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Everyone has diarrhea at one time or another. We all have our
own idea of exactly what diarrhea is. Is it one liquid stool each
day? Is it several soft, semi formed stools each day? Or is it
frequent, watery stools throughout the day and even the night?
Stool is made up mostly of water. For the average person in the
Western World, the maximum daily amount of water in stool is
generally no more than 7 oz. or 200 ml (8 oz. = I cup). When it
is consistently more, then medically it is called diarrhea.
Causes of Diarrhea
There are many causes of diarrhea.
Fortunately, in most instances, the change in bowel habits is
short lived and clears up on its own. In these cases, we assume
it is a virus infection or even "something I ate."
Whenever diarrhea lasts more than two or three weeks, medical
advice is generally recommended. Among the many known causes
are:
Food - Most people have certain foods that may cause diarrhea.
For hot pepper lovers (the chemical in it is called capaiscin),
diarrhea often occurs the morning after. Many people are
intolerant to milk and milk products so that even small amounts
of the milk sugar lactose can cause diarrhea. Large amounts of
fatty foods cause the same problem in other people. The obvious
solution in all these instances is to avoid the offending
agent.
Chemical Laxatives - Many people become dependent on laxatives
early in life and use them on a daily basis. The names for the
usual chemical stimulants: Milk Of Magnesia, magnesium (Epsom
salt), cascara (Nature's Remedy), phenolphthalein (Extax,
Correctol, Feen-A,Mint). Magnesium can be inadvertently ingested
in various over-the- counter preparations such as Maalox or
Mylanta. Check labels! Sorbitot is an artificial sweetener that
is used in sugar free gum and prepared foods such as jams and
jellies. Sorbitol, too, is a laxative.
Prescription Drugs - If a change in bowel habit occurs after
taking a new drug, the physician should be contacted. In
particular, antibiotics are known to cause diarrhea, at times
quite severe. Diarrhea can develop up to one month after taking
antibiotics.
Infection - There are over 400 different bacteria that
normally live quietly and beneficially in the large intestine.
There are also many viruses and other infectious agents that find
their way into our bodies. Some of these can infect the
intestinal tract and cause diarrhea. Fortunately, most of the
time these infections come and go on their own. Some bacterial
infections, such as salmonella, are nasty and require medical
evaluation. Salmonella commonly comes from contaminated poultry.
There are parasites, such as amoeba and Giardia, that attack the
intestines. Giardia is often found in wild animals and in
contaminated streams and well water. For people infected with the
AIDS virus, there are a number of infections that can occur in
the intestinal tract. Close medical follow up is always required
in these instances. Virus infection is probably the most common
cause of transient diarrhea and, fortunately, it usually clears
up on its own.
Traveler's Diarrhea - The cause of traveler's diarrhea
is a toxic bacteria called E. Coli. It most often occurs in
developing countries where sanitation is not good. This infection
can often be prevented by avoiding fresh, uncooked produce and
fruits. Fruits, such as oranges, that have protective skins are
safe. In particular, tap water in any form and especially ice
should be avoided. Bottled beverages are recommended. The
physician should be contacted prior to travel to Third World
countries to obtain more information on prevention and
treatment.
Diseases - There are certain intestinal disorders that can
cause chronic diarrhea. These include colitis, Crohn's
disease, diverticulosis, and even colon cancer. These are all
serious diseases that require careful medical attention and
treatment. It is a major reason why the cause of chronic diarrhea
should always be known.
Stress and Irritable Bowel Syndrome (IBS) - IBS is a problem
that occurs when the colon does not contract in a smooth,
rhythmic manner. The contractions can be exaggerated in which
case diarrhea occurs or they may be sluggish and result in
constipation. Sometimes there is alternating constipation and
diarrhea. Emotional stress often aggravates these symptoms.
Diagnosis
The discovery of the cause of diarrhea may be very simple,
such as discontinuing magnesium-containing antacids. Or it may be
more difficult. Testing of blood and stool may be needed. X-rays
and ultrasound may also be necessary. In some cases,
sigmoidoscopy or colonoscopy are required to visually inspect the
colon with a lighted, flexible tube. Testing depends on how
severe and prolonged the condition is, and how the physician
evaluates each case.
Treatment
There are simple things that can be done at the beginning of a
diarrheal episode which may help reduce symptoms. Taking only
liquids by mouth and avoiding solid food and milk may be helpful.
Over-the-counter constipating agents, such as Pepto-Bismol,
Kaopectate, or Imodium can also be tried. For explosive or
persistent diarrhea, treatment will obviously depend on the
cause. Fortunately, the source of diarrhea can almost always be
found and effective treatment is then usually available.
In Summary
Diarrhea is a common problem which is usually not serious. If
it is severe or persistent, a specific diagnosis should be
sought. By working closely with the physician, effective
treatment is almost always available.
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