Chronic Diarrhea

Diarrhea is loose, watery stools. Having diarrhea means passing loose stools 3 or more times a day. Diarrhea that lasts longer than 4 weeks is considered long-lasting (chronic). Symptoms of chronic diarrhea may be continual or may come and go. People of all ages can get diarrhea. Body fluid loss (dehydration) may occur as a result of diarrhea. This means the body does not have as many fluids and salts (electrolytes) as it needs.

CAUSES

There are many causes of chronic diarrhea. Causes may be different for children and adults. The various causes can be grouped into 2 categories: diarrhea caused by an infection and diarrhea not caused by an infection. Sometimes, the cause is unknown.

Diarrhea caused by an infection may result from:

  • Parasites.

  • Bacteria.

  • Viral infections.

Diarrhea not caused by an infection may result from:

  • Irritable bowel syndrome.

  • Reaction to medicines, such as antibiotics, cancer drugs, blood pressure medicines, and antacids.

  • Intestinal disease (Crohn's disease, ulcerative colitis, celiac disease).

  • Food allergies or sensitivity to additives (fructose, lactose, sugar substitutes).

  • Tumors.

  • Diabetes, thyroid disease, and other endocrine diseases.

  • Reduced blood flow to the intestine.

  • Previous surgery or radiation of the abdomen or gastrointestinal tract.

Risk factors for chronic diarrhea include:

  • Having a severely weakened immune system, such as from HIV/AIDS.

  • Taking certain types of cancer-fighting drugs (chemotherapy) or other medicines.

  • A recent organ transplant.

  • Having a portion of the stomach removed.

  • Traveling to countries where food and water supplies are often contaminated.

SYMPTOMS

In addition to frequent, loose stools, diarrhea may cause:

  • Cramping.

  • Abdominal pain.

  • Nausea.

  • Urgent need to use the bathroom, or loss of bowel control.

If dehydration occurs, problems include:

  • Thirst.

  • Less frequent urination.

  • Dark urine.

  • Dry skin.

  • Fatigue.

  • Dizziness.

Infections that cause diarrhea may also cause a fever, chills, or bloody stools.

DIAGNOSIS

Diagnosis may be difficult. Your caregiver must take a careful history and perform a physical exam. Tests given are based on your symptoms and history. Tests may include:

  • Blood or stool tests, in which 3 or more stool samples may be examined. Stool cultures may be used to test for bacteria or parasites.

  • X-rays.

  • A procedure in which a thin tube is inserted into the mouth or rectum (endoscopy). This allows the caregiver to look inside the intestine.

TREATMENT

  • Diarrhea caused by an infection can often be treated with antibiotics.

  • Diarrhea not caused by an infection is more difficult to diagnose and treat. Long-term medicine use or surgery may be required. Specific treatment should be discussed with your caregiver.

  • If the cause cannot determined, treatment to relieve symptoms includes:

  • Preventing dehydration. Serious health problems can occur if you do not maintain proper fluid levels. Many oral rehydration solutions (ORS) are available at drug stores. Ask your caregiver what product is best for you.

  • Not drinking beverages that contain caffeine (tea, coffee, soft drinks).

  • Not drinking alcohol. It causes dehydration.

  • Not relying on sports drinks and broths alone to maintain proper fluid levels. They should not be used to prevent severe dehydration.

  • Maintaining well-balanced nutrition. This may help you recover faster.

PREVENTION

  • Drink clean or purified water.

  • Use proper food handling techniques.

  • Maintain proper hand-washing habits.

HOME CARE INSTRUCTIONS

  • Avoid:

  • Caffeine.

  • Greasy foods.

  • High fiber.

  • If you have problems digesting lactose during or after an episode of diarrhea, you might want to try yogurt. Yogurt is often better tolerated, because it has less lactose than milk. Yogurt with active, live bacterial cultures may even help you recover faster.

SEEK MEDICAL CARE IF:

The person with diarrhea is an otherwise healthy adult and has:

  • Signs of dehydration.

  • Diarrhea for more than 2 days.

  • Severe pain in the abdomen or rectum.

  • An oral temperature above 102° F (38.9° C).

  • Stools containing blood or pus.

  • Stools that are black and tarry.

SEEK IMMEDIATE MEDICAL CARE IF:

The person with diarrhea is a child, elderly person, or has a weakened immune system and has:

  • Signs of dehydration.

  • Diarrhea for more than 1 day.

  • Severe pain in the abdomen or rectum.

  • An oral temperature above 102° F (38.9° C), not controlled by medicine.

  • Stools containing blood or pus.

  • Stools that are black and tarry.