You know what they say … when you gotta go, you gotta go. But when the going gets too frequent, and is accompanied by other uncomfortable symptoms, you need relief! Most diarrhea is short-lived and lasts only a couple of days. Common over-the-counter (OTC) antidiarrheal medications such as loperamide (brand name Imodium) or bismuth subsalicylate (brand names Pepto-Bismol or Kaopectate) may help bring that needed relief. Probiotics can also help restore and maintain gut health. But understanding the specific symptoms of diarrhea and the factors that can cause diarrhea are important to getting you the treatment you need. 

Diarrhea Defined

Diarrhea can be defined simply as an increase in the frequency of bowel movements. This is relative to what is typical for you. Or it can be defined in absolute terms as more than five loose, watery bowel movements per day. The increase in frequency of bowel movements is often accompanied by other symptoms such as abdominal cramps, fever, bloating, and dehydration. You may experience acute diarrhea (lasting a few days) or chronic diarrhea (typically lasting more than three weeks). Diarrhea is very common among all age groups, and is one of the top illnesses blamed for missed work or school.

When Should I Call My Doctor?

While most cases of acute diarrhea will resolve on their own in a couple of days, and can be treated with over-the-counter medications, there are some warning signs to watch for. 

If you have concerns about your situation, it’s always a good idea to talk with your doctor. Anyone who experiences any of the following should consult with their doctor or a gastroenterologist right away:

  • If you have blood or mucus in your stool.
  • If you experience loose watery stools that lasts more than two days.
  • If you show signs of dehydration including dry mouth, dizziness, and headache.
  • If you are already taking other prescription medication.
  • If you have any other underlying medical conditions.
  • If you develop side effects to OTC medication including, but not limited to, abdominal pain, dizziness, constipation, or vomiting.

What Causes Diarrhea?

There are a number of things that can cause diarrhea, and identifying the underlying reasons for the issues you are experiencing will help you find the right treatment. You may not always know why you got sick, but understanding the causes of diarrhea can help you narrow it down.

Let’s start with three basic reasons diarrhea develops. The first is when too much water is secreted in the intestines. This is a normal part of digestion, but if too much water is secreted, you get loose, watery stools. Second is when the water that is typically absorbed by the small intestine doesn’t get absorbed correctly. When this absorption process doesn’t happen, too much liquid remains in the stool and creates diarrhea. Finally, if the undigested food passes through the small intestine too quickly so the excess water does not have time to be absorbed, this also creates loose watery stools.

What causes these different scenarios to develop? Most cases of diarrhea are caused by a virus, typically short-lived and treatable with OTC medication. But more serious cases can be caused by a bacterial infection or parasites. Frequent watery stools can also be the result of a reaction to medication or an intolerance or allergy to certain foods (such as lactose intolerance).

You may also have heard references to traveler’s diarrhea, which occurs as a result of exposure to bacteria from contaminated food or water. This type of diarrhea often comes on suddenly and includes severe pain and fever. If you travel to an area where you are at risk of developing traveler’s diarrhea, you can limit that risk by drinking bottled or purified water and eating only peeled and/or cooked fruits and vegetables.

Underlying diseases such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), Crohn's disease, celiac disease, or ulcerative colitis are also possibilities and should be ruled out by your doctor.

Diarrhea Treatment Options

So what should you do when you find yourself rushing to the toilet too often? Acute diarrhea can be treated with a number of options, including OTC and prescription medications. For most cases of diarrhea, common over-the-counter antidiarrheal medications such as loperamide (ex: Imodium) or bismuth subsalicylate (ex: Pepto-Bismol or Kaopectate) can help control symptoms and make you more comfortable. But before you run for the medicine cabinet, it’s best to start with some simple changes to your diet. First, drink a lot of water to prevent dehydration. This is especially important for young children who may not easily identify the signs of dehydration. Dehydration can overwhelm a very young system. If diarrhea lasts longer than 24 hours, consult your pediatrician. Pedialyte may be used for very young children to help them hydrate and replace electrolytes. Along with lots of fluids, eat foods that are easy on the stomach—many people suggest what is called the BRAT diet (bananas, rice, applesauce, toast). And be sure to get plenty of rest to help your body recover and heal.

Cases of diarrhea caused by bacteria or parasites should not be treated with the OTC medication, loperamide (Imodium). Loperamide works by slowing down the speed with which food moves through your system. This process of slowing things down often makes bacterial or parasitic diarrhea worse rather than better. If you suspect these or don’t know the cause of your diarrhea, your best bet is to stay hydrated while allowing the diarrhea to run its course. If you aren’t sure or have concerns about what’s causing your issues, consult your doctor who will help you determine the best course of action. Based on your specific situation, your doctor may prescribe other medications to treat your diarrhea, the underlying cause, or both.  

Can Diarrhea be Prevented?

We’d like to respond with, “Definitely, yes!” But sorry to say, the true answer is, “Unfortunately, no.” Diarrhea is very common and can’t always be avoided. But there are some lifestyle choices you can make to help limit the occurrences. The first is simple—wash your hands. Good hygiene will help keep infectious agents out of your system in the first place. Exercise and staying hydrated also contribute to overall health and wellness that will strengthen your immune system. Focusing on staying healthy helps you fight off diarrhea and recover more quickly when it strikes. 

What About Probiotics?

Does it sound strange to fight bacteria with bacteria? You may think that any bacteria is bad, but the truth is that our bodies have all kinds of bacteria at work all the time. And while bacteria gets a bad rap for the damage it can do, good bacteria in the right places is a great thing. That is why many people take probiotics to help maintain gut health. While there is still much to be studied about the impact of probiotics, they have been shown to be helpful in maintaining the balance of bacteria, as well as rebuilding the good bacteria in the gut after illness or the use of certain medications like antibiotics. Probiotics are also used by many people to fight against the effects of irritable bowel syndrome, which can also cause diarrhea. 

Need More Information? 

Diarrhea is typically short-lived and can be treated with changes to diet and over-the-counter medications. However, if you experience frequent diarrhea or if your your day-to-day life is being disrupted by symptoms, make an appointment with a gastroenterologist at Asheville Gastroenterology Associates. We can answer your questions, diagnose your condition, and work with you to explore your best options for treatment.