowel syndrome), an intestinal infection, celiac disease, or IBD (inflammatory bowel disease).

Types of Diarrhea

Types

Regular diarrhea and severe diarrhea are classified in different ways.

  • Acute watery diarrhea is the most common type of diarrhea people experience. It’s characterized by loose, watery diarrhea that lasts from one to two days and usually resolves itself without treatment. This type of diarrhea includes cholera.
  • Persistent diarrhea can last up to four weeks
  • Acute bloody diarrhea, also called dysentery, is more serious and requires a doctor’s visit
  • Chronic diarrhea involves diarrhea lasting for more than four weeks. Chronic diarrhea may regularly come and go over a long period of time.

Stages of Diarrhea

Stages

The stages of diarrhea refer to the severity of diarrhea. For instance:

  • Mild diarrhea will cause a few watery stools during a 24-hour period
  • Moderate diarrhea means more than a few watery stools, but not more than ten during a 24-hour period
  • Severe diarrhea causes more than 10 watery, loose stools during a 24-hour period

If symptoms of diarrhea continue for more than four days, visit a primary care doctor who can help address the symptoms. If a child is experiencing diarrhea, contact a pediatrician.

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Signs & Symptoms of Diarrhea

Symptoms

Diarrhea symptoms depend on the severity of diarrhea and the cause of the gastrointestinal discomfort. Severe diarrhea can be an indication of a more serious, underlying condition. The leading symptom of diarrhea is loose or watery stool.

Diarrhea symptoms can include:

  • Bloated stomach
  • Stomach cramps
  • An urgent need to use the bathroom
  • Nausea and an upset stomach

Additional symptoms of severe diarrhea may include:

  • Dehydration is common with severe diarrhea, especially among young children and older adults
  • Fever could indicate an infection somewhere else in the body that’s causing the diarrhea
  • Weight loss could also be a sign of an infection elsewhere in the body
  • Severe pain may occur with diarrhea due to cramping, gas, and bloating in the gastrointestinal tract
  • Vomiting is sometimes associated with a stomach virus, which may also cause diarrhea
  • Blood may be present in stool after several bouts of diarrhea due to irritation of the bowels. If blood in the stool is excessive, contact your doctor.

Severe diarrhea could be a symptom of a more serious illness. Contact your healthcare provider and seek medical care if your diarrhea increases in frequency or lasts longer than 48 hours.

Some people experience fecal incontinence with extreme diarrhea. Fecal incontinence is the inability to hold your bowel movement before reaching a toilet. It can occur because of an onset of unexpected diarrhea. Impaired muscles or nerves in the rectum can cause fecal incontinence.

The rectum contains the muscles that allow you to control your bowel movements. If they become damaged, fecal incontinence could happen. This is not considered a normal part of aging, though it does occur more often in older adults, and is more common among women than men.

What Causes Diarrhea?

Causes
  • Viral gastroenteritis. Most people can relate to having a “stomach bug.” It spreads quickly around the office, school, or anywhere with many people in one space. This type of stomach virus is called viral gastroenteritis and is caused by a virus that causes inflammation in the lining of the GI tract. Viruses known to cause this type of inflammation include the rotavirus, norovirus, and adenovirus. There is a vaccination available to babies against the rotavirus. Typical symptoms of gastroenteritis include nausea, vomiting, and frequent loose, watery stool.
  • Bacterial gastroenteritis exhibits similar symptoms to viral gastroenteritis. However, it is caused by bacterial infections in the GI tract. Symptoms can include nausea, vomiting, fever, diarrhea, cramping, and pain. If you have bacterial gastroenteritis, take precautions to avoid dehydration by drinking plenty of liquids.
  • Infectious organisms. There are numerous microbes responsible for causing gastrointestinal infections that can result in diarrhea. Some of these infectious organisms include:
    • E. coli is found in ground beef and fecal-contaminated farm products
    • Salmonella is found in raw eggs, unpasteurized dairy products, and uncooked poultry
    • Shigella is spread by eating or drinking foods contaminated by an infected person, or touching your mouth after touching contaminated surfaces
    • Campylobacter is found in contaminated dairy products
    • Clostridium, an infectious microbe, is found in contaminated meats
    • Parasites such as Giardia, Entamoeba, and Ascaris can cause intestinal infections and diseases
  • Preformed toxins. These gastrointestinal infections are caused by Staphylococcus aureus and Bacillus cereus (emetic toxin). They produce heat-resistant toxins in foods that are not destroyed by cooking.
  • Types of food that upset digestion. Most people know that certain foods “do not agree with them.” Avoid eating foods that upset your stomach and cause diarrhea.
  • Allergies or intolerances to foods. Some people have extreme allergic reactions to certain foods that can even cause anaphylactic shock, which could be deadly. Others have difficulty tolerating certain foods, such as dairy, and can experience stomach cramping and diarrhea after eating them.
  • Lactose intolerance. People who have lactose intolerance are unable to fully digest the lactose (sugar) in dairy products. Diarrhea, bloating, and gas pains are common for people who consume dairy products and have lactose intolerance.
  • Medications. Some medicines that can cause diarrhea include:
    • Antibiotics
    • Antidepressants
    • Antacids
    • Proton pump inhibitors: omeprazole (Prilosec) and lansoprazole (Prevacid)
    • Chemotherapy drugs are used to treat cancer.
  • Radiation enteritis occurs after radiation therapy, causing inflammation of the intestines. Diarrhea, nausea, vomiting, and stomach cramps are common symptoms for people receiving radiation therapy aimed at the abdomen, pelvis, or rectum.
  • Malabsorption syndrome. One of the main symptoms of malabsorption syndrome is diarrhea. In people with malabsorption syndrome, food moves too fast through the digestive system and bowels for nutrients to be absorbed.

Risk Factors for Diarrhea

Risk Factors

Poor sanitation and hygiene and inadequate water sources are the main risk factors for diarrhea-related diseases. Children and older adults are most at risk of contracting diarrhea from these conditions.

Other risk factors include:

  • Low-income households
  • Lack of education
  • Unsanitary water storage facilities
  • Untreated water sources in the home
  • Overcrowded households, particularly with many children under the age of five

People may have pre-existing conditions where diarrhea is a common symptom. These conditions include:

  • Irritable bowel syndrome (IBS) is an intestinal condition marked by bloating, gas, and belly pain, with either constipation or diarrhea
  • Crohn’s disease, a chronic, inflammatory bowel disease of the intestinal lining
  • Ulcerative colitis is a chronic, inflammatory bowel disease in the digestive tract, usually affecting the lining of the large intestine (colon) and rectum
  • Celiac disease, an autoimmune disease affecting a person’s ability to digest wheat, barley, or rye.

How to Prevent Diarrhea

Prevention

Some causes of diarrhea are easily preventable. Though diarrhea can be a symptom of another condition, these suggestions can decrease your chance of contracting an infection that causes diarrhea:

  • Washing your hands with soap and water often can help reduce your chance of acquiring an infection or organism that causes diarrhea. Always wash your hands after using the bathroom. Wash your hands before and while you cook, especially if you handle raw meat or eggs. Additionally, wash your hands after using public transportation or when returning home from shopping or being in public places. Doorknobs are notorious for harboring infectious germs that cause diarrhea.
  • Vaccinations. Have your children vaccinated as infants with the rotavirus vaccine; it is administered at intervals during a baby’s first year.
  • Food storage. Keep your foods stored at the suggested temperatures. Refrigerate leftovers to avoid bacteria that can cause diarrhea. Do not eat foods that have gone bad.
  • Drinking water safety. Avoid drinking water in places where proper water treatment facilities are limited. Do not drink tap water or use ice cubes that were made with it. Do not brush your teeth with tap water.

People usually know which foods their body can tolerate and which cause a problem. Some foods known to cause diarrhea are:

  • Milk and dairy products
  • Fried foods
  • Spicy foods
  • Processed foods that use chemical additives
  • Pork, veal, and sardines
  • Raw vegetables
  • Rhubarb
  • Fruits (pineapple, cherries, seeded berries, figs, currants, and grapes, and citrus fruits)
  • Alcohol
  • Carbonated drinks, especially those containing caffeine
  • Coffee
  • Artificial sweeteners, especially sorbitol
  • Unpasteurized dairy products or juices

Some foods can help ease diarrhea, such as the BRAT diet, which includes bananas, rice (white), applesauce, and toast.

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Trust NewYork-Presbyterian for Diarrhea Care

If you are experiencing diarrhea for more than four days, make an appointment with a doctor and learn more about your treatment options.

NewYork-Presbyterian offers convenient online patient portals, virtual appointments, and referrals to an extensive array of knowledgeable, experienced, and compassionate specialists. No matter what your health issue is, NewYork-Presbyterian has a doctor for you.