FREQUENTLY ASKED QUESTIONS

DIARRHEA

1. What is diarrhea?
2. What causes diarrhea?
3. What are the types of diarrhea?
4. When should a physician be consulted?
5. How is diarrhea managed?

1. What is diarrhea?

Diarrhea is the passage of loose and watery stools (more than 3 bowel movements per day) often associated with gassiness, bloating, and abdominal pain. It may also be accompanied by nausea, vomiting, and fever.

Diarrhea results to loss of body fluids and salts leading to dehydration of varying severity. Severe dehydration may cause death especially in children and the elderly.

2. What causesdiarrhea?

* Infection due to:
o virus (Rotavirus, Hepatitis B virus)
o bacteria (Cholera, Shigella)
o intestinal parasites (E. histolytical, ponworm)
- these microorganisms are usually spread by contaminated hands, or through food and water.
* Food intolerance (lactose deficiency, spicy food)
* Use of laxative and antacid
(magnesium hydroxide)
* Use of antibiotics like tetracycline and cephalosporins
* Inflammatory bowel disease
(ulcerative colitis)
* Emotional stress
* Cancer of the colon (characterized by alternating diarrhea and constipation)

3. What are the types of diarrhea?

Diarrhea is classified as either acute or chronic.

Acute diarrhea is the sudden onset of abnormally frequent watery stools accompanied by weakness, flatulence (farting), abdominal pain and sometimes fever and vomiting. It may be caused by eating spoiled food. This lasts for 2 to 5 days.

Chronic diarrhea lasts for more than 2 weeks and is associated with weight loss and anemia. This is usually caused by chronic use of laxatives or amoebiasis.

4. When should a physician be consulted?

* If the patient is less than 3 years old
* If the patient is a pregnant woman
* if diarrhea is associated with fever and dehydration
if diarrhea continues for more than 3 days
* If diarrhea is associated with bloody, mucoid stools (dysentery)
* If diarrhea is associated with abdominal tenderness and cramping

5. How is diarrhea managed?

The objectives of diarrhea therapy are to:

1. Prevent excessive loss of fluid and salts

Diarrhea, if severe, leads to dehydration and loss of salts. To prevent these life threatening problems particularly in children and the elderly, oral rehydration solution must be given as early as possible.

2. Identify and treat the cause

Diarrhea caused by bacteria (Shigella, Enterotoxigenic Escherichia coli) should be treated with antibiotics like cotrimoxazole and fluoroquinolones. Diarrhea caused by protozoa (Entamoeba histolytica and Giardia lamblia) should be treated with metronidazole in combination with other anti-amoebic drugs.

3. Provide symptomatic relief

In adults, antidiarrheal agents like loperamide and attapulgite may help in reducing the frequency of bowel movement and in improving the consistency of stool of stools.

Consult your doctor if diarrhea is severe especially in children and the elderly.

Remember:

* Patients should continue to eat to prevent or minimize nutritional damage.
* Patients should drink water during their illness, especially if they have fever.
* Patients should be monitored closely, particularly children who do not show a clear improvement within 2 days after beginning treatment with an effective antibiotic.
* Since most of diarrhea-causing micro-organisms are spread by contaminated hands, thorough handwashing with soap and water and careful cleaning of all parts of the hand is an important measure to prevent diarrhea.