Diarrhea
Diarrhea is an abnormal increase in the frequency,
fluidity, and volume of bowel movements. More than three
soft, loose, or watery bowel movements in a day constitute
diarrhea. In a healthy adult, most cases of diarrhea
last from 24 to 48 hours and are not serious. Diarrhea
can be more dangerous to infants and older people because
of an increased risk of dehydration, upsetting body
chemistry and depleting important body salts. Left untreated,
it can lead to shock. Persistent or severe diarrhea
requires medical attention. A sudden onset after years
of regularity can suggest a serious digestive disorder,
such as colon cancer. Diarrhea accompanied by symptoms
such as weight loss, abdominal pain, or rectal bleeding
requires a doctor's attention.
Causes
Under normal circumstances, the colon absorbs water
from food residue, leading to semisolid feces. When
the small intestine becomes inflamed, it fails to absorb
food and instead secretes additional water and salts
into the digestive tract. The colon cannot absorb the
excess water, resulting in diarrhea. Most frequently,
diarrhea is due to a viral infection or change in diet.
Sometimes, it can be traced to changes in the bacterial
population of the digestive tract due to taking antibiotics
or to foreign travel. Another cause can be increased
frequency or intensity of contractions in the digestive
tract, causing food to pass too quickly through the
colon. Other common causes include food poisoning, gastroenteritis,
celiac disease, lactose intolerance, malabsorption,
diverticular disease, inflammatory bowel disease, irritable
bowel syndrome, anxiety, over consumption of alcohol,
and reaction to medications.
Diagnosis and Treatment
If symptoms last longer than 48 hours, it is important
to seek medical attention. For moderate cases, the doctor
may try to treat the symptoms and observe the person.
In more severe cases, the doctor will conduct a physical
examination and may order such tests as blood tests,
stool analysis, a lower gastrointestinal (GI) series
(an x-ray procedure also called a barium enema) and
sigmoidscopy, or colonoscopy (examination of the rectum
and colon using flexible viewing tubes passed through
the anus).
The symptoms of diarrhea provide clues to its cause.
Diarrhea accompanied by nausea and vomiting is usually
due to gastroenteritis. Bloody diarrhea that last for
more than a few days is a sign of inflammatory bowel
disease, while mucus is associated with irritable bowel
syndrome, inflammatory bowel disease, and cancer. Loose,
yellow, greasy, strong smelling feces that are hard
to flush are a symptom of malabsorption. Food poisoning,
food allergy, drug toxicity, or anxiety can bring on
watery diarrhea.
Doctors advise resting and drinking clear fluids until
diarrhea subsides. Because watery diarrhea can rapidly
cause a loss of body fluids and crucial body salts,
oral rehydration fluid may be needed; available over-the-counter
at pharmacies, this specially prepared solution contains
water, salts, and glucose. Other over-the counter medication
may relieve symptoms. In severe cases, the doctor may
prescribe drugs that slow intestinal activity and ease
cramping. To prevent diarrhea, it is important to wash
hands thoroughly after using the toilet and before preparing
foods. When diarrhea is due to underlying problems,
it is important to seek treatment.
Source: AMA Complete Medical Encyclopedia,
Copyright 2003, American Medical Association
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