Living with diarrhea

Overview

Diarrhea is when you pass loose or watery stools (bowel movements) more often than usual. It happens when your digestive system cannot absorb water properly, or when food moves through your gut too quickly. Most episodes are short and get better on their own.

Yes, diarrhea is one of the most common health problems in the world. Most adults have it at least once or twice a year, and children can have it more often.

Diarrhea can affect anyone at any age. It can be more serious in babies, young children, older adults, and people with weakened immune systems or long-term health conditions.

Symptoms

Common symptoms

• Loose, watery stools more than three times a day
• A sudden need to use the toilet
• Cramping or pain in your belly
• Nausea or vomiting
• Feeling bloated
• Sometimes a mild fever

Symptoms in children

• Very frequent watery stools
• Vomiting
• A high temperature
• Dry mouth or tongue
• No tears when crying
• Sunken eyes or, in a baby, a sunken soft spot on the head
• Being unusually sleepy or irritable
• Fewer wet nappies or urine than usual

Symptoms in older adults

• Sudden confusion or feeling very dizzy
• Dry mouth
• Dark urine or less urine than usual
• Feeling very weak
• Fainting or feeling faint when standing up
• Fast heartbeat or cold, clammy skin

Causes

Main causes

• Viral infections, such as norovirus
• Bacterial infections from contaminated food or water
• Parasites
• Medicines, especially antibiotics
• Food intolerances or allergies
• Digestive conditions such as irritable bowel syndrome or inflammatory bowel disease

Risk factors

• Travelling to places with unsafe drinking water or poor sanitation
• Taking antibiotics
• Being in close contact with someone who has diarrhea
• Eating undercooked or unsafe food
• Having a weakened immune system
• Not having clean water or proper handwashing facilities

When to see a doctor

See a doctor urgently if:

• See a doctor the same day if diarrhea lasts more than 24 to 48 hours, or if you have signs of dehydration.
• Seek help quickly if you have severe pain, fever, blood in your stool, or cannot keep fluids down.
• If you are pregnant, have a weakened immune system, or have a long-term health condition, seek advice early.

Book a routine appointment if:

• Make a routine appointment if diarrhea keeps returning, lasts longer than a couple of weeks, causes weight loss, or if it is affecting your daily life.
• If you have had recent surgery or are on medicines that affect your stomach, tell your doctor.
• Ask for a check-up if you have ongoing gut symptoms, such as bloating, pain, or changes in your bowel habits.

Diagnosis

A doctor will ask about your symptoms, how long you have had diarrhea, what you have eaten, recent travel, and whether anyone close to you is also unwell. They may press gently on your stomach and check you for signs of dehydration.

Tests that may be done

• A stool sample can be tested to look for infection.
• Blood tests can check for dehydration or signs of inflammation.
• A breath test may be used to check for food intolerances.
• If diarrhea is long-lasting, you may be referred to a specialist who can look inside the bowel using a flexible tube with a camera.

What to expect at your appointment

Most people do not need any tests. If tests are needed, your doctor will explain what is involved and why. You can ask questions and take someone with you for support.

Treatment

Treatment depends on the cause, but the most important step is replacing fluids and preventing dehydration. Most cases of diarrhea improve with self-care at home. If an infection or another health problem is found, your doctor can treat the underlying cause.

Self-care at home

• Drink plenty of fluids, little and often.
• For babies, continue breastfeeding or formula feeding unless a doctor says otherwise.
• Use rehydration drinks from a pharmacy if a pharmacist or doctor recommends them.
• Eat small, bland meals when you feel able, such as rice, bananas, toast, or plain crackers.
• Wash your hands carefully with soap and water after using the toilet and before preparing food.
• Avoid alcohol, caffeine, very sugary drinks, and heavy or spicy meals until you feel better.

Medical treatments

A healthcare provider may recommend treatments based on the cause. If bacteria or parasites are causing the diarrhea, they may prescribe medicines to treat the infection. For long-term digestive conditions, they can help you manage those conditions. Some medicines can reduce how often you go to the toilet, but they should only be used with guidance from a doctor or pharmacist, and never with certain infections.

When is surgery considered?

Surgery is rarely needed for diarrhea itself. It may be considered if diarrhea is caused by a problem such as a blockage, severe inflammation, or another condition that does not improve with other treatments.

Living with this condition

If diarrhea keeps returning or lasts a long time, it helps to plan ahead. Know where toilets are when you go out, carry a small kit with wipes, a change of underwear, and plastic bags, and bring fluids with you. Tell people you trust so they can support you. Rest when you need to and do not feel embarrassed.

Lifestyle tips

• Keep a diary of your symptoms, foods, and stress levels to spot patterns.
• Avoid foods and drinks that seem to trigger your symptoms.
• Try gentle ways to manage stress, such as breathing exercises or talking to someone.
• Get enough sleep and try to keep a regular routine.
• Stay active in a gentle way if you feel able, such as short walks.

Diet and exercise

During a flare, bland, low-fibre foods like rice, bananas, toast, and plain crackers can be easier to manage. When you feel better, slowly add fruits, vegetables, and other high-fibre foods back into your diet. Gentle exercise like walking can help your mood and digestion, but intense exercise may be best avoided until you are feeling stronger.

Mental health and emotional wellbeing

Living with diarrhea can be stressful, embarrassing, and exhausting. It can affect work, social life, and relationships. If it is making you anxious, low, or isolated, tell your doctor or ask to speak to a counsellor. Reaching out for help is a sign of strength, not weakness.

Prevention

Many cases of diarrhea can be prevented with simple steps. Wash your hands with soap and water after using the toilet, before eating, and before preparing food. Store and cook food safely. When travelling to places with unsafe water, drink bottled or boiled water and avoid ice, uncooked vegetables, and raw or undercooked meat.

Vaccines

Vaccines can protect against some causes of diarrhea, such as rotavirus in babies. Ask your health service whether this vaccine is available or recommended for you or your child.

Screening programmes

Routine screening is not usually needed for diarrhea. If diarrhea continues for several weeks, your doctor may suggest tests or screening to look for other causes.

Complications

If left untreated

• Dehydration, which can make you feel dizzy, weak, and confused
• Chemical imbalances in the body because of losing too much salt and water
• Weight loss and poor growth in children
• Worsening of existing health conditions
• In rare cases, kidney damage or other serious problems

Long-term outlook

Most diarrhea clears up within a few days, and most people have no long-term problems. Even when diarrhea is linked to a long-term condition, good care can greatly improve symptoms and quality of life. With the right support, most people manage very well.

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