Diarrhoea Explained: Understanding Causes, Symptoms, Diagnosis, and Management
According to WHO, diarrhoea disease claimed 370,000 young lives under age five in 2019, ranking as the second leading cause of death in this age group.
Diarrhoea, defined by the frequent passage of loose, watery stools, is a common health issue affecting individuals of all ages. While it often resolves on its own, it can sometimes lead to severe dehydration and other complications, notably in young children and older adults.
What are the Types of Diarrhoea?
According to WHO guidelines, diarrhoea manifests in three primary clinical types:
1. Acute Watery Diarrhoea: It is characterised by loose, watery stools, often caused by viral or bacterial infections like cholera, that resolve within days.
2. Acute Bloody Diarrhoea/Dysentery: It involves bloody stools due to bacterial infections like Shigella, treated with antibiotics.
3. Persistent Diarrhoea: It lasts over 14 days and needs a thorough evaluation for causes like chronic infections or inflammatory bowel disease.
What are the Causes of Diarrhoea?
Diarrhoea can stem from a variety of factors, including:
1. Infections: Infections by viruses (e.g., rotavirus, norovirus), bacteria (e.g., E. coli, Salmonella, Shigella, Campylobacter), and parasites (e.g., Giardia lamblia, Entamoeba histolytica) are common causes of diarrhoea, often due to contaminated food or water.
2. Dietary Factors: Dietary habits and intolerances, such as lactose intolerance, food allergies, and ingesting artificial sweeteners like sorbitol and mannitol, can trigger diarrhoea. Contaminated food or water is also a common cause, especially for travellers.
3. Medications: Certain medications, notably antibiotics, can disrupt gut bacteria and cause diarrhoea. Antacids containing magnesium can also induce diarrhoea.
4. Medical Conditions: Conditions like Inflammatory Bowel Disease (IBD), Irritable Bowel Syndrome (IBS), including Crohn’s disease, ulcerative colitis, and celiac disease, can lead to persistent diarrhoea due to ongoing inflammation or intolerance to certain foods.
What are the Symptoms of Diarrhoea?
The primary symptom is the frequent passage of loose, watery stools. Additional diarrhoea symptoms may include:
1. Abdominal Cramps and Pain: These are often due to the increased motility of the intestines.
2. Bloating: Excess gas production can lead to a feeling of fullness or swelling in the abdomen.
3. Nausea and Vomiting: These symptoms can accompany diarrhoea, mainly when infections cause it.
4. Fever: A high temperature may indicate an infection.
5. Dehydration: Severe or prolonged diarrhoea can lead to significant fluid loss, resulting in dehydration, characterised by dry mouth, decreased urination, dizziness, and fatigue.
What is the Diagnosis Procedure for Diarrhoea?
When experiencing diarrhoea, especially if it is severe, persistent, or accompanied by concerning symptoms such as blood in the stool or high fever, diagnostic tests are crucial to identify the underlying cause. Here are the primary tests for diarrhoea used:
1. Stool Tests:
i. Stool Culture: Identifies bacterial infections like Salmonella, Shigella, and E. coli
ii. Ova and Parasites Test: Detects parasitic infections such as Giardia lamblia
iii. Clostridium Difficile Test: Identifies C. difficile toxins, common in antibiotic-associated diarrhoea
iv. Faecal Occult Blood Test (FOBT): Detects hidden blood, indicating possible inflammation or other conditions
v. Faecal Calprotectin: Measures inflammation in the intestines, helpful in diagnosing inflammatory bowel disease (IBD)
2. Blood Tests:
i. Complete Blood Count (CBC): Checks for infection or anaemia
ii. Electrolyte Panel: Assesses dehydration and electrolyte imbalances
iii. C-reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR): Measures inflammation
3. Imaging Studies
i. Abdominal X-ray: Detects bowel obstruction or perforation
ii. Abdominal Ultrasound: Evaluates gallbladder disease, liver conditions, or intestinal obstruction
iii. CT Scan: Provides detailed images to diagnose conditions like diverticulitis, IBD, or tumours
4. Endoscopic Procedures
i. Colonoscopy: Examines the colon and rectum; biopsies can diagnose IBD, colorectal cancer, or other conditions
ii. Upper Endoscopy (EGD): Examines the oesophagus, stomach, and duodenum for upper GI tract conditions
5. Specialised Tests
i. Hydrogen Breath Test: Diagnoses lactose intolerance or bacterial overgrowth in the small intestine
ii. Serologic Tests for Celiac Disease: Measures antibodies to diagnose celiac disease
How to Manage and Treat Diarrhoea?
Managing diarrhoea involves the following:
1. Hydration: Maintain hydration by drinking plenty of water, oral rehydration solutions (ORS), and clear broths. ORS is especially effective due to its balanced mix of salts and sugars. Avoid caffeinated, alcoholic, and sugary drinks.
2. Diet: Follow the BRAT diet (Bananas, Rice, Applesauce, Toast) for bland, low-fibre foods that help firm stools. Avoid dairy, fatty, and spicy foods until symptoms improve.
3. Medications: Consult a healthcare professional before using any medications. Over-the-counter anti-diarrhoeal medications can reduce bowel movement frequency but should not be used for lengthy periods. Antibiotics may be needed for bacterial infections.
4. Probiotics: Probiotics, available in supplements or foods like yoghurt, can help restore gut flora balance and may reduce the duration and severity of diarrhoea.
Diarrhoea, while often a mild and self-limiting condition, may result in serious health risks if not managed properly. Schedule a stool examination test at Dr Lal PathLabs for precise diagnosis and effective treatment.
FAQs
1. What causes diarrhoea?
Diarrhoea can be caused by infections, dietary factors, medications, medical conditions, stress, or contaminated food or water.
2. How to prevent diarrhoea?
To prevent infections and foodborne illnesses, practise good hygiene (hand washing), ensure food safety (cook thoroughly, wash produce), and drink safe water.
