The diarrhea is a common problem. It is characterized by stools of liquid or soft consistency, more voluminous and numerous than usual (more than 3 stools per day).
It is not a disease, but a symptom of colitis. Its most common cause is ingestion of water or contaminated food. It lasts 1 day or 2, and then disappears without requiring treatment.
During all its duration, it is necessary to be well hydrated, because the body can lose a lot of water and mineral salts by the saddles. This is particularly important for children and the elderly, for whom dehydration can have more serious consequences. Indeed, after only 1 or 2 days of diarrhea, young children can be dehydrated very seriously. In industrialized countries, it is very rare that diarrhea causes death. However, in underdeveloped countries, it is the 2 leading cause of death in children under 5 years.
|What is digestion?
Digestion is a biological process in which foods are degraded and processed into nutrients .
Digestion begins in the mouth, where the food is crushed and mixed with saliva, then continues in the stomach, which secretes acidic digestive juices and continues to grind food for a few hours. Upon exiting the stomach, predigested foods (called chyme) continue to be degraded in the small intestine by digestive juices from the pancreas and gallbladder. Transformed into nutrients, they can then cross the semi-permeable membrane of the intestine and be absorbed by blood and lymph. From there, they can circulate in the body and be used according to the needs of the body. What has not been absorbed is transformed into fecal matter in the colon.
An adult drinks about 2 liters of fluid a day. Its digestive system receives an additional 7 to 8 liters (saliva, digestive juices, bile, etc.). Thus, a total of 9 to 10 liters of fluid passes through the intestines daily. The majority of the water present in the faeces is extracted during the passage in the intestines. The body absorbs or “recycles” about 99% of the water that passes through the digestive system. This system is finely tuned: it suffices that this absorption rate drops by 1% (due to infection, intestinal disease, etc.) to trigger diarrhea.
Causes of Diarrhea
The diarrhea is an intestinal problem that involves any of the following 3 mechanisms. Sometimes they are present simultaneously.
- A lack of absorption by the intestines of the liquid contained in the stool;
- An accelerated intestinal transit , preventing the drying of feces;
- An abnormal passage of water and mineral salts from the body through the wall of the intestines.
When an intestinal disease is involved, the diarrhea is often chronic.
Here are the most common causes
- Food poisoning (for example, poultry infected with salmonella or meat contaminated with Escherichia coli );
- Viral gastroenteritis;
- Stress or anxiety;
- Taking antibiotics: it alters the intestinal flora, and thus reduces the absorption capacity of the intestinal wall. Antibiotics cause diarrhea in 5 to 30% of users, depending on the type of antibiotic used;
- Chronic bowel disease: celiac disease (gluten intolerance), Crohn’s disease, irritable bowel syndrome , etc. ;
- Lactose intolerance;
It should be noted that cholera can cause 10 liters of diarrhea per day. It is, however, very infrequent in industrialized countries.
|The tourist, diarrhea of the traveler
Familiarly is called “tourista” all infectious diarrheas contracted during a trip. Every year, 20 to 50% of travelers experience this. Destinations at risk are Latin America, Africa, the Middle East and Asia. Ingestion of food or water contaminated by bacteria is the main cause. That said, traveling, the stress of adventure, fatigue, jet lag and eating habits can also trigger diarrhea.
The dehydration and all the problems it can cause are the main complications that can occur and it is important to try to avoid.
On the other hand, people on antibiotic therapy may experience increased diarrhea if they develop Clostridium difficile infection. This occurs most often in a hospital setting. C. difficile bacteriabenefits from a weakening of the intestinal flora to grow in the intestines. It secretes 2 toxins (A and B) that cause significant diarrhea by accelerating intestinal transit and reducing fluid absorption in the intestines. Thus, once antibiotic treatment is over, if the diarrhea is severe or persistent, seek medical attention immediately. Up to one third of the diarrhea associated with antibiotics is caused by these bacteria: a small proportion of them worsen.
When to consult?
Consult a doctor as soon as possible if any of the following signs occur.
- Very heavy diarrhea (more than 10 stools a day) that persists for more than 48 hours;
- Signs of dehydration , especially in a young child or elderly person (see below);
- A fever of 38.5 ° C (101.5 ° F) or more;
- The blood in the stool;
- Severe abdominal pain;
- Chronic diarrhea
Symptoms of Diarrhea
- Loose or liquid stools;
- More frequent urges to go to the saddle;
- Abdominal pain and cramps;
Signs of dehydration
- The thirst ;
- Dryness of the mouth and skin
- Feelings of urination less frequent, and urine darker than usual;
- Muscle cramps;
- Loss of appetite;
- Physical weakness;
- Hollow eyes ;
- A state of shock and fainting.
People at risk for Diarrhea
All individuals can have diarrhea one day or another. Several situations can be the cause. See the list of causes above.
See the list of causes above.
|Basic preventive measures|
Diarrhea of the traveler
Diarrhea associated with antibiotics
|Measures to prevent complications|
|Be sure to rehydrate (see below ).|
Medical treatments for diarrhea
In general, acute diarrhea heals after 1 day or 2 with rest and some changes in the diet. During this time, the diet must include only liquids to prevent dehydration, then a gradual intake of certain foods.
In the case of antibiotic- related diarrhea, the symptoms usually stop within a few days of stopping antibiotic therapy.
Drink at least 1-2 liters of water each day, vegetable broths or lean meat, rice or barley water, light teas or caffeine-free sodas. Avoid alcohol and drinks that contain caffeine, which have the effect of increasing losses of water and mineral salts. In addition, avoid drinking several glasses of soft drinks, since their high sugar content can cause diarrhea.
Adults who have severe diarrhea – as is sometimes the case with travelers’ diarrhea – should drink a rehydration solution. Get them in a pharmacy (Gastrolyte) or prepare one yourself (see recipes below).
Some older people, like young children, may have more difficulty feeling thirsty or reporting it to others. The help of a loved one is very important.
Recipe from the World Health Organization (WHO)
– Mix 1 liter of sterile water, 6 tbsp. coffee (= tea) sugar and 1 tbsp. coffee (= tea) salt.
Conservation. These solutions are stored for 12 hours at room temperature and 24 hours in the refrigerator.
Tips on feeding
As long as major discomfort continues, it is best to avoid eating the following foods, which aggravate cramps and diarrhea.
- Dairy products ;
- Citrus juices;
- The meat ;
- Spicy dishes;
- The sweets ;
- Foods high in fat (including fried foods);
- Foods that contain wheat flour (bread, pasta, pizza, etc.);
- Corn and bran, which are high in fiber;
- Fruits, with the exception of bananas, which would be rather beneficial, even in young children from 5 to 12 months
- Raw vegetables.
First, reintroduce starchy foods such as white rice, sugar-free cereals, white bread and crackers. These foods may cause mild discomfort. It is better to persevere than to stop eating, unless the discomfort becomes important again. Gradually add fruits and vegetables (potatoes, cucumber, and squash), yogurt, then protein foods (lean meat, fish, egg, cheese, etc.).
It is best not to treat diarrhea, even if it causes discomfort. Consult a doctor before taking any medicine for diarrhea, even those available over the counter. Some products prevent the body from eliminating the infection, so they are not helpful. In addition, if blood is in the stool or severe abdominal crampsare felt, it is imperative to consult a doctor.
Some medications may be convenient for travelers who have to travel long bus or car journeys, or who do not have easy access to medical services. Antiperistaltic drugs stop diarrhea by slowing down bowel movements (for example, loperamide, such as Imodium or Diarr-Eze). Others decrease the secretion of water in the intestines (for example, bismuth salicylate, or Pepto-Bismol, which also acts as an antacid).
If necessary, antibiotics can control diarrhea caused by a bacterium or parasite.
|Attention. Diarrhea can interfere with the absorption of drugs, which can make them less effective. Consult a doctor if in doubt.|
In more severe cases, hospitalization may be necessary. Doctors then use an intravenous infusion to rehydrate the body. Antibiotics are prescribed as needed to treat severe bacterial diarrhea.