Diarrhea - overview
Stools - watery; Frequent bowel movements; Loose bowel movements; Unformed bowel movements
Diarrhea is when you pass loose or watery stool.
Campylobacter jejuni infection causes cramping, diarrhea, abdominal pain and fever within 2 to 5 days after a person has been exposed to the organism. Campylobacter jejuni is one of the most common bacterial causes of diarrhea. Most cases of Campylobacter jejuni come from handling or ingesting raw or undercooked poultry meat. Although poultry and other birds are not affected by the bacterium, other animals can be. Therefore it is possible for a person to acquire the infection from contact with infected stool of an ill cat or dog. This is what Campylobacter organisms look like through a microscope. (Image courtesy of the Centers for Disease Control and Prevention.)
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Cryptosporidium is a protozoan parasite found in contaminated water. It has been increasingly recognized as the cause of outbreaks of diarrhea when water supplies become contaminated. In normal individuals, it is a self-limited disease. Among immunocompromised individuals with AIDS, cryptosporidium can cause severe diarrheal disease, gallbladder disease (cholecystitis), and inflammation of the pancreas (pancreatitis).
The most common cause of diarrhea is a mild viral infection that resolves on its own with in a few days, usually known as the stomach flu. Two other common causes of diarrhea is from food poisoning and travelers diarrhea. They occur from eating food or drinking water contaminated with organisms like bacteria and parasites. Medications can also cause diarrhea, especially antibiotics, laxatives containing magnesium, and chemotherapy for cancer treatment.
Considerations
In some people, diarrhea is mild and goes away in a few days. In other people, it may last longer.
Diarrhea can make you feel weak and dehydrated.
Diarrhea in babies and children can be serious. It needs to be treated differently than you would treat diarrhea in adults.
Talk with your health care provider if your child has diarrhea. There can be a lot to know. Your provider can help you learn how to recognize and treat diarrhea in babies and in children.
Diarrhea isn't something most people want to talk about, much less have. Not only can diarrhea be uncomfortable, with gas, bloating, and that mad dash to the toilet, but it's a sign that you're either sick, or you've eaten something that really didn't agree with you. With diarrhea, the stools become loose and watery instead of solid. If you have diarrhea, there's a good chance you picked up a stomach virus. Or, you may have gotten food poisoning from eating food or drinking water that was contaminated with bacteria. A lot of people get sick from tainted food while traveling, because they're not used to the food and water in the foreign country. This is called traveler's diarrhea. Certain diseases that affect your intestines can cause diarrhea, including celiac disease, irritable bowel syndrome, Crohn's disease, and ulcerative colitis. If you've taken medications such as antibiotics or laxatives, diarrhea can be an unpleasant side effect. Protect your stomach by giving it healthy bacteria called probiotics. You can find them in yogurt and supplements. Among other things, probiotics help crowd out the bad bacteria that cause diarrhea. To avoid getting sick, wash your hands or use an alcohol-based hand sanitizer so bacteria can't get into your body. And when you travel to areas that may have unclean water, drink only bottled water without ice. Also avoid eating any uncooked fruits or vegetables that don't have a peel. Usually diarrhea goes away by itself pretty quickly, but it can stick around for a few days or even weeks. Loose stools are very watery, and they can dehydrate you pretty quickly. Stay hydrated by drinking at least 8 to 10 glasses of clear liquids a day. Drink one glass every time you have a loose bowel movement. To replace the electrolytes you're also losing with diarrhea, consider an electrolyte drink or rehydration solution. Also you may want to eat soup, pretzels, and other salty foods, as well as bananas and other high-potassium foods. Infants and children are especially likely to get dehydrated from diarrhea, and this can be really dangerous. You can tell your baby is dehydrated because his mouth will be dry, he'll make fewer wet diapers, and he won't produce tears when he cries. To keep your child hydrated, give 2 tablespoons of fluid every 30 to 60 minutes. You can use breast milk, formula, broth, or a solution like B.R.A.T. or Pedialyte, which also comes in a kid-friendly popsicle form. Diarrhea is an unpleasant, but fortunately short-term affliction most of the time. If it does stick around, call your doctor. The doctor will ask questions about your symptoms, where you've been traveling, and what new medicines you've taken or foods you've eaten. Until you're feeling better, drink plenty of fluids so you don't get dehydrated.
Causes
The most common cause of diarrhea is the stomach flu (viral gastroenteritis). This mild viral infection most often goes away on its own within a few days.
Eating or drinking food or water that contains certain types of bacteria or parasites can also lead to diarrhea. This problem may be called food poisoning.
Certain medicines may also cause diarrhea, including:
- Some antibiotics
- Chemotherapy drugs for cancer
- Laxatives containing magnesium
Diarrhea may also be caused by medical disorders, such as:
- Celiac disease
- Inflammatory bowel diseases (Crohn disease and ulcerative colitis)
- Irritable bowel syndrome (IBS)
- Lactose intolerance (which causes problems after drinking milk and eating other dairy products)
- Malabsorption syndromes
Less common causes of diarrhea include:
- Carcinoid syndrome
- Disorders of the nerves that supply the intestines
- Removal of part of the stomach (gastrectomy) or small intestine
- Radiation therapy
People who travel to developing countries can get diarrhea from unclean water or food that has not been handled safely. Plan ahead by learning the risks and treatment for traveler's diarrhea before your trip.
Home Care
Most times, you can treat diarrhea at home. You will need to learn:
- To drink plenty of fluids to prevent dehydration (when your body does not have the proper amount of water and fluids)
- Which foods you should or should not eat
- What to do if you are breastfeeding
- What danger signs to watch for
Avoid medicines for diarrhea that you can buy without a prescription unless your provider tells you to use them. These drugs can make some infections worse.
If you have a long-term form of diarrhea, such as diarrhea caused by irritable bowel syndrome, changes to your diet and lifestyle may help.
When to Contact a Medical Professional
Contact your provider right away if you or your child shows signs of dehydration:
- Decreased urine (fewer wet diapers in infants)
- Dizziness or lightheadedness
- Dry mouth
- Sunken eyes
- Few tears when crying
Schedule an appointment with your provider if you have:
- Blood or pus in your stools
- Black stools
- Stomach pain that does not go away after a bowel movement
- Diarrhea with a fever above 101°F or 38.33°C (100.4°F or 38°C in children)
- Recently traveled to a foreign country and developed diarrhea
Also contact your provider if:
- The diarrhea gets worse or does not get better in 2 days for an infant or child, or 5 days for adults
- A child over 3 months old has been vomiting for more than 12 hours; in younger babies, call as soon as vomiting or diarrhea begins
What to Expect at Your Office Visit
Your provider will perform a physical exam and ask about your medical history and symptoms.
Lab tests may be done on your stools to find the cause of your diarrhea.
This is also a good time to ask your provider any questions you have about diarrhea.
Over-the-counter supplements that contain healthy bacteria may help prevent diarrhea caused by taking antibiotics. These are called probiotics. Yogurt with active or live cultures is also a good source of these healthy bacteria.
The following healthy steps can help you prevent illnesses that cause diarrhea:
- Wash your hands often, particularly after using the toilet and before eating.
- Use alcohol-based hand gel frequently.
- Teach children to not put objects in their mouth.
- Take steps to avoid food poisoning.
When traveling to underdeveloped areas, follow the steps below to avoid diarrhea:
- Drink only bottled water and DO NOT use ice, unless it is made from bottled or purified water.
- DO NOT eat uncooked vegetables or fruits that do not have peels.
- DO NOT eat raw shellfish or undercooked meat.
- DO NOT consume dairy products.
References
Schiller LR, Sellin JH. Diarrhea. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 16.
Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 131.
Version Info
Last reviewed on: 11/3/2022
Reviewed by: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
