Diarrhea FAQ – Is Diarrhea Normal? Can Diarrhea Kill?

Diarrhea is a common condition. It is not a disease but a symptom of several diseases. These diseases are sometimes referred to as diarrheal illnesses but in most cases diarrhea is not the only symptom. Most people do not seek professional medical attention for  every instance of diarrhea. However, when diarrhea is severe, bloody, persisting or worsening then it requires immediate medical attention.

It is important to understand the various facets of diarrhea, from its causes, to the mechanism, treatment and prevention. There are several misconceptions about diarrhea and sometimes this can prolong or even worsen the diarrheal illness. Some of the common and uncommon questions about diarrhea have been answered below. However, it is important to seek professional medical advice for any diarrheal illness.

Why does diarrhea occur?

Diarrhea is a symptom of some underlying disturbance of the digestive tract, particularly of the bowels (small and large intestines). This may occur for many reasons.

Acute diarrhea is where the diarrhea occurs suddenly and is usually severe but only lasts for a short period. Most of the time acute diarrhea is due to infections with viruses, bacteria or protozoa, or it is caused by the toxins from these infectious agents. Certain foods, ingested irritants, medication and other toxic substances may also cause acute diarrhea. Sometimes diarrhea can be due to psychogenic factors like anxiety and psychological stress.

Chronic diarrhea is where diarrhea persists for long periods of time and usually presents with recurrent episodes of diarrhea. However, sometimes the diarrhea may be persistent and continuous. Chronic diarrhea can also be due to ongoing infections but is more commonly associated with chronic bowel conditions like inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). Certain digestive abnormalities may also be responsible.

Is diarrhea normal?

No. Diarrhea is not normal. It is an abnormality in  bowel habit whereby a person passes stool more than three times in a 24 hour period and where the stool is watery. Normally stool is passed between three times a day and three times a week. The stool should be soft, smooth and sausage-shaped. Diarrhea stool is abnormal in shape and consistency and diarrhea is an abnormality in the number of stools passed in a day.

How long does diarrhea last?

The duration of diarrhea can vary depending on the cause, treatment and management as well as other factors such as a person’s general health status and immune defenses. Acute diarrhea  lasts for less than 2 weeks, subacute lasts for 2 to 4 weeks and chronic diarrhea lasts for 4 weeks or more. Most of the time diarrhea is acute and often related to conditions like viral gastroenteritis or food poisoning. The diarrhea lasts for about 2 to 3 days and sometimes up to a week.

Can diarrhea spread among people?

Diarrhea is only a symptom of a disease. If diarrhea is due to infectious causes then it may be contagious. For example, certan viruses that may cause diarrheal illnesses can be easily spread from person to person through bodily secretions. Therefore people in close contact may contract the infection. Fecal particles that contaminate food and water are a common route of transmission of infections that can cause diarrhea.

Read more on is diarrhea contagious?

How do diseases cause diarrhea?

Diarrhea usually arises as a result of one or more of four mechanisms. Substances within the bowels may draw more water out of the body (secretory), hamper reabsorption of water in the colon (osmotic), damage to the intestinal lining (infectious/inflammatory) or very fast movement throughout the bowels (rapid gastrointestinal motility). In all of these mechanisms, the reabsorption of water is hampered causing the stool to be watery.

Can diarrhea kill a person?

Yes. Diarrhea can result in death due to dehydration. In fact diarrhea is the leading cause of infantile death across the globe and particularly in developing nations. Dehydration is the result of a loss of fluid and electrolytes through diarrheal stool as well as in vomiting if present.

When the levels of fluid and electrolytes become too low, it affects the functioning of the heart, kidneys, brain and nerves. Ultimately this can be deadly. Depending on the cause of diarrhea, other complications like septicemia may rise which can be deadly but this is not due to the diarrhea.

Can food be eaten during diarrhea?

Solid foods can and should be eaten during any diarrheal illness. It is advisable to keep to a bland and balanced diet so as to ensure adequate nutrition without worsening the diarrhea. The only time when avoiding solid foods should be considered is if there is vomiting and eating food cannot be tolerated. However, diarrhea should not be the sole reason to opt for a liquid diet.

How much of fluids to drink during diarrhea?

Drinking fluid is a very important part of managing diarrhea. Oral rehydration ensures that adequate fluids and electrolytes are consumed to make up for the loss of fluids and electrolytes due to diarrhea. The exact quantity of fluid that should be consumed daily during diarrhea varies. Always monitor for the signs of dehydration as this is an indicator of how much fluids should be consumed.

Read more oral rehydration therapy.

An adult without diarrhea should consume at least 2 liters (68oz) daily.  Therefore more than 2 liters of fluid should be consumed daily during diarrhea and particularly when the diarrhea is severe. Caffeinated beverages like coffee, sodas and fruits juices should be avoided as this increases water loss. An oral rehydrating solutions (ORS) is the best option for rehydrating.

It is important to note that if oral rehydration (replenishing fluids and electrolytes by drinking beverages) may not always be sufficient to prevent and treat dehydration. Sometimes intravenous (IV) fluid administration is necessary.

Is there a cure for diarrhea?

The causes of diarrhea need to be treated in order for symptoms like diarrhea to resolve. There are drugs like antidiarrheals that can stop diarrhea for a period of time. This is not a cure. In fact using these drugs can lead to serious complications in the early stages particularly when diarrhea is due to infectious causes.

Therefore the focus should be on treating and managing the cause of the diarrhea. Some of these causes are curable and some are preventable. However, there are instances where the cause of the diarrhea is unknown (idiopathic diarrhea) and treatment in these cases may have to be directed at the symptoms such as diarrhea.

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