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American Heritage Dictionary:
di·ar·rhe·a |
[Middle English diaria, from Medieval Latin, from Late Latin diarrhoea, from Greek diarroia, from diarrein, to flow through : dia-, dia- + rhein, to flow, run.]
diarrheal di'ar·rhe'al or di'ar·rhe'ic (-ĭk) or di'ar·rhet'ic (-rĕt'ĭk) adj.|
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Fowler's Modern English Usage:
diarrhoea |
Britannica Concise Encyclopedia:
diarrhea |
For more information on diarrhea, visit Britannica.com.
Gale Encyclopedia of Cancer:
Diarrhea |
Key Terms: Defecation, Dehydration, Electrolytes.
Description
Diarrhea is the abnormal increase of liquid in stool and increase in the frequency of passing stool (defecation). The person with diarrhea has watery or loose stool more than three times a day. Other symptoms include cramping, pain, feeling the urge to defecate, irritation of the skin around the anus (perianal), and inability to control defecation (fecal incontinence). Approximately 10% of the patients with advanced cancer suffer from diarrhea. Diarrhea lasting fewer than two weeks is called "acute diarrhea," and diarrhea lasting for longer than two months is called "chronic diarrhea."
Diarrhea is a debilitating condition that can significantly affect quality of life. Diarrhea can prevent patients from participating in social activities and going to work. Persons with diarrhea fear soiling their clothing or bed linens, a fear that prevents them from leaving home. Loss of sleep due to nighttime diarrhea can cause fatigue, which ultimately affects the patient's ability to function normally. Uncontrolled diarrhea can lead to chemical imbalances, loss of fluids (dehydration), and even death.
Causes
Although there are many causes of diarrhea, only those associated with cancer will be discussed. The most common cause of diarrhea in cancer patients is related to constipation or its treatment. Cancer patients may experience diarrhea as a result of their treatment, or it can be due to dietary changes, infections, hormone imbalances, digestion disorders, or inflammation. Treatment-related diarrhea can be caused by chemotherapy, hormone therapy, radiation therapy, biological response modifiers (drugs that improve the patient's immune system), or surgery. In addition, cancer patients may develop temporary lactose intolerance, which causes diarrhea.
Chemotherapy drugs kill the rapidly growing cancer cells. However, certain normal cells of the body are rapidly growing and they too are affected. Rapidly growing cells are found in the intestines, as well as other parts of the body. Diarrhea occurs as a result of injury to the cells of the intestine. These effects are temporary. Chemotherapy drugs, hormones, and biological response modifiers that frequently cause diarrhea include:
Radiation therapy can cause diarrhea if the intestines are in the treatment field. Diarrhea results from the injury and destruction of the cells lining the intestines, which leads to a decrease in the uptake (absorption) of fluids and an increase in the speed with which stool moves through the intestines. Radiation therapy can cause diarrhea, and other intestinal problems, many months or years after treatment has been completed.
Diarrhea usually develops within one week following pretreatment (chemotherapy and irradiation) for bone marrow transplantation. This diarrhea usually disappears within two weeks. Also, bone marrow transplant patients with graft-versus-host disease develop severe diarrhea.
Treatments
Prevention
There are some measures that can prevent diarrhea. Patients who are receiving abdominal radiation therapy can be put into certain positions to minimize exposure of healthy intestines to radiation. Diarrhea caused by chemotherapy cannot be prevented; however, the administration of atropine during treatment with irinotecan may prevent diarrhea. Patients should stop taking dietary supplements, as these can cause diarrhea.
There are many dietary changes that can be made to prevent or reduce diarrhea. Foods to avoid include:
Management
Of the utmost importance in the treatment of diarrhea is the replacement of fluids lost by frequent, watery stools. The patient should drink six to eight glasses of fluid daily, including clear broth, ginger ale (without the fizz), water, weak tea, and commercial formulas that contain sugars and minerals (electrolytes). Patients with severe diarrhea may need intravenous fluid replacement either at home or in the hospital.
Diarrhea can cause the perianal skin to become irritated and painful; therefore, it needs to be cleaned thoroughly after each bout of diarrhea. Baby wipes or a mild soap with water can be used to clean the irritated skin. The area should be patted dry and occasionally exposed to air. Taking a sitz bath (sitting in a bathtub of shallow water) with lukewarm water may relieve the discomfort. Petroleum jelly or other type of barrier cream may be used.
The patient should eat small, frequent meals. Foods and drinks should be taken at room temperature. Foods that can help control diarrhea include:
There are some medications that can slow down the movement of stool through the intestines and increase intestinal water absorption. The patient may need a combination of drugs and/or dose adjustments to achieve relief. A physician should be consulted before any over-the-counter antidiarrheal medications are taken. Anti-diarrheal medications include:
These medications should not be used if infection as the cause of diarrhea has not been eliminated.
Patients who are experiencing diarrhea due to graft-versus-host disease will continue to take their immunosuppressant drugs. They may also be treated with corticosteroids and antidiarrheal medications.
Alternative and Complementary Therapies
Peppermint tea, chamomile tea, valerian capsules, or aloe vera juice may reduce cramping and intestinal spasms. An Ayurvedic physician may recommend taking equal parts of yogurt and water with fresh ginger, or a powder of beleric myrobalan fruit. Ginger capsules may relieve intestinal spasms and pain. Glutamine supplements may speed up the healing process and relieve irritated intestines.
Resources
Books
Lenhard, Raymond E, Robert T. Osteen, and Ted Gansler. Clinical Oncology. American Cancer Society, 2000.
Maleskey, Gale. Nature's Medicines: from Asthma to Weight Gain, from Colds to High Cholesterol—The Most Powerful All-Natural Cures. Emmaus, PA: Rodale Press, Inc., 1999.
Yarbro, Connie Henke, Margaret Hansen Frogge, and Michelle Goodman, editors. Cancer Symptom Management. 2nd ed. Sudbury, MA: Jones and Bartlett Publishers, 1999.
Yarbro, Connie Henke, Michelle Goodman, Margaret Hansen Frogge, and Susan L. Groenwald, editors. Cancer Nursing, Principles and Practice. 5th ed. Sudbury, MA: Jones and Bartlett Publishers, 2000.
Periodicals
Kornblau, Steven, Al B. Benson III, Robert Catalano, Richard E. Champlin, Constance Engelking, et al. "Management of Cancer Treatment—Related Diarrhea: Issues and therapeutic Strategies." Journal of Pain and Symptom Management 19, no. 2 (February 2000): 118-127.
Other
"What About Diarrhea?" American Cancer Society, Inc. 2000. [cited July 1, 2001].
—Belinda Rowland, Ph.D.
McGraw-Hill Science & Technology Encyclopedia:
Diarrhea |
The passage of loose or watery stools, usually at more frequent than normal intervals. Diarrhea is a symptom of many diseases and may be accompanied by nausea, vomiting, griping, tenesmus, and other general or specific indications of a disease.
The more common specific disorders which may produce diarrhea include intestinal infections, such as dysentery, cholera, typhoid fever, food poisonings, and parasitic infestations; food sensitivities; drug and chemical irritation; and vitamin deficiency states.
Emotional and psychic disturbances frequently produce diarrhea and other visceral derangements. The poorly understood entities of regional enteritis and ulcerative colitis are perhaps related to these disturbances, as are other psychosomatic disorders.
Diarrhea is a common symptom in gastrointestinal obstruction or in inflammations from local infections or tumor invasion. See also Bacillary dysentery; Food poisoning; Medical parasitology.
Antonyms by Answers.com:
diarrhea |
Gale Encyclopedia of Children's Health:
Diarrhea |
Definition
To most individuals, diarrhea means an increased frequency or decreased consistency of bowel movements; however, the medical definition is more exact than this. Diarrhea best correlates with an increase in stool weight; this increase is mainly due to excess water, which normally makes up 60 to 85 percent of fecal matter. In this way, true diarrhea is distinguished from diseases that cause only an increase in the number of bowel movements (hyperdefecation) or incontinence (involuntary loss of bowel contents).
Diarrhea is also classified by physicians as acute, which lasts one to two weeks, and as chronic, which continues for longer than two or three weeks. Viral and bacterial infections are the most common causes of acute diarrhea.
Description
In many cases, acute infectious diarrhea is a mild, limited annoyance common to adults and children. Chronic diarrhea, though, can have considerable effect on health and on social and economic well-being. People with celiac disease, inflammatory bowel disease, and other prolonged diarrheal illnesses develop nutritional deficiencies that diminish growth and immunity. They affect social interaction and result in the loss of many working hours. Rapid diagnosis and proper treatment can prevent much of the suffering associated with these illnesses.
Demographics
Worldwide, acute infectious diarrhea has a huge impact, causing over 5 million deaths per year. While most deaths are among children under five years of age in developing nations, the impact, even in developed countries, is considerable. For example, over 250,000 individuals are admitted to hospitals in the United States each year because of one of these episodes.
Causes and Symptoms
Diarrhea occurs because more fluid passes through the large intestine (colon) than that organ can absorb. As a rule, the colon can absorb several times more fluid than is required on a daily basis. However, when this reserve capacity is overwhelmed, diarrhea occurs.
Diarrhea is caused by infections or illnesses that either lead to excess production of fluids or prevent absorption of fluids. Also, certain substances in the colon, such as fats and bile acids, can interfere with water absorption and cause diarrhea. Rapid passage of material through the colon can also do the same.
Symptoms related to any diarrheal illness are often those associated with any injury to the gastrointestinal tract, such as fever, nausea, vomiting, and abdominal pain. All or none of these may be present depending on the disease causing the diarrhea. The number of bowel movements can vary—up to 20 or more per day. In some persons, blood or pus is present in the stool. Bowel movements may be difficult to flush (float) or contain undigested food material.
The most common causes of acute diarrhea are infections (the cause of traveler's diarrhea), food poisoning, and medications. Medications are a frequent and often over-looked cause, especially antibiotics and antacids. Less often, various sugar-free foods, which sometimes contain poorly absorbable materials, cause diarrhea.
Chronic diarrhea is frequently due to many of the same things that cause the shorter episodes (infections, medications, etc.); however, symptoms last longer. Some infections can become chronic. This occurs mainly with parasitic infections (such as Giardia) or when people have altered immunity (such as AIDS). In children, more common causes of chronic diarrhea are food allergy and lactose intolerance. Toddlers who drink too much juice can have frequent, loose stools.
When to Call the Doctor
A physician or other healthcare provider should be contacted when the number of bowel movements exceeds three per day for 2 days or more or when fecal material contains blood. A doctor should be called if a person becomes dehydrated. Signs of dehydration include decreased urination, lethargy, poor skin tone, and generalized weakness. In very young children, the parents should call a doctor if they observe these symptoms of dehydration:
Parents should also call the doctor if a child is vomiting so often that he or she cannot keep fluids down, has a high fever, complains of severe abdominal pain, or shows no improvement in symptoms after 24 hours.
Diagnosis
Most cases of acute diarrhea never need diagnosis or treatment, as many are mild and produce few problems. But persons of any age with fever over 102°F (38.9°C), signs of dehydration, bloody bowel movements, severe abdominal pain, known immune disease, or prior use of antibiotics need prompt medical evaluation.
When diagnostic studies are needed, the most useful are stool culture and examination for parasites; however, these are often negative, and a cause cannot be found in a large number of people. The earlier cultures are performed, the greater the chance of obtaining a positive result. For those with a history of antibiotic use in the preceding two months, stool samples need to be examined for the toxins that cause antibiotic-associated colitis. Tests are also available to check stool samples for microscopic amounts of blood and for cells that indicate severe inflammation of the colon. Examination with an endoscope is sometimes helpful in determining severity and extent of inflammation. Tests to check changes in blood chemistry (potassium, magnesium, etc.) and a complete blood count (CBC) are also often performed.
Chronic diarrhea is quite different, and most persons with this condition receive some degree of testing. Many exams are the same as for an acute episode, as some infections and parasites cause both types of diarrhea. A careful history to evaluate medication use, dietary changes, family history of illnesses, and other symptoms is necessary. Key points in determining the seriousness of symptoms are weight loss of over 10 lbs (4.5 kg), blood in the stool, and nocturnal diarrhea (symptoms that awaken an individual from sleep).
Both prescription and over-the-counter medications can contain additives, such as lactose and sorbitol, that will produce diarrhea in sensitive individuals. Review of allergies or skin changes may also point to a cause. Social history may indicate that stress is playing a role or may identify activities which can be associated with diarrhea (for example, diarrhea that occurs in runners).
A combination of stool, blood, and urine tests may be needed in the evaluation of chronic diarrhea; in addition, a number of endoscopic and x-ray studies are frequently required.
Treatment
Treatment is ideally directed toward correcting the cause; however, the first aim should be to prevent or treat dehydration and nutritional deficiencies. The type of fluid and nutrient replacement depends on whether oral feedings can be taken and on the severity of fluid losses. Oral rehydration solution (ORS) or intravenous fluids are the choices; ORS is preferred if possible.
A physician should be notified if a person is dehydrated. If oral replacement is suggested then commercial (Pedialyte and others) or homemade preparations can be used. The World Health Organization (WHO) has provided this easy recipe for home preparation, which can be taken in small frequent sips:
When feasible, food intake should be continued even in those people with acute diarrhea. A physician should be consulted regarding what type and how much food is permitted.
Anti-motility agents (loperamide, diphenoxylate) are useful for those with chronic symptoms; their use is limited or even contraindicated in most individuals with acute diarrhea, especially in those with high fever or bloody bowel movements. They should not be taken without the advice of a physician, and should not be used in children.
Other treatments are available, depending on the cause of symptoms. For example, the bulk agent psyllium helps some people by absorbing excess fluid and solidifying stools; cholestyramine, which binds bile acids, is effective in treating bile-salt-induced diarrhea. Low fat diets or more easily digestible fat is useful in some people. Antidiarrheal drugs that decrease excessive secretion of fluid by the intestinal tract is another approach for some diseases. Avoidance of medications or other products that are known to cause diarrhea (such as lactose) is curative in some people but should be discussed with a physician.
Alternative Treatment
It is especially important to find the cause of diarrhea, since stopping diarrhea when it is the body's way of eliminating something foreign is not helpful and can be harmful in the long run.
One effective alternative approach to preventing and treating diarrhea involves oral supplementation of aspects of the normal flora in the colon with the yeasts Lactobacillus acidophilus, L. bifidus, or Saccharomyces boulardii. In clinical settings, these "biotherapeutic" agents have repeatedly been helpful in the resolution of diarrhea, especially antibiotic-associated diarrhea.
Nutrient replacement also plays a role in preventing and treating episodes of diarrhea. Zinc especially appears to have an effect on the immune system, and deficiency of this mineral can lead to chronic diarrhea. Also, zinc replacement improves growth in young persons. To prevent dehydration, individuals suffering from diarrhea should take plenty of fluids, especially water. The BRAT diet also can be useful in helping to resolve diarrhea. This diet limits food intake to bananas, rice, applesauce, and toast. These foods provide soluble and insoluble fiber without irritation. If the toast is slightly burnt, the charcoal can help sequester toxins and pull them from the body.
Acute homeopathic remedies can be very effective for treating diarrhea especially in infants and young children.
Prognosis
Prognosis is related to the cause of the diarrhea; for most individuals in developed countries, a bout of acute, infectious diarrhea is at best uncomfortable. However, in both industrialized and developing areas, serious complications and death can occur.
For those with chronic symptoms, an extensive number of tests are usually necessary to make a proper diagnosis and begin treatment; a specific diagnosis is found in 90 percent of people. In some, however, no specific cause is found and only treatment with bulk agents or anti-motility agents is indicated.
Prevention
Proper hygiene and food handling techniques can prevent many cases. Traveler's diarrhea can be avoided by people using products containing bismuth, such as Pepto-Bismol and/or antibiotics. The most important action is to prevent the complications of dehydration.
Nutritional Concerns
Replacement of fluids and electrolytes is important for people experiencing diarrhea. These individuals should take in foods that contain salt, potassium, phosphates, and sugar. Most sodas, sport drinks and non-cream soups are good sources of electrolytes.
Parental Concerns
Parents should be sure that their children who experience diarrhea drink plenty of fluids and replace electrolytes with an oral rehydration solution. A doctor should be called if the parent suspects a child is becoming dehydrated. Severe dehydration requires intravenous fluid administration in a medical setting. Antidiarrheal medications should be be given only on the advise of a physician.
Resources
Books
Ahlquist, David A., and Michael Camilleri. "Diarrhea and Constipation." In Harrison's Principles of Internal Medicine, 15th ed. Edited by Eugene Braunwald et al. New York: McGraw-Hill, 2001, pp. 241–9.
Ghishan, Fayez K. "Chronic Diarrhea." In Nelson Textbook of Pediatrics, 17th ed. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2003, pp. 1276–80.
Greenbaum, Larry A. "Acute Diarrhea and Oral Rehydration." In Nelson Textbook of Pediatrics, 17th ed. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2003, pp. 249–50.
——. "Diarrhea in Chronically Malnourished Children." In Nelson Textbook of Pediatrics, 17th ed. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2003, pp. 2250–1.
Sack, R. Bradley. "The Diarrhea of Travelers." In Cecil Textbook of Medicine, 22nd ed. Edited by Lee Goldman et al. Philadelphia: Saunders, 2003, pp. 1864–5.
Semrad, Carol E. and Don W. Powell. "Approach to the Patient with Diarrhea and Malabsorption." In Cecil Textbook ofMedicine, 22nd ed. Edited by Lee Goldman et al. Philadelphia: Saunders, 2003, pp. 842–60.
Organizations
American Academy of Pediatrics. 141 Northwest Point Blvd., Elk Grove Village, IL 60007–1098. Web site: www.aap.org.
American College of Gastroenterology. 4900 B South 31st Street, Arlington VA 22206. Web site: www.acg.gi.org/.
Web Sites
"Diarrhea." Centers for Disease Control and Prevention. Available online at www.cdc.gov/ncidod/dpd/parasiticpathways/diarrhea.htm (accessed January 5, 2005).
"Diarrhea." Merck Manual. Available online at www.merck.com/mrkshared/mmanual/section3/chapter27/27b.jsp (accessed January 5, 2005).
"Diarrhea." National Digestive Diseases Information Clearinghouse. Available online at
"Diarrhea." MedlinePlus. Available online at www.nlm.nih.gov/medlineplus/diarrhea.html (accessed January 5, 2005).
"Traveler's Diarrhea." American Academy of Family Practice. Available online at
[Article by: L. Fleming Fallon, Jr., MD, DrPH]
Gale Nutrition Encyclopedia:
Diarrhea |
| Causes | Examples |
| Viral infections | Rotavirus, Norwalk virus |
| Bacterial infections | E. coli, Vibrio cholerae, Campylobacter, Shigella |
| Parasites | Giardia, Entamoeba |
| Helminths (intestinal worms) | Strongyloides |
| Allergic | Lactose intolerance, celiac sprue, medication side effects |
| Autoimmune | Ulcerative colitis, Crohn's disease |
| Malabsorptive | Pancreatic deficiency, biliary disease |
| Nutritional | Zinc deficiency, vitamin A deficiency, enteral feedings consisting of liquid nutritional formulas delivered straight to the bowels |
| Functional | Irritable bowel syndrome, short bowel syndrome, cancer |
Columbia Encyclopedia:
diarrhea |
Dictionary of Cultural Literacy: Health:
diarrhea |
The frequent passage of abnormally watery feces, which is a sign of illness.
Saunders Veterinary Dictionary:
diarrhea |
Rapid movement of fecal matter through the intestine resulting in poor absorption of water, nutritive elements and electrolytes, and producing abnormally frequent evacuation of watery droppings. The major causes are local irritation of the intestinal mucosa by infectious or chemical agents (gastroenteritis). In all types of diarrhea there is rapid evacuation of water and electrolytes resulting in a loss of these essential substances. Base (bicarbonate) especially is depleted by diarrhea, thus producing acidosis as well as fluid volume deficit.
Mosby's Dental Dictionary:
diarrhea |
The frequent passage of loose, watery stools. The stool may also contain mucus, pus, blood, or excessive amounts of fat. Diarrhea is usually a symptom of some underlying disorder. See antidiarrheals
Random House Word Menu:
categories related to 'diarrhea' |
Rhymes:
diarrhoea |
Bradford's Crossword Solver's Dictionary:
diarrhea |
See crossword solutions for the clue Diarrhoea.
Wikipedia on Answers.com:
Diarrhea |
 An electron micrograph of rotavirus, the cause of nearly 40% of hospitalizations from diarrhea in children under 5[1] |
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| ICD-10 | A09, K59.1 |
|---|---|
| ICD-9 | 787.91 |
| DiseasesDB | 3742 |
| eMedicine | ped/583 |
| MeSH | D003967 |
Diarrhea (from the Greek διάρροια meaning "flowing through"[2]), also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day.[3] It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and electrolyte imbalances. In 2009 diarrhea was estimated to have caused 1.1 million deaths in people aged 5 and over[4] and 1.5 million deaths in children under the age of 5.[1] Oral rehydration salts and zinc tablets are the treatment of choice and have been estimated to have saved 50 million children in the past 25 years.[1]
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Contents
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Diarrhea is defined by the World Health Organization as having 3 or more loose or liquid stools per day, or as having more stools than is normal for that person.[3]
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. In this type of diarrhea intestinal fluid secretion is isotonic with plasma even during fasting.[5] It continues even when there is no oral food intake.
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 has lactose intolerance can have difficulty absorbing lactose after an extraordinarily high intake of dairy products. In persons who have fructose malabsorption, excess fructose intake can also 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.[5] Osmotic diarrhea stops when offending agent (e.g. milk, sorbitol) is stopped.
Exudative diarrhea occurs with the presence of blood and pus in the stool. This occurs with inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis, and other severe infections such as E. coli or other forms of food poisoning.[5]
Motility-related diarrhea is caused by the rapid movement of food through the intestines (hypermotility). If the food moves too quickly through the gastrointestinal 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[citation needed]. Hyperthyroidism can produce hypermotility and lead to pseudodiarrhea and occasionally real diarrhea. Diarrhea can be treated with antimotility agents (such as loperamide). Hypermotility can be observed in people who have had portions of their bowel removed, allowing less total time for absorption of nutrients.
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.[citation needed]
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 a symptom of, among others, Shigella, Entamoeba histolytica, and Salmonella.
Diarrhea is most commonly due to viral gastroenteritis with rotavirus, which accounts for 40% of cases in children under five.[1] (p. 17) In travelers however bacterial infections predominate.[6] Various toxins such as mushroom poisoning and drugs can also cause acute diarrhea.
Chronic diarrhea can be the part of the presentations of a number of chronic medical conditions affecting the intestine. Common causes include ulcerative colitis, Crohn's disease, microscopic colitis, celiac disease, irritable bowel syndrome and bile acid malabsorption.
There are many causes of infectious diarrhea, which include viruses, bacteria and parasites.[7] Norovirus is the most common cause of viral diarrhea in adults,[8] but rotavirus is the most common cause in children under five years old.[9] Adenovirus types 40 and 41,[10] and astroviruses cause a significant number of infections.[11]
The bacterium Campylobacter is a common cause of bacterial diarrhea, but infections by Salmonellae, Shigellae and some strains of Escherichia coli (E.coli) are frequent.[12]
In the elderly, particularly those who have been treated with antibiotics for unrelated infections, a toxin produced by Clostridium difficile often causes severe diarrhea.[13]
Parasites do not often cause diarrhea except for the protozoan Giardia, which can cause chronic infections if these are not diagnosed and treated with drugs such as metronidazole,[14] and Entamoeba histolytica.[15][16]
Other infectious agents such as parasites and bacterial toxins also occur.[6] In sanitary living conditions where there is ample food and a supply of clean water, an otherwise healthy person 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.[17]
Malabsorption is the inability to absorb food fully, mostly from disorders in the small bowel, but also due to maldigestion from diseases of the pancreas.
Causes include:
The two overlapping types here are of unknown origin:
Another possible cause of diarrhea is irritable bowel syndrome (IBS) which usually presents with abdominal discomfort relieved by defecation and unusual stool (diarrhea or constipation) for at least 3 days a week over the previous 3 months.[18] Symptoms of diarrhea-predominant IBS can be managed through a combination of dietary changes, soluble fiber supplements, and/or medications such as loperamide or codeine. About 30% of patients with diarrhea-predominant IBS have bile acid malabsorption diagnosed with an abnormal SeHCAT test.[19]
According to two researchers, Nesse and Williams, diarrhea may function as an evolved expulsion defense mechanism. As a result, if it is stopped, there might be a delay in recovery.[21] They cite in support of this argument research published in 1973 which found that treating Shigella with the anti-diarrhea drug (Co-phenotrope, Lomotil) caused people to stay feverish twice as long as those not so treated. The researchers indeed themselves observed that: "Lomotil may be contraindicated in shigellosis. Diarrhea may represent a defense mechanism".[22]
The following types of diarrhea may indicate further investigation is needed:
A severity score is used to aid diagnosis in children.[23]
A rotavirus vaccine has the potential to decrease rates of diarrhea.[1] There are currently two licensed vaccines against rotavirus. New vaccines against rotavirus, Shigella, ETEC, and cholera are under development, as well as other causes of infectious diarrhea.
A Cochrane Review of studies found that in institutions and in communities, interventions that promote hand washing lead to significant reductions in the incidence of diarrhea.[24]
In many cases of diarrhea, replacing lost fluid and salts is the only treatment needed. This is usually by mouth – oral rehydration therapy – or, in severe cases, intravenously.[1] Diet restrictions such as the BRAT diet are no longer recommended.[25] Research does not support the limiting of milk to children as doing so has no effect on duration of diarrhea.[26]
Medications such as loperamide (Imodium) and bismuth subsalicylate may be beneficial; however they may be contraindicated in certain situations.[27]
While antibiotics are beneficial in certain types of acute diarrhea, they are usually not used except in specific situations.[28][29] There are concerns that antibiotics may increase the risk of hemolytic uremic syndrome in people infected with Escherichia coli O157:H7.[30] In resource poor countries, treatment with antibiotics may be beneficial.[29] However, some bacteria are developing antibiotic resistance, particularly Shigella.[31]
While bismuth compounds (Pepto-Bismol) decreased the number of bowel movements in those with travelers' diarrhea, they do not decrease the length of illness.[32] These agents should only be used if bloody diarrhea is not present.[33]
Anti motility agents like loperamide are effective at reducing the duration of diarrhea.[29]
Codeine is used in the treatment of diarrhea to slow down peristalsis and the passage of fecal material through the bowels - this means that more time is given for water to reabsorb back into the body, which gives a firmer stool, and also means that feces is passed less frequently.[34]
Bile acid sequestrants such as cholestyramine, colestipol and colesevelam can be effective in chronic diarrhea due to bile acid malabsorption. Therapeutic trials of these drugs are indicated in chronic diarrhea if bile acid malabsorption cannot be diagnosed with a specific test, such as SeHCAT retention.
A Cochrane systematic review found that zinc supplementation benefits children suffering from diarrhea in developing countries, but only in infants over six months old. This supports the World Health Organisation guidelines for zinc, but not in the very young.[35]
A 2010 systematic review determined the effectiveness of probiotics in treating acute infectious diarrhea. The study demonstrated that the use of probiotics reduced the duration of symptoms by one day and reduced the chances of symptoms lasting longer than four days by 60%.[36] The probiotic lactobacillus can help prevent antibiotic associated diarrhea in adults but possibly not children.[37] For those who with lactose intolerance, taking digestive enzymes containing lactase when consuming dairy products is recommended.[who?]
World wide in 2004 approximately 2.5 billion cases of diarrhea occurred which results in 1.5 million deaths among children under the age of five.[1] Greater than half of these were in Africa and South Asia.[1] This is down from a death rate of 5 million per year two decades ago.[1] Diarrhea remains the second leading cause of death (16%) after pneumonia (17%) in this age group.[1]
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Translations:
Diarrhoea |
Français (French)
n. - diarrhée
Deutsch (German)
n. - Durchfall
Ελληνική (Greek)
n. - (παθολ.) διάρροια
Português (Portuguese)
n. - diarréia (f)
Español (Spanish)
n. - diarrea
中文（简体）(Chinese (Simplified))
腹泻
中文（繁體）(Chinese (Traditional))
n. - 腹瀉
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 | toxigenic |
| Blastocystis hominis |
| BVDV |
 | Why do you have diarrhea? Read answer... |
| What is diarrheas? Read answer... |
| How do you have diarrhea? Read answer... |
 | If you went to the restroom normal from diarrhea and you had diarrhea before that? |
| How does diarrhea work? |
| What rhymes with diarrhea? |
Copyrights:
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 | American Heritage Dictionary. The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2007, 2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved. Read more |
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Fowler's Modern English Usage. Oxford University Press. © 1999, 2004 All rights reserved. Read more | |
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| Britannica Concise Encyclopedia. Britannica Concise Encyclopedia. © 1994-2012 Encyclopædia Britannica, Inc. All rights reserved. Read more |
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| Gale Encyclopedia of Cancer. Gale Encyclopedia of Cancer. Copyright © 2006 by The Gale Group, Inc. All rights reserved. Read more |
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| McGraw-Hill Science & Technology Encyclopedia. McGraw-Hill Encyclopedia of Science and Technology. Copyright © 2005 by The McGraw-Hill Companies, Inc. All rights reserved. Read more |
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| Antonyms by Answers.com. © 1999-present by Answers Corporation. All rights reserved. Read more |
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| Gale Encyclopedia of Children's Health. © 2006 by The Gale Group, Inc. All rights reserved. Read more |
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| Gale Nutrition Encyclopedia. Nutrition and Well-Being A-Z © 2004 The Gale Group, Inc. All rights reserved. Read more |
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| Columbia Encyclopedia. The Columbia Electronic Encyclopedia, Sixth Edition Copyright © 2012, Columbia University Press. Licensed from Columbia University Press. All rights reserved. www.cc.columbia.edu/cu/cup/. Read more |
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| Dictionary of Cultural Literacy: Health. The New Dictionary of Cultural Literacy, Third Edition Edited by E.D. Hirsch, Jr., Joseph F. Kett, and James Trefil. Copyright © 2002 by Houghton Mifflin Company. Published by Houghton Mifflin. All rights reserved. Read more |
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| Sign Language Videos. Copyright © 2009 Signing Savvy, LLC. All rights reserved. Read more |
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| Saunders Veterinary Dictionary. Saunders Comprehensive Veterinary Dictionary 3rd Edition. Copyright © 2007 by D.C. Blood, V.P. Studdert and C.C. Gay, Elsevier. All rights reserved. Read more |
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| Mosby's Dental Dictionary. Mosby's Dental Dictionary. Copyright © 2004 by Elsevier, Inc. All rights reserved. Read more |
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| Random House Word Menu. © 2010 Write Brothers Inc. Word Menu is a registered trademark of the Estate of Stephen Glazier. Write Brothers Inc. All rights reserved. Read more |
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Rhymes. Oxford University Press. © 2006, 2007 All rights reserved. Read more | |
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| Bradford's Crossword Solver's Dictionary. Collins Bradford's Crossword Solver's Dictionary © Anne Bradford, 1986, 1993, 1997, 2000, 2003, 2005, 2008 HarperCollins Publishers All rights reserved. Read more |
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| Wikipedia on Answers.com. This article is licensed under the Creative Commons Attribution/Share-Alike License. It uses material from the Wikipedia article Diarrhea. Read more |
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