In medicine, diarrhea, also spelled diarrhoea (see spelling differences), is frequent loose or liquid bowel movements.
Although for many people diarrhea is merely unpleasant, diarrhea that is both acute and severe is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. It is often due to gastroenteritis.
Causes of Diarrhea
Diagram of the human gastrointestinal tract.
Diarrhea is most commonly caused by viral infections, parasites or bacterial toxins.[1] In sanitary living conditions where there is ample food and a supply of clean water, an otherwise healthy patient usually recovers from viral infections in a few days. However, for ill or malnourished individuals diarrhea can lead to severe dehydration and can become life-threatening without treatment.[2]
Diarrhea can also be a symptom of more serious diseases, such as dysentery, cholera, or botulism, and can also be indicative of a chronic syndrome such as Crohn’s disease or severe mushroom poisoning syndromes. Though appendicitis patients do not generally have diarrhea, it is a common symptom of a ruptured appendix. It is also an effect of severe radiation sickness.
Diarrhea can also be caused by dairy intake in those who are lactose intolerant.
Symptomatic treatment for diarrhea involves the patient consuming adequate amounts of water to replace that loss, preferably mixed with electrolytes to provide essential salts and some amount of nutrients. For many people, further treatment is unnecessary. The following types of diarrhea indicate medical supervision is required:
- Diarrhea in infants
- Moderate or severe diarrhea in young children;
- Diarrhea associated with blood
- Diarrhea that continues for more than two days;
- Diarrhea that is associated with more general illness such as non-cramping abdominal pain, fever, weight loss, etc;
- Diarrhea in travelers, since they are more likely to have exotic infections such as parasites;
- Diarrhea in food handlers, because of the potential to infect others;
- Diarrhea in institutions such as hospitals, child care centers, or geriatric and convalescent homes.
A severity score is used to aid diagnosis in children.[3]
Types of Diarrhea
There are at least four types of diarrhea: secretory diarrhea, osmotic diarrhea, motility-related diarrhea, and inflammatory diarrhea.
Secretory diarrhea
Secretory diarrhea means that there is an increase in the active secretion, or there is an inhibition of absorption. There is little to no structural damage. The most common cause of this type of diarrhea is a cholera toxin that stimulates the secretion of anions, especially chloride ions. Therefore, to maintain a charge balance in the lumen, sodium is carried with it, along with water.
Osmotic diarrhea
Osmotic diarrhea occurs when too much water is drawn into the bowels. This can be the result of maldigestion (e.g., pancreatic disease or Coeliac disease), in which the nutrients are left in the lumen to pull in water. Osmotic diarrhea can also be caused by osmotic laxatives (which work to alleviate constipation by drawing water into the bowels). In healthy individuals, too much magnesium or vitamin C or undigested lactose can produce osmotic diarrhea and distention of the bowel. A person who does not have lactose intolerance can have difficulty absorbing lactose after an extraordinarily high intake of dairy products. In persons who do not have fructose malabsorption, excess fructose intake can still cause diarrhea. High-fructose foods that also have a high glucose content are more absorbable and less likely to cause diarrhea. Sugar alcohols such as sorbitol (often found in sugar-free foods) are difficult for the body to absorb and, in large amounts, may lead to osmotic diarrhea.
Motility-related diarrhea
Motility-related diarrhea is caused by the rapid movement of food through the intestines (hypermotility). If the food moves too quickly through the GI tract, there is not enough time for sufficient nutrients and water to be absorbed. This can be due to a vagotomy or diabetic neuropathy, or a complication of menstruation. Hyperthyroidism can produce hypermotility and lead to pseudodiarrhea and occasionally real diarrhea. Diarrhea can be treated with antimotility agents (such as loperamide).
Inflammatory diarrhea
Inflammatory diarrhea occurs when there is damage to the mucosal lining or brush border, which leads to a passive loss of protein-rich fluids, and a decreased ability to absorb these lost fluids. Features of all three of the other types of diarrhea can be found in this type of diarrhea. It can be caused by bacterial infections, viral infections, parasitic infections, or autoimmune problems such as inflammatory bowel diseases. It can also be caused by tuberculosis, colon cancer, and enteritis.
Dysentery
Generally, if there is blood visible in the stools, it is not diarrhea, but dysentery. The blood is trace of an invasion of bowel tissue. Dysentery is caused by an excess of water by a release of antidiuretic hormone from the posterior pituitary gland. Dysentery is a symptom of, among others, Shigella, Entamoeba Histolytica, and Salmonella.
Infectious diarrhea
Infectious diarrhea is diarrhea caused by a microbe such as a bacterium, parasite, or virus.
Malabsorption
Malabsorption is the inability to absorb food, mostly in the small bowel but also due to the pancreas.
Causes include celiac disease (intolerance to wheat, rye, and barley gluten, the protein of the grain), lactose intolerance (intolerance to milk sugar, common in non-Europeans), fructose malabsorption, pernicious anemia (impaired bowel function due to the inability to absorb vitamin B12), loss of pancreatic secretions (may be due to cystic fibrosis or pancreatitis), short bowel syndrome (surgically removed bowel), radiation fibrosis (usually following cancer treatment), and other drugs, including agents used in chemotherapy.
Inflammatory bowel disease
The two overlapping types here are of unknown origin:
- Ulcerative colitis is marked by chronic bloody diarrhea and inflammation mostly affects the distal colon near the rectum.
- Crohn’s disease typically affects fairly well demarcated segments of bowel in the colon and often affects the end of the small bowel.
Irritable Bowel Syndrome
Another possible cause of diarrhea is Irritable Bowel Syndrome (IBS). Symptoms defining IBS: abdominal discomfort or pain relieved by defecation and unusual stool (diarrhea or constipation or both) or stool frequency, for at least 3 days a week over the previous 3 months.[4] IBS symptoms can be present in patients with a variety of conditions including food allergies, infective diarrhea, celiac, and inflammatory bowel diseases. Treating the underlying condition (celiac disease, food allergy, bacterial dysbiosis, etc.) usually resolves the diarrhea.[5] IBS can cause visceral hypersensitivity. While there is no direct treatment for undifferentiated IBS, symptoms, including diarrhea, can sometimes be managed through a combination of dietary changes, soluble fiber supplements, and/or medications.
Other important causes
- Ischemic bowel disease. This usually affects older people and can be due to blocked arteries.
- Bowel cancer: Some (but not all) bowel cancers may have associated diarrhea. Cancer of the large intestine is most common.
- Hormone-secreting tumors: some hormones (e.g. serotonin) can cause diarrhea if excreted in excess (usually from a tumor).
- Bile salt diarrhea: excess bile salt entering the colon rather than being absorbed at the end of the small intestine can cause diarrhea, typically shortly after eating. Bile salt diarrhea is a bad side-effect of gallbladder removal. It is usually treated with cholestyramine, a bile acid sequestrant.
- Celiac Disease
Alcohol
Chronic diarrhea can be caused by chronic ethanol ingestion.[6] Consumption of alcohol affects the body’s capability to absorb water – this is often a symptom that accompanies a hangover after a heavy drinking session. The alcohol itself is absorbed in the intestines and as the intestinal cells absorb it, the toxicity causes these cells to lose their ability to absorb water. This leads to an outpouring of fluid from the intestinal lining, which is in turn poorly absorbed. The diarrhea usually lasts for several hours until the alcohol is detoxified and removed from the digestive system. Symptoms range from person to person and are influenced by both the amount consumed as well as physiological differences.
Treatment of Diarrhea
In many cases of diarrhea, replacing lost fluid and salts is the only treatment needed. Medicines that are available without a doctor’s prescription include loperamide (Imodium) and bismuth subsalicylate (as found in Pepto Bismol and Kaopectate).[7]
Homeopathy Tratment for Diarrhea
Keywords: homeopathy, homeopathic, treatment, cure, remedy, remedies, medicine
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution, family history, presenting symptoms, underlying pathology, possible causative factors etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’. The disease diagnosis is important but in homeopathy, the cause of disease is not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness are also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition. The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology is not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can be greatly improved with homeopathic medicines.
The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy. To study any of the following remedies in more detail, please visit the Materia Medica section at www.kaisrani.com .
None of these medicines should be taken without professional advice and guidance.
Homeopathy Remedies for Diarrhea:
Acet-ac., acon., aesc., aeth., agar., alet., all-s., aloe., alum., am-m., ammc., anan., ang., ant-a., ant-c., ant-t., anthr., apis., apoc., aran., arg-m., arg-n., arn., ars-i., ars., arum-m., asaf., asar., asc-t., astac., aster., aur-m., aur., bapt., bar-c., bar-m., bell., benz-ac., berb., bism., bor., bov., brach., brom., bry., bufo., cact., calc-ar., calc-p., calc-s., calc., canth., caps., carb-ac., carb-s., carb-v., casc., cast., caust., cean., cham., chel., chim., chin-a., chin-s., chin., cic., cina., cinnam., cist., clem., cob., cocc., coff., colch., coll., coloc., con., cop., corn., crot-h., crot-t., cub., cupr-ar., cupr., cycl., dig., dios., dulc., echi., ferr-ar., ferr-i., ferr-p., ferr-s., ferr., fl-ac., gamb., gels., gran., graph., grat., guai., ham., hell., hep., hydr., hyos., ign., ill., ind., iod., ip., iris., jab., jatr., jug-c., kali-ar., kali-bi., kali-c., kali-chl., kali-i., kali-n., kali-p., kali-s., kreos., lac-c., lac-d., lach., lact-ac., laur., lec., led., lept., lil-t., lith., lyc., lyss., mag-c., mag-m., mag-p., manc., med., meli., merc-c., merc-sul., merc., mez., morph., mur-ac., naja., nat-a., nat-c., nat-m., nat-p., nat-s., nicc., nit-ac., nuph., nux-m., nux-v., ol-an., ol-j., olnd., op., ox-ac., par., petr., ph-ac., phel., phos., phyt., pic-ac., plan., plb., podo., prun-s., psor., ptel., puls., raph., rat., rheum., rhod., rhus-t., rumx., sabad., samb., sang., sanic., sars., sec., sel., seneg., sep., sil., squil., stann., staph., stram., stry., sul-ac., sulph., sumb., tab., tarax., tarent., ter., thuj., trom., uran., valer., verat., xan., zinc., zing.
Footnotes
- ^ Wilson ME (2005). “Diarrhea in nontravelers: risk and etiology“. Clin. Infect. Dis. 41 Suppl 8: S541–6. doi:. PMID 16267716.
- ^ Alam NH, Ashraf H (2003). “Treatment of infectious diarrhea in children”. Paediatr Drugs 5 (3): 151–65. PMID 12608880.
- ^ Ruuska T, Vesikari T (1990). “Rotavirus disease in Finnish children: use of numerical scores for clinical severity of diarrhoeal episodes”. Scand. J. Infect. Dis. 22 (3): 259–67. doi:. PMID 2371542.
- ^ Longstreth GL, Thompson WG, Chey WD, Houghton LA, Mearin F, and Spiller RC. (2006). Functional Bowel Disorders. Gastroenterology 2006; 130:1480–1491
- ^ Wangen, S. “The Irritable Bowel Syndrome Solution”. page 113. 2006; Innate Health Publishing. ISBN 978-0-9768537-8-7. Excerpted with the author’s permission at http://www.IBSTreatmentCenter.com
- ^ Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL. Harrison’s Principles of Internal Medicine. New York: McGraw-Hill, 2005. ISBN 0-07-139140-1.
- ^ Schiller LR (2007). “Management of diarrhea in clinical practice: strategies for primary care physicians“. Rev Gastroenterol Disord 7 Suppl 3: S27–38. PMID 18192963.
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