Chronic Diarrhea

Diarrhea is frequent loose and watery bowel movements. It can cause you to feel weak and dehydrated. Dehydration can cause you to become tired and thirsty and to have a dry mouth, decreased urination, and dark yellow urine. Diarrhea is a sign of another problem, most often an infection that will not last long. In most cases, diarrhea lasts 2–3 days. Diarrhea that lasts longer than 4 weeks is called long-lasting (chronic) diarrhea. It is important to treat your diarrhea as directed by your health care provider to lessen or prevent future episodes of diarrhea.

CAUSES

There are many causes of chronic diarrhea. The following are some possible causes:

  • Gastrointestinal infections caused by viruses, bacteria, or parasites.  

  • Food poisoning or food allergies.  

  • Certain medicines, such as antibiotics, chemotherapy, and laxatives.  

  • Artificial sweeteners and fructose.  

  • Digestive disorders, such as celiac disease and inflammatory bowel diseases.  

  • Irritable bowel syndrome.

  • Some disorders of the pancreas.

  • Disorders of the thyroid.

  • Reduced blood flow to the intestines.

  • Cancer.

Sometimes the cause of chronic diarrhea is unknown.

RISK FACTORS

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

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

  • Having had a recent organ transplant.  

  • Having a portion of the stomach or small bowel 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.  

  • Fever.

  • Fatigue.

  • Urgent need to use the bathroom.

  • Loss of bowel control.

DIAGNOSIS

Your health care provider 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. Three 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 health care provider to look inside the intestine.  

TREATMENT

  • Treatment is aimed at correcting the cause of the diarrhea when possible.

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

  • Diarrhea not caused by an infection may require you to take long-term medicine or have surgery. Specific treatment should be discussed with your health care provider.  

  • If the cause cannot be determined, treatment aims to relieve symptoms and prevent dehydration. Serious health problems can occur if you do not maintain proper fluid levels. Treatment may include:  

  • Taking an oral rehydration solution (ORS) .

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

  • Not drinking alcohol.  

  • Maintaining well-balanced nutrition to help you recover faster.

HOME CARE INSTRUCTIONS

  • Drink enough fluids to keep urine clear or pale yellow. Drink 1 cup (8 oz) of fluid for each diarrhea episode. Avoid fluids that contain simple sugars, fruit juices, whole milk products, and sodas. Hydrate with an ORS. You may purchase the ORS or prepare it at home by mixing the following ingredients together:  

  • ⅓–⅔ tsp (1.7–3 ⅓ mL) table salt.  

  • ¾ tsp (3 ¾ mL) baking soda.  

  • ⅓ tsp (1.7 mL) salt substitute containing potassium chloride.  

  • 1 ⅓ tbsp (20 mL) sugar.  

  • 4.2 c (1 L) of water.  

  • Certain foods and beverages may increase the speed at which food moves through the gastrointestinal (GI) tract. These foods and beverages should be avoided. They include:  

  • Caffeinated and alcoholic beverages.  

  • High-fiber foods, such as raw fruits and vegetables, nuts, seeds, and whole grain breads and cereals.  

  • Foods and beverages sweetened with sugar alcohols, such as xylitol, sorbitol, and mannitol.  

  • Some foods may be well tolerated and may help thicken stool. These include:

  • Starchy foods, such as rice, toast, pasta, low-sugar cereal, oatmeal, grits, baked potatoes, crackers, and bagels.  

  • Bananas.  

  • Applesauce.  

  • Add probiotic-rich foods to help increase healthy bacteria in the GI tract. These include yogurt and fermented milk products.  

  • Wash your hands well after each diarrhea episode.  

  • Only take over-the-counter or prescription medicines as directed by your health care provider.  

  • Take a warm bath to relieve any burning or pain from frequent diarrhea episodes.

SEEK MEDICAL CARE IF:

  • You are not urinating as often.

  • Your urine is a dark color.  

  • You become very tired or dizzy.  

  • You have severe pain in the abdomen or rectum.  

  • Your have blood or pus in your stools.  

  • Your stools look black and tarry.  

SEEK IMMEDIATE MEDICAL CARE IF:

  • You are unable to keep fluids down.  

  • You have persistent vomiting.  

  • You have blood in your stool.

  • Your stools are black and tarry.  

  • You do not urinate in 6–8 hours, or there is only a small amount of very dark urine.  

  • You have abdominal pain that increases or localizes.  

  • You have weakness, dizziness, confusion, or lightheadedness.  

  • You have a severe headache.  

  • Your diarrhea gets worse or does not get better.  

  • You have a fever or persistent symptoms for more than 2–3 days.  

  • You have a fever and your symptoms suddenly get worse.  

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.