Worldwide, diarrhea is considered to be one of the leading causes of mortality as it can cause severe dehydration as fluids, minerals and salt are lost every bowel movement. Statistics show that roughly around 25 million cases occur each year, majority of which are from those populations that are considered to be at risk such as the elderly, children below 5 years old and those that are immunocompromised. In fact, in parts of Asia and Africa alone, 4 to 6 million children are affected each year.
Diarrhea may be further classified as acute, persistent or chronic depending on how long the disease process continues. The diarrhea is said to be acute if it lasts for less than 2 weeks, persistent if it lasts from 2 to 4 weeks and chronic if it lasts more than one month. Diarrhea usually occurs when an ingested substance irritates the bowel disrupting the normal action of the colon of absorbing liquids from the digested food resulting to watery stools. Diarrhea may also be caused when food passes the bowel too quickly or in huge quantity that exceeds the absorptive capacity of the bowel.
Diarrhea is clinically diagnosed when there is bowel movement of 3 or more times per day, stool weight of at least 200 grams and urgency is felt prompting the need to defecate right away.
Causes of Diarrhea
Diarrhea is caused by a multitude of factors. Acute diarrhea is often secondary to food poisoning or to an infection while chronic diarrhea may be a manifestation of a disease process anywhere along the gastrointestinal tract or even medications. Listed below are some of the examples:
- Bacteria – Bacteria such as Staphylococcus aureus, Escherichia coli and Salmonella are common pathogens in cases of food poisoning. This kind of diarrhea is often referred to as Traveler’s Diarrhea.
- Virus – Viruses such as the Rotavirus, which is the main pathogen in cases of diarrhea in children, Norwalk virus and cytomegalovirus can cause diarrhea.
- Parasites – Parasites such as Giardia Lamblia and EntamoebaHistolytica can also cause diarrhea. Parasites usually gain access through contaminated food or water.
- Medications/Drugs – The following substances can trigger diarrhea in some people: NSAIDs, laxatives, alcohol, antibiotics
- Sorbitol and Fructose containing food
- Metabolic/Endocrine diseases – Hyperthyroidism, Addison’s disease, carcinoid syndrome, Diabetes
- Digestive disorders – the kind of diarrhea associated with digestive disorders is usually chronic. Some examples are the following: Irritable bowel syndrome, Chron’s Disease, Celiac Disease
Signs and Symptoms of Diarrhea
Increased passage of abnormally formed stools is the most common presenting symptom of diarrhea. However, the following may also be symptoms of diarrhea:
- Presence of abdominal tenderness or pain
- Presence of abdominal cramps
- Wasting or weight loss
- Bloody stools
- Dehydration – Signs of dehydration in adults include:
- Pulse rate >90
- Postural or orthostatic hypotension
- Absence of palpable pulse
- Dry tongue
- Sunken eyeballs
Treatment for Diarrhea
A case of diarrhea usually resolves on its own after a few days. However, assessing the magnitude or degree of dehydration is one of the most important aspects of managing diarrhea as it poses the most serious risk especially to young children. Therefore, it is of utmost important to prevent diarrhea by replenishing the lost fluids with water.
In cases wherein dehydration has set in, the best way to resolve diarrheal dehydration is through the Oral Rehydration Therapy which makes use of oral rehydration salt solutions which can successfully rehydrate 90% of the time. However, if dehydration is severe, rehydration via intravenous fluids is recommended.
Other treatment options for diarrhea are as follows:
- Zinc – supplementation of zinc can reduce duration of diarrhea by up to 25%
- Multivitamins supplementation
- Continue giving food
- Anti-motility agents such as loperamide
- Antibiotics if bacterial in origin
Gastroenteritis, or simply referred to as diarrhea, is the passage of poorly formed or abnormally loose or liquid stools at an increased frequency.