Diarrhea: Signs, Symptoms and Treatment

Diarrhea is a condition where you have more than 3 bowel movements per day. The stool becomes runny and may contain mucus or blood. This is an unpleasant symptom that occurs in many diseases.

Diarrhea lowers the patient's quality of life and can lead to dehydration. When such a symptom appears, it is important to find out its cause in time and start treatment as soon as possible.

In this book, we will talk about the most common causes of diarrhea, the diagnosis of possible pathologies and their treatment.

Types of diarrhea

Diarrhea is divided according to the mechanism of occurrence:

• secretory - characterized by the accumulation of chlorine and sodium in the intestinal lumen. This leads to the release of fluid into the intestines and the appearance of frequent stools that have a liquid consistency. With secretory diarrhea, the body loses a large amount of electrolytes, which is fatal. This mechanism is typical for cholera, hormonally active tumors, salmonellosis, viral infections;
• osmotic - develops as a result of the transition of water into the intestinal lumen due to the high osmotic pressure of feces. A lot of feces are formed. This type of diarrhea is common with rotavirus infection;
• invasive - diarrhea develops due to impaired absorption of fluid in the inflamed part of the intestine. Typical for amebiasis and dysentery;
• motor - diarrhea appears due to fast intestinal motility. Typical for stress, scleroderma, diabetes, amyloidosis;
• exudative - the stake becomes liquid due to the release of mucus, blood, exudate, pus into the intestinal lumen. Typical for tuberculosis, ulcerative colitis, intestinal tuberculosis.

Causes

Violation of the stool in the form of diarrhea can develop with a variety of pathologies. Let's consider each in more detail.

Irritable bowel syndrome

Irritable bowel syndrome is a disorder of bowel function that is accompanied by recurrences of abdominal pain that occurs at least 1 time per week.

In this case, the pain syndrome is associated either with defecation, or with an altered frequency or shape of stool.

The patient is worried about diarrhea or constipation. Diarrhea occurs in the morning after the first meal. Stool frequency is 2 to 4 times, sometimes more, in a short period of time.

A strong urge to defecate is characteristic, while the person feels that the intestines, as if, have not been emptied completely.

The patient notes that during the first bowel movement, the stool was denser than during the subsequent ones. Moreover, with the following bowel movements, the volume of the stool decreases. Symptoms are absent at night.

Also, with irritable bowel syndrome, the patient is worried about pain. The pain syndrome can be aching, burning, dull.

Sometimes the patient describes the pain as dagger, twisting, constant. Soreness is felt in the iliac region (limited to the lower ribs and pelvic bones), often on the left.

A patient with irritable bowel syndrome notes that abdominal discomfort increases after eating. The pain goes away after having a bowel movement, taking drugs that reduce the spasm (antispasmodics), or passing gas.

Another sign of irritable bowel syndrome is bloating (flatulence).

Patients note that flatulence appears after eating, increases during the day. At the same time, abdominal distention is not observed in the morning hours.

In addition, patients with irritable bowel syndrome may be disturbed by: a feeling of heaviness and fullness in the stomach, nausea, heartburn, soreness in the lumbar region, pain in muscles and joints, symptoms from the genitourinary system (feeling of incomplete emptying bladder, frequent urge to urinate, frequent urination at night), soreness during intercourse in women, sleep disturbance.

Infectious process

Diarrhea can be caused by cholera, salmonellosis, enterovirus. All these conditions lead to the appearance of diarrhea due to the release of toxins.

With salmonellosis, signs of toxic infection appear 2 hours after eating an infected product.

Soreness and heaviness in the epigastrium, nausea, vomiting, diarrhea appear. The diarrhea is very thin and lasts about 4 days.

With an enterovirus infection, the patient complains of a sharp increase in temperature, chills, dizziness, diarrhea, sleep disturbance, runny nose, sore throat, muscle pain.

Dysbacteriosis

Dysbacteriosis is a condition characterized by an increase in the number of pathogenic microflora and a decrease in the number of beneficial bacteria in the intestine.

With dysbiosis, patients complain of diarrhea or constipation, or their alternation. Feces can be either hard at the beginning and mushy at the end of emptying, or "sheep" for constipation.

Also, patients note the presence of belching, nausea and vomiting, cramping abdominal pain, flatulence, frequent urge to defecate, in which a small amount of feces is released.

There are also metallic taste in the mouth, rumbling in the abdomen, mucus in the stool, allergic rashes, dry skin, "seizures" in the corners of the mouth, headache, itching of the skin, weakness, sleep disturbance.

The causes of dysbiosis are frequent intestinal infections, long-term use of non-steroidal anti-inflammatory drugs and hormonal drugs, unhealthy diet, impaired immune defense, taking antibacterial drugs, chemotherapy and radiation therapy, stress.

Ulcerative colitis and Crohn's disease

Ulcerative colitis is a chronic pathology characterized by an inflammatory process in the mucous membrane of the large intestine.

Patients with ulcerative colitis complain of blood in the stool, diarrhea (up to 15-20 times a day), including at night, false urge to defecate. Constipation, bloating, soreness in the left abdomen, and weight loss are also characteristic.

The causes of ulcerative colitis are not fully understood. Perhaps infection, heredity, stress, and the use of non-steroidal anti-inflammatory drugs play a role in the onset of the disease.

Crohn's disease is a chronic pathology characterized by inflammation of all tissues of the gastrointestinal tract, from the oral cavity to the anal canal.

Patients complain of diarrhea for more than 6 weeks, while there is no blood in the stool.

Also, patients are worried about soreness in the abdomen, fever, nausea, vomiting, impaired gas and feces, and bloating.

The causes of Crohn's disease are heredity, impaired immunity, dysbiosis.

Chronic pancreatitis

Pancreatitis is an inflammation of the pancreas that causes irreversible changes in the organ.

Diarrhea in chronic pancreatitis develops in case of insufficient secretion of enzymes by the pancreas.

In addition to diarrhea, the patient complains of greasy, fetid feces that are difficult to flush off the toilet; the allocation of a large amount of feces, vomiting, which does not bring relief, weight loss.

The appearance of yellowness of the sclera and skin, dryness of the skin is characteristic. On the body, red eruptions are found, which do not disappear when pressed.

Also, with pancreatitis, the patient is worried about abdominal pain. It is localized in the epigastric region (in the navel and 2-3 cm above it). Soreness "gives" to the back and becomes worse after eating.

The pain syndrome subsides after adopting a sitting position or when the trunk is tilted forward. In 10% of cases, the pathology can proceed without abdominal pain.

Pancreatitis is characterized by recurrence of pain, with short attacks lasting up to 10 days. In some cases, the pain is permanent.

Painful episodes are long, the painless period lasts about 2 months (typical for alcoholic chronic pancreatitis).

With the progression of the disease, the soreness gradually subsides, it becomes less common.

Cirrhosis of the liver

Cirrhosis of the liver is a chronic disease that manifests itself as jaundice, enlargement of the esophageal, gastric and hemorrhoidal veins, bleeding, swelling, and enlargement of the spleen.

With cirrhosis, diarrhea occurs, pain in the right side, in the hypochondrium on the left, heaviness and overflow of the stomach after eating, diarrhea. Veins appear on the abdomen - a consequence of the expansion of the veins of the stomach.

In addition, gastrointestinal bleeding, hematomas, decreased muscle mass, yellowness of the skin, and weight loss are characteristic of cirrhosis.

With the development of bleeding from the dilated veins of the esophagus, stomach or rectum, the patient notes bloody vomiting, black stools.

Also noteworthy is the reddening of the palms, red rashes on the skin, thickening of the fingers, an increase in the spleen.

Intestinal tuberculosis

The disease is characterized by recurrent diarrhea. With the progression of tuberculosis, complaints of pain are added to diarrhea. The patient feels discomfort in the navel area.

Improper nutrition

Frequent consumption of spicy foods, carbonated drinks, spices, and rough plant foods can contribute to diarrhea.

The cause of diarrhea can be a lack of vitamin K, PP, B₂. Another reason for diarrhea is non-adherence to the diet.

Traveler's diarrhea

This is the name of a stool disorder that appears after a change in climate, habitual food or water. Diarrhea appears 3-7 days after moving and disappears upon returning home or when the local cuisine is abandoned.

Diarrhea after taking antibiotics

After taking cephalosporins, amoxicillin, ampicillin, clindamycin, diarrhea may appear. Also, patients are worried about soreness in the lower abdomen, fever. There may be blood in the stool.

Which doctor to contact

If repeated diarrhea occurs, you should consult a therapist or gastroenterologist. The doctor will prescribe an examination and treatment.

In the future, you may need to consult an infectious disease specialist, phthisiatrician, psychiatrist, surgeon.

Survey

How to find out the cause of diarrhea? This will help laboratory and instrumental research methods.

Laboratory includes:

• a general blood test - will help detect an infectious or inflammatory process in the body;
• biochemical blood test - will indicate pancreatitis, cirrhosis, hepatitis, cholecystitis;
• coprogram - allows you to study the composition of feces, the presence of undigested food debris, bile pigments;
• analysis of feces for occult blood;
• analysis of feces for bacteria of the intestinal group. Allows to detect bacteria of the Shigella group, Salmonella, Yersinia, botulinum toxins in the feces;
• breath test - allows you to detect excessive growth of intestinal bacteria in a patient;
• morphological examination of intestinal biopsy - assess the presence of changes in the tissues of the intestine;
• microscopic analysis of feces - the study of the composition of microflora under a microscope.

Instrumental research methods:

• sigmoidoscopy and colonoscopy - these studies are necessary to assess the condition of the intestinal mucosa, taking biopsies from suspicious areas. With sigmoidoscopy, the rectum and sigmoid colon are examined, and with colonoscopy, the entire large intestine. Before conducting these studies, the patient needs to prepare. Preparation takes 1 to 3 days, during which you should adhere to a liquid-based diet, drink a laxative the night before the study. The examination is carried out under anesthesia;
• irrigoscopy - X-ray examination of the large intestine with a contrast agent;
• Ultrasound of the abdominal organs - allows you to assess the condition of the abdominal organs, identify a tumor or inflammation;
• bowel ultrasonography - an ultrasound examination of the bowel. Allows you to identify neoplasms and free fluid during inflammation;
• plain x-ray of the abdominal organs - the method is rarely used at the moment. Allows you to identify calcification in the projection area of ​​the pancreas or stones in its ducts;
• CT scan of the abdominal organs.

Treatment

Treatment for diarrhea includes treating the symptoms and causes of diarrhea, and diet.

Non-drug treatment

When diarrhea occurs, it is important to follow a diet.

First of all, it is necessary to drink as much liquid as possible, since the patient loses a lot of fluid in the place with the stool, which can threaten dehydration.

Drink at least a glass of water after each episode of diarrhea. The patient should drink 2-3 liters of water per day.

You need to eat in small portions, at least 5 times a day. Food should be light and digestible quickly. The following foods should be excluded from the diet:

• chips;
• cocoa;
• fatty foods;
• spicy;
• smoked meats;
• chocolate;
• fish, mushroom and meat broths;
• coffee;
• alcohol;
• carbonated drinks;
• legumes;
• eggs;
• pastry with cream;
• frozen desserts.

You can eat the following foods:

• lean fish, meat;
• potato;
• vegetable oils;
• eggs;
• rice, corn, buckwheat;
• potato;
• fresh berries and fruits;
• natural tea;
• fresh, boiled or baked vegetables.

Drug treatment

Medical treatment for diarrhea depends on the underlying cause. Consider the treatment for each type of diarrhea.

Infectious diarrhea

To eliminate diarrhea during infection, antibiotics, adsorbents, probiotics and antiseptics are used.

Antibiotics are selected individually, depending on the pathogen that caused the disease.

Adsorbents include Smecta, Enterosgel, Activated carbon. Preparations of this adsorb bacterial toxins on their surface and remove them from the body.

Antiseptics include Enterofuril, Sumetrolim. These drugs target the bacteria in the intestines, killing them.

Probiotics - Linex, Bifiform, Bactisubtil, Bactisporin. Probiotics are microorganisms that are used to treat dysbiosis.

When they enter the intestine, they populate it, restoring the normal intestinal microflora.

Lost fluid is also replenished.

Viral and parasitic diarrhea

For viral and parasitic infections, probiotics and antiseptics are also used. Also, the patient is prescribed Regidron to replenish lost fluid.

In addition, medications that interfere with intestinal secretion (Meteospazmil, Platyphyllin) may be prescribed.

Irritable Bowel Syndrome Treatment

For the treatment of irritable bowel syndrome, the following are used:

• Loperamide - due to a decrease in motor activity and intestinal tone, the stool acquires a normal consistency. The urge to defecate also decreases. However, it must be remembered that Loperamide does not relieve pain;
• Smecta is an antidiarrheal and absorbent agent. The drug protects the intestinal mucosa from toxins and infection. Smecta also adsorbs toxins on itself and removes them from the body. To relieve diarrhea, flatulence and pain, take 1 sachet three times a day daily;
• antibiotic Rifaximin. This drug not only relieves diarrhea, but also eliminates bloating. The antibiotic is taken in a short course;
• probiotics - Florasan-D;
• Trimedat - eliminates abdominal pain and fights stool disturbance;
• Iberogast is a herbal preparation. Normalizes intestinal motility, has an anti-inflammatory effect;
• antidepressants - Desipramine, Paroxetine, Sertraline.

Treating diarrhea after taking antibiotics

First of all, antibiotics that caused diarrhea are canceled. The patient may be prescribed Metronidazole or Vancomycin, as well as probiotics (Linex, Acylact, Bifinorm).

Treatment of diarrhea in chronic pancreatitis

To eliminate diarrhea, a patient with chronic pancreatitis should take at least 25-45 thousand. units lipases for the main meal and 10-25 thous. units per intermediate.

The effectiveness of enzymatic treatment is assessed by the relief of diarrhea, the absence of fatty, fetid feces, and a decrease in its amount.

If symptoms are present even after the appointment of the necessary doses of enzymes, then you need to additionally take proton pump inhibitors (Omeprazole, Lansoprazole, Esomeprazole, etc.).

Folk remedies

Alternative methods of treatment can be used in conjunction with drug therapy. Before using folk recipes, you should consult your doctor.

Recipes:

• grind 25 g of oak bark and pour half a liter of boiling water over them. Leave the mixture under a closed lid for 3 hours, then strain. Permeate 100 ml three times a day;
• a third of a glass of dried bird cherry berries pour 750 ml of boiling water. Put on fire and simmer for 15 minutes, then strain. Take 100 ml twice a day;
• dry the pomegranate peels in the oven and chop them. 2 tbsp. l. powder from the crusts, pour a glass of boiling water and put on fire for 25 minutes. Then strain and take 7 tbsp. l. ;
• Pour 25 g of starch with a glass of warm water and add 15 g of honey. Stir until thickened. Take several times a day;
• brew strong black tea in a bag in a glass of boiling water. Tea should be without additives, and the sachet should be kept in a mug for at least 10 minutes;
• eat 5 pieces of peppercorns and drink plenty of water. Take pepper in this way from 4 to 6 times a day.

Conclusion

Diarrhea is a condition where you have more than 3 bowel movements per day. The stool becomes runny and may contain mucus or blood.

This symptom occurs quite often in various diseases. The cause of diarrhea can be irritable bowel syndrome, infectious process, dysbiosis, nonspecific ulcerative colitis, chronic pancreatitis, cirrhosis of the liver, intestinal tuberculosis, unhealthy diet, traveler's diarrhea, intake antibiotics.

Diagnosis of the disease that caused diarrhea includes laboratory and instrumental research methods.

Laboratory tests include general and biochemical blood tests, coprogram, feces for occult blood, fecal analysis for bacteria of the intestinal group, morphological and microscopic analyzes of feces.

Instrumental methods include sigmoidoscopy and colonoscopy, irrigoscopy, ultrasound of the abdominal organs cavities, ultrasonography of the intestine, plain X-ray of the abdominal organs, CT of the abdominal organs cavity.

Therapy for diarrhea includes adherence to diet, drinking regimen, and treatment of the cause. Drug therapy is based on the suspected cause of the diarrhea.

If you have frequent loose stools, you should consult a doctor as soon as possible, because the condition can be aggravated by dehydration, which can be fatal.