Diarrhoea persistent causes patient overview

Overview

Persistent diarrhoea means having loose, watery stools (poo) that last for more than a few days but less than four weeks. It's different from a short stomach bug, which usually clears up in a day or two. Persistent diarrhoea can be a sign that something in your digestive system needs attention.

Yes, persistent diarrhoea is fairly common. Many people experience it at some point, often after a stomach infection or when they have a food sensitivity. It can affect anyone.

It can affect people of all ages, from children to older adults. People who travel to areas with different hygiene standards, those with weakened immune systems, or those with certain gut conditions are more likely to get persistent diarrhoea.

Symptoms

Common symptoms

• Loose or watery stools that last for more than a few days
• Needing to go to the toilet urgently or more often than usual
• Stomach cramps or pain
• Feeling bloated or gassy
• Nausea or vomiting (sometimes)

Symptoms in children

• Watery stools that persist beyond a week
• Fussiness or crying more than usual
• Refusing to eat or drink
• Sunken eyes or dry mouth (signs of dehydration)
• Fewer wet nappies than normal

Symptoms in older adults

• Persistent loose stools with stomach discomfort
• Confusion or feeling very weak (can be a sign of dehydration)
• Dry mouth, dizziness, or dark urine
• Weight loss or feeling very tired

Causes

Main causes

• Infections – like a stomach bug (gastroenteritis) that hasn't fully cleared, or parasites such as Giardia after travel
• Food intolerances – trouble digesting lactose (milk sugar) or fructose (fruit sugar) can cause ongoing diarrhoea
• Medications – antibiotics, some heartburn drugs, or laxatives can upset your gut
• Irritable bowel syndrome (IBS) – a common gut condition that can cause diarrhoea, pain, and bloating
• Inflammatory bowel disease (IBD) – conditions like Crohn's disease or ulcerative colitis (less common but important to check)

Risk factors

• Travelling to areas with limited clean water or poor food hygiene
• Having a weakened immune system (for example, from cancer treatment or HIV)
• Recent antibiotic use
• Being under 5 years old or over 65 years old
• Eating a lot of sugar-free foods that contain sweeteners like sorbitol

When to see a doctor

See a doctor urgently if:

• See a doctor within 24 hours if you have signs of dehydration, such as feeling faint, passing little dark urine, or having a dry mouth.
• If you see blood in your stool or have severe belly pain, get medical attention quickly (same day).

Book a routine appointment if:

• If diarrhoea lasts more than 7 days, make a routine appointment with your GP or local health centre.
• If you've been on antibiotics recently and diarrhoea starts, tell your doctor.
• If you have a known condition like IBS and symptoms change, check with your doctor.

Diagnosis

Your doctor will ask about your symptoms, travel history, diet, and medications. They may also press gently on your belly and listen to your stomach. In most cases, they can start treatment without tests. If symptoms continue, they may suggest a stool sample or blood test.

Tests that may be done

• Stool sample – to check for infections, parasites, or signs of inflammation
• Blood test – to look for signs of infection, dehydration, or conditions like coeliac disease
• Breath test – to check for lactose intolerance or bacterial overgrowth
• Colonoscopy or sigmoidoscopy – a camera test to look inside your bowel (only if symptoms are severe or long-lasting)

What to expect at your appointment

The doctor will explain what they think might be causing your diarrhoea and suggest simple steps to help. If a test is needed, they'll tell you how to prepare. Most tests are quick and not painful. The goal is to find the cause so you can feel better.

Treatment

Treatment depends on the cause. For most people, simple home care and staying hydrated are enough. If an infection is found, antibiotics may be given (but only if needed). For food intolerances, avoiding the trigger food helps. For IBS or IBD, your doctor can suggest a plan to manage symptoms.

Self-care at home

• Drink plenty of water or oral rehydration solution (available from pharmacies) to replace lost fluids
• Eat small, frequent meals – plain foods like rice, toast, bananas, or applesauce can settle your stomach
• Avoid coffee, alcohol, spicy foods, and high-fibre foods while symptoms last
• Wash your hands regularly to prevent spreading any infection
• Rest as much as possible to help your body recover

Medical treatments

If self-care isn't enough, your doctor may recommend medicines that slow down the bowel movements (such as loperamide) or treat an infection with antibiotics. They might also suggest probiotics (friendly bacteria) in some cases. Always follow your doctor's advice about which medicine is right for you.

When is surgery considered?

Surgery is rarely needed for persistent diarrhoea itself. It may be considered only if an underlying condition like severe inflammatory bowel disease or a growth in the bowel is found. Your doctor will discuss this with you in detail if it applies.

Living with this condition

Living with persistent diarrhoea can be tiring and inconvenient, but with the right care, most people manage well. Keep a record of your symptoms and any foods that seem to make them worse. Stock up on oral rehydration sachets and comfortable clothes. Plan ahead for trips away – know where toilets are and carry a change of clothes if you feel anxious.

Lifestyle tips

• Drink plenty of fluids throughout the day – aim for small sips often
• Eat a balanced diet when you feel up to it, but avoid trigger foods
• Get enough sleep – your body uses rest to heal
• Manage stress – deep breathing, gentle walks, or talking to someone can help
• Stay active when you can, but don't overdo it

Diet and exercise

A simple diet of bland, low-fibre foods can ease symptoms until they improve. As you feel better, slowly add back fruits, vegetables, and whole grains. Gentle exercise like walking can help digestion and mood. Avoid heavy exercise until you're fully recovered, as dehydration can make you feel worse.

Mental health and emotional wellbeing

Having persistent diarrhoea can feel embarrassing or stressful, especially if it affects your work or social life. It's normal to feel worried or frustrated. Talk to your doctor or a counsellor if you feel overwhelmed. Remember, you are not alone – many people go through this, and getting support can help you cope.

Prevention

Not always, but you can lower your risk by washing your hands well, especially after using the toilet and before eating. Drink safe water when travelling, and be careful with food hygiene. If you have a food intolerance, avoid that food. Taking probiotics during a course of antibiotics may help prevent antibiotic-related diarrhoea – ask your pharmacist.

Vaccines

There is a rotavirus vaccine for babies that helps prevent a common cause of severe diarrhoea in children. For adults, no routine vaccine exists for diarrhoea, but making sure you are up to date with travel vaccines may help if you travel to high-risk areas.

Screening programmes

No routine screening for persistent diarrhoea exists in the general population. If you have symptoms, your doctor will suggest tests as needed. People with a family history of bowel conditions may be offered regular check-ups.

Complications

If left untreated

• Dehydration – can cause dizziness, confusion, kidney problems, and in severe cases, hospital care
• Weight loss and malnutrition – because your body may not absorb enough nutrients
• Anal irritation or skin breakdown from frequent stools
• Worsening of an underlying condition like inflammatory bowel disease

Long-term outlook

The outlook for persistent diarrhoea is very good. Most people get better with simple treatment and time. Even when a specific cause is found, it can often be managed well. With support from your doctor and some lifestyle changes, you can return to your normal routine without long-term problems.

Find support

International organisations

• World Gastroenterology Organisation (WGO) ↗

Local organisations

• NHS (UK) – Diarrhoea and vomiting ↗ · United Kingdom

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