Chronic diarrhea in adults: causes, treatment, diet

One of the most unpleasant, exhausting ailments is chronic diarrhea. This is a pathology in which a liquefied, unformed stool leaves the patient for several months. Defecation occurs more than three times a day. They are accompanied by a weakened state, rumbling in the abdomen and intestines, pain in the stomach, bloating, false urge to defecate, dehydration of the body and the appearance in the stool of pathological impurities.

Why is this condition possible, and how can chronic diarrhea be cured? There are several reasons for this disease. With regard to treatment, it should be medication, in combination with dietary measures.

How diarrhea becomes chronic

Diarrhea, as a synonym for diarrhea, is a well-known phenomenon. But diarrhea itself is not a disease. Therefore, when patients try to treat it, especially without the participation of a doctor, by their own means, it can turn into chronic diarrhea and become a symptom of one or more dangerous diseases.

Important! You cannot cure diarrhea, and even more so chronic diarrhea, without diagnosing the disease or not discovering other pathologies that caused it.

The generally accepted definition of diarrhea is the outcome of liquefied stools an increased number of times. The body of a healthy person excretes from 100 to 300 g of normally formed feces per day. The frequency can be any, it is different for each organism, but usually it is one, maximum twice a day. If the feces are evacuated more often, but their consistency is within the normal range, we can talk about increased intestinal motility, which can occur as a result of the use of certain foods that contribute to this. This does not apply to manifestations of diarrhea.

Loose stools can occur for the following non-pathological reasons:

• indigestion, which usually occurs after overeating and an abundance of poorly digested foods;
• food poisoning of the first and average degree;
• allergic manifestation to the use of an allergen product;
• taking laxatives;
• the use of synthesized sugar substitutes;
• stress;
• travel and climate change.

Everyone has experienced diarrhea at least once in their life due to one of the listed reasons. It rarely lasts more than three to four days, in the most serious cases, a week. By the official medical definition, such diarrhea cannot be considered chronic.

More serious sources of diarrhea include:

• viral infection;
• toxic poisoning;
• intestinal inflammation;
• enzyme deficiency;
• diseases of the gastrointestinal tract.

Here, the manifestations of diarrhea can last for a much longer time, be accompanied by other symptoms, and we are often talking about the chronic nature of the disease.

Mechanism of occurrence

Diarrhea is not one, but a complex of symptoms that is characteristic of the following pathological conditions of the body.

1. Intestinal infection.
2. Non-infectious bowel disease.
3. Diseases of the digestive tract with damage to its upper sections.
4. Chronic intoxication.
5. Psychoemotional pathologies.
6. Diseases of other (non-digestive) organs.

Causes of occurrence

Since the list of causes of occurrence is quite extensive, there are four groups of mechanisms for the development of this disease:

• hyperkinetic;
• hypersecretory;
• hyperexudative;
• hyperosmotic.

Table. Classification of diarrhea by development mechanisms.

Mechanism type	Description
Hyperkinetic	It is formed in the process of increased stimulation of the intestinal walls, in which its motor activity increases. It can occur both at the neurogenic level (diabetes, irritable bowel), and under the influence of hormones (Addison's disease) or drug stimulation. The latter case occurs most often, since many patients abuse laxatives, taking them without a doctor's prescription and in high dosages.
Hypersecretory	In this case, an increased secretion of electrolytes and fluids is noted in the intestinal lumen. The process can be passive (with lymphoma or Whipple's disease), or actively (presence of E. coli or staphylococcal infection). Some of the laxatives and hormonal drugs also cause disease.
Hyperexudative	Occurs after inflammation of the intestinal wall, which is characterized by an increased dose of injecting exudate into the intestinal lumen. It is noted in a number of inflammatory bowel processes. It can also accompany chronic infections (intestinal tuberculosis), ischemic lesions, polyps and oncological formations.
Hyperosmotic	The reason for the development is a digestive disorder and a violation of the absorption process in the gastrointestinal tract. Provocateurs: fistula, pancreatitis, anastomosis, pancreatic tumor, malabsorption syndrome.

The primary sources of chronic diarrhea are the above factors, both individually and in combination.

In addition, an ailment can lead to diseases such as:

• polyposis;
• functional diarrhea;
• intestinal amyloidosis;
• colorectal cancer;
• helminthiasis;
• carcinoid syndrome;
• intestinal lipodystrophy;
• uremia;
• syphilis.

Symptomatic manifestations

As already noted, the main signs are loose stools and increased frequency of bowel movements. But how can you differentiate between common diarrhea and chronic diarrhea if the two main symptoms are the same? Medical professionals disagree on this score.

By the way. Someone makes a chronic diagnosis based on symptomatic manifestations lasting three weeks or more. Someone recognizes the chronic stage of the disease only if the symptoms continue for six weeks or more.

Be that as it may, the main signs of the named pathology are as follows.

1. More than three episodes of bowel movements per day.
2. The chair is loose or inadequate.
3. The consistency of the stool is viscous, mushy or liquid, watery.
4. Continuation of this condition without changes for at least three weeks.
5. Associated pain.
6. False urge to defecate.
7. Increased flatulence.
8. Rumbling in the abdomen and throughout the intestines.
9. Foreign matter in the stool (pus, fat, mucus, blood, water).
10. Decrease in the amount of stool.

For pathological conditions of the small intestine characteristic fatty impurities in watery stools, without a pronounced pain syndrome.

Esland pathology in the large intestine (upper sections), in the feces there is mucus and pus, occasionally blood. In addition, this type of disease almost always has a concomitant pain syndrome.

With pathology in the lower colon stool is minimal in volume, bowel movements more often than three times a day, the patient experiences false stool urges.

If diarrhea accompanies colorectal cancer, a feeling of fatigue, loss of appetite, weight loss, intestinal obstruction and intestinal perforation are added to diarrhea.

At intestinal inflammation added to diarrhea is hyperthermia and extraintestinal symptoms such as stomatitis.

If chronic diarrhea occurs due to endocrine disorders, hormonal regulation is disrupted.

Diagnostics

Since this disease is not independent, the main diagnostic measures are aimed at identifying the causes of its occurrence. What disease or pathology is behind the diarrhea that lasts for weeks? To clarify this issue, medicine has the following tools.

1. Collecting anamnesis, description of symptoms.
2. Determination of the localization and extent of the lesion.
3. Examination of the patient (visually determined by the degree of bloating, its asymmetry, the presence of painful foci on palpation).
   

   Superficial and deep palpation of the abdomen

4. Examination of the anus to detect traces of blood, pus and other pathological impurities.
5. Scatological analysis of feces.
6. Endoscopic examination.
   

   The main principle of the endoscopy department is oncological vigilance during each endoscopic examination.

7. Irrigoscopy.
8. Colonoscopy.
   

   Colonoscopy

9. Retromanoscopy.
10. Biopsy.
11. Examination by other specialists (proctologist, nephrologist, endocrinologist - if necessary).

Irrigoscopy prescribed for suspected polyposis or cancer.

Colonoscopy allows you to assess the integrity of the intestinal walls and determine, in the presence of ulcers, their number, size and localization.

Sigmoidoscopy will show the presence of polyps and help identify tumors.

During the endoscopy procedure, a biopsy may be taken in parallel.

How is chronic diarrhea treated?

After a thorough examination of the patient, the doctor draws up a treatment plan, which can be of two types.

1. Pathogenetic - in the presence of pathologies, with the use of drug therapy and non-drug techniques, as well as surgery.
   

   Treatment begins with the appointment of drugs.

2. Symptomatic - consists in relieving symptoms by prescribing a special diet and symptomatic drugs. It can be antibacterial drugs, probiotics, sorbents.
   

   Symptomatic treatment consists of a combination of medication and diet.

Important! Despite advertising claims, there is no “diarrhea pill”. Moreover, from chronic diarrhea. You will need a whole range of medical measures and compliance with the necessary conditions (changing the diet, getting rid of bad habits, improving the lifestyle).

Sorbents

One of the most important points in the treatment of chronic diarrhea, since during the entire period of therapy it is necessary to remove toxins and bacteria from the patient's body, as well as remove gas formation.

Advice. When prescribing these drugs, doctors warn that they should not be combined with other drugs. What does this mean? Take them separately, at least two hours before or two hours after taking other drugs, otherwise their absorption will be impaired.

Enterosorbents are not prescribed for diarrhea only in one case, when the absorption process in the intestine is impaired. So that nutrients are not removed from the body along with toxins, sorbents are not accepted.

The choice of drugs in this group is great. The most commonly prescribed drugs are:

• Activated carbon;
  

  Activated carbon

• Attapulgit;
  

  Attapulgite

• "Smecta";
  

  Smecta is an effective antidiarrheal drug

• "Polyphepan";
  

  "Polyphepan"

• "De-Nol".
  

  "De-Nol"

  

  Instructions for the drug

Antidiarrheal drugs

Their choice depends on the cause of the diarrhea and the underlying disease. Stopping diarrhea, reducing peristalsis, the following drugs:

• Loperamide;
• Diarol;
• "Imodium";
• Laremid;
• Diara.
  

  Loperamide

  

  "Imodium"

Intestinal anti-inflammatory

With intestinal infections, it is necessary to relieve inflammation, therefore, the patient is prescribed antiseptics that act in all parts of the intestine, but are not absorbed into the blood. These are drugs such as:

• Salofalk;
• "Mesakol";
• Mesalazin;
• "Pentasa";
• "Rectodelt".
  

  "Salofalk"

  

  "Pentasa"

Probiotics

This group is mandatory and indispensable in the treatment of diarrhea of ​​any etiology. This disease completely imbalances the intestinal microflora, and probiotic preparations are best suited for its restoration.

The probiotic group includes:

• Enterol;
• Linex;
• Galavit;
• "Baktisubtil";
• "Khilak Forte".
  

  Enterol

  

  Galavit

Phytopreparations

They help to reduce intestinal secretion, normalize peristalsis. They are composed of natural plant components with astringent properties.

These plants include:

• bird cherry (berries);
• oak (bark);
• cinquefoil (root);
• alder (cones);
• chamomile (flowers).

It is best to purchase this plant raw material at a pharmacy, or use ready-made multicomponent collections.

Diet and drinking regimen

If diarrhea occurs, rehydration therapy is necessary without waiting for the disease to become chronic. It should be started immediately, at the first sign of diarrhea. It is very easy to do this, any patient can replenish the loss of fluid in the body on their own. However, this simple action is often underestimated by patients, and they still become severely dehydrated until they decide to see a doctor for diarrhea.

What to drink with diarrhea

It is important to immediately organize a drinking regimen that will prevent dehydration. Fluid should enter the body in a volume of at least two liters per day, while drinking should be of such a nature that fluids in the body are retained, and not excreted along with diarrhea. Plain water in this case is not the most suitable option. You need to drink solutions that will maintain balance and normalize water-salt metabolism.

1. "Rehydron" and similar rehydrating solutions, specially designed to restore water-salt balance and maintain sugar levels.
   

   "Regidron"

2. Salted water (a teaspoon of regular salt in a glass of water).
3. Soda solution (half a teaspoon).
   

   Soda solution

4. Sugar solution (four tablespoons per glass).
5. Herbal tea (best from chamomile flowers with sugar or honey).
   

   Chamomile tea

6. Potassium chloride solution (quarter teaspoon).
7. Tea with added sugar and orange juice.
   

   Tea with juice

You have to drink a lot throughout the course of the treatment of diarrhea, until the symptoms disappear. You need to take a drink often, but in small portions and sips.

What to eat with diarrhea

With diarrhea, and especially its chronic forms, a special diet must be observed. The composition of food affects the quality and quantity of feces, and the rate of bowel emptying. Therefore, supportive nutrition can correct and enhance the effect of medications taken.

First of all, you need to remove the following from the menu.

1. Condiments and spices.
2. Raw vegetables.
3. Raw fruits.
4. Spicy, sour, and salty foods.
5. Fatty foods.
6. Gas-forming products.
7. Foods containing coarse fiber.

Grocery list, prohibited for diarrhea until it is completely cured, looks like that:

• prunes, dried apricots, figs and other dried fruits;
  

  Figs, dried apricots, prunes

• tomatoes, carrots, cabbage, beets, cucumbers;
• milk and cream, fatty sour cream;
• grapes and grape juice;
  

  Grape juice

• turnip and radish;
• black bread;
• lingonberries and apples;
  

  Lingonberry and apples

• fried meat and fatty meat, cooked in any way;
• concentrated meat broth;
• offal;
  

  Offal

• fried fish and fatty fish cooked in any way;
• canned food;
• smoking;
  

  Smoked meats

• mushrooms;
• hard-boiled eggs and fried fried eggs;
• sour fruits and berries;
  

  Sour fruits and berries

• any baked goods;
• carbonated drinks, alcoholic and kvass.

The list is quite impressive, and at first glance it may seem that a patient with chronic diarrhea will have to sit on breadcrumbs and water for several months. This is not the case, since the list of permitted foods is also not small.

For chronic diarrhea, the following are allowed:

• wheat flour crackers;
  

  The use of crackers is directly related to the quality of the products that make up them.

• puree from permitted vegetables, stewed vegetables;
• any boiled porridge on the water;
  

  Oatmeal on the water

• steamed lean meat and lean fish;
• dairy products;
  

  Dairy products

• jelly, teas and compotes from permitted berries and fruits.

On the first day, it is recommended to drink only tea with sugar and a small amount of crackers. Then gradually introduce the permitted food, but make sure that it is taken in minimal portions (up to 200 g) every three hours. Thus, a patient on an antidiarrheal diet should eat at least five times a day. Do not forget about maintaining the drinking regime.

After a week, the harsh conditions of the diet can be mitigated and introduced:

• pasta;
• soups with meat, fish and vegetable broth;
• milk and butter;
• cottage cheese and low-fat cheeses;
• fresh fruits and berries;
• legumes and cocoa.

Chronic diarrhea is difficult to treat. But the disease is a logical continuation of the usual diarrhea, which is easier to cure. If you self-medicate and don't see a doctor while waiting for the diarrhea to become chronic, you can skip the onset of many serious illnesses. Do not wait for the emergence of a critical situation and the transition of diarrhea to a chronic form. If you have a tendency to diarrhea and indigestion, follow the diet, take preventive measures, and if loose stools last more than three days, go to the doctor for a complete survey.

Video - Frequent (chronic) diarrhea