Sievering Clinic

Competence Centre for Minimally Invasive Medical Services

Diarrhoea

Diarrhoea, also spelled diarrhea, is the production of three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. Massive loss of fluid causes dehydration and electrolyte imbalances. Oral rehydration salts and zinc tablets are the treatment of choice and have been estimated to have saved 50 million children in the past 25 years.

Acute diarrhoea
Chronic diarrhoea
Less than 3 weeks More than 3 weeks
Cause:

  • infections
  • food poisoning
  • drugs
Cause:

  • functional diarrhoea
  • chronic inflammatory bowel disease
  • laxative abuse

Causes of functional diarrhoea include drug abuse, insufficient fluid intake and incorrect diet.
Various bacteria, viruses or parasites can cause stomach and intestinal infections. These can be found in unclean water, such as E. coli diarrhoea, or in spoiled food, such as in a Salmonella infection, which is highly contagious.

Most of diarrhoea problems are harmless. But the clarification of the causes must never be neglected, as they could hide underlying conditions such as hyperthyroidism and diabetes mellitus, neurological diseases, including Parkinson’s disease or tumours.

Most common causes of diarrhoea include
  • Anxiety
  • Stress or nervousness
  • Intake of medication (especially antibiotics)
  • Alcohol abuse
  • Irritable bowel syndrome (then often enough caffeine or hot food as the trigger)
  • Food allergies
  • Unusual diet
  • Food poisoning
  • Chronic inflammation of the intestine (Crohn’s disease, ulcerative colitis)
  • Infections => bacteria (salmonella, E coli)
  • Viruses (Reto virus)
  • Protozoa (amoeba)
  • Carcinomas
  • Hormones (hyperthyroidism)
  • Irritable bowel syndrome
  • Laxatives

The mushy stools can occur very suddenly and are often accompanied by nausea, vomiting, abdominal pain or cramps. Many patients also suffer from fever, body aches and cold symptoms. Bloody mucous diarrhoea may occur in some colon inflammation, but should always be examined by a doctor, because, for example, colon cancer can be the reason.
In this disease, the body loses fluids and minerals, which can result in severe cases lead to circulatory collapse.

Diarrhoea can be especially dangerous in young children and infants, because they have greater risks of drying out as in adults.

See a doctor immediately if:
  • There is bleeding in soft chair or pushing
  • The chair is deformed or finger or pencil-thin
  • Rhythm of chair changes at otherwise unchanged habits
Necessary studies history and clinical examination
  • When asked about the medical histories do not miss drugs
  • Digitorectale investigation
  • Stool examination for bacteria, parasites and blood
  • Colonoscopy with biopsy
  • Abdominal sonography (liver, kidney, ascites)
  • Blood laboratory (CRP, blood count, blood sugar, electrolytes, creatinine, TSH basal) to collect laboratory parameters, belongs to the basic examination, as hyperthyroidism, hyperparathyroidism or diabetes (neuropathy) can also cause constipation.
  • Serology for food intolerance
History and physical examination:
  • Digitorectal investigation
  • Stool examination for bacteria, parasites and blood
  • Colonoscopy with biopsy
  • Abdominal sonography (liver, kidney, ascites)
  • Blood laboratory (CRP, blood count, blood sugar, electrolytes, creatinine, TSH basal) to collect laboratory parameters, belongs to the basic examination, as hyperthyroidism, hyperparathyroidism or diabetes (neuropathy) can also cause constipation.
  • Serology for food intolerance
Live-saving tips
  • Increase physical activity
  • Increase fluid intake
  • Fibre-rich diet – (Diet-enteritis)
  • Do not try to force desperately daily bowel movement.
  • To compensate for the water and mineral loss, at least 2.5 litres a day should be consumed. Chamomile or fennel tea, bottled water or isotonic drinks are best here. No fruit juices or caffeinated beverages! You can compensate the loss of liquid by taking electrolyte. There are special blends for infants and toddlers.
  • The ill person should comply with diet. In case of severe diarrhoea eat only biscuit gruel on the first day. This can be salted and sugared. A day or two of bad diarrhea is not usual. A treatment by a doctor is usually not necessary.
  • In elderly, debilitated people, for example, a salmonella infection can be life threatening. Here and in other severe cases a doctor should be called immediately.
  • In persistent or recurrent diarrhoea, the physician should be consulted.
  • Make sure that you do not store food too long. For example, foods that contain eggs (mayonnaise, tiramisu) spoil very quickly when left uncooled.
  • If you are afflicted with diarrhoea, pay particular attention to hygiene. Disinfect the toilet and wash your hands!
  • Only previously boiled water should be consumed in hot countries and fruits are eaten peeled. On lettuce, mayonnaise, ice cream and ice cubes in drinks dispense. Water should be boiled before drinking, even before brushing teeth!
  • When traveling to certain countries, vaccination against diarrheal diseases such as typhus is appropriate.