Diarrhoea in older adults

Overview

Diarrhoea is when you have loose, watery bowel movements (stools) more often than usual. In older adults, it can be more serious because it can quickly lead to dehydration (loss of too much water from the body).

Yes, diarrhoea is fairly common in older adults. It can happen for many reasons, and it is important to know when to seek advice.

Diarrhoea can affect anyone, but older adults over 65, people with weakened immune systems, or those with long-term illnesses are more at risk of complications.

Symptoms

Common symptoms

• Frequent, loose, or watery stools
• Stomach cramps or pain
• Bloating
• Nausea
• Urgent need to go to the toilet

Symptoms in children

• Loose or watery stools
• Vomiting
• Fever
• Signs of dehydration: dry mouth, no tears, fewer wet nappies than usual

Symptoms in older adults

• Watery stools more than three times a day
• Stomach cramps
• Nausea or vomiting
• Fever
• Signs of dehydration: dry mouth, dark urine, feeling dizzy, confusion, not passing much urine

Causes

Main causes

• Infections from bacteria, viruses, or parasites (like food poisoning)
• Side effects of medicines, especially antibiotics
• Long-term conditions such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD)
• Food intolerances (for example, lactose)
• Traveller's diarrhoea from contaminated food or water

Risk factors

• Being over 65 years old
• Living in a care home or hospital
• Having a weakened immune system
• Taking several different medicines
• Recent use of antibiotics
• Having chronic conditions like diabetes or kidney disease

When to see a doctor

See a doctor urgently if:

• Diarrhoea that lasts more than 2 days
• Signs of dehydration that do not improve after drinking
• Blood in your stool
• Severe abdominal pain
• High fever
• Confusion or dizziness

Book a routine appointment if:

• Mild diarrhoea that lasts a few days without other symptoms
• You have a long-term condition like IBS and your symptoms change

Diagnosis

A doctor will ask about your symptoms, medical history, recent travel, and any medicines you take. They may also do a physical exam.

Tests that may be done

• Stool sample to check for infection
• Blood tests to look for dehydration or infection
• Sometimes a colonoscopy (a camera test inside your bowel) if diarrhoea lasts a long time

What to expect at your appointment

Most tests are simple. You can provide a stool sample at home or in the clinic. Blood tests are quick. Your doctor will explain the results and what they mean for you.

Treatment

Treatment for diarrhoea focuses on preventing dehydration and treating the cause. Most cases get better with self-care. If needed, a doctor can offer specific treatments.

Self-care at home

• Drink plenty of fluids such as water, clear broth, or oral rehydration salts (available from your pharmacy)
• Eat small, plain meals like rice, bananas, toast, and applesauce
• Rest to let your body recover
• Avoid dairy, fatty foods, and sugary drinks as they can make diarrhoea worse

Medical treatments

If an infection is found, your doctor may prescribe antibiotics or antivirals. For chronic conditions, there are medicines to help control bowel movements or reduce inflammation. Always follow your doctor’s advice. Do not take over-the-counter anti-diarrhoea medicines unless a doctor says it is safe, as they can sometimes be harmful.

When is surgery considered?

Surgery is rarely needed for diarrhoea. It may be considered for very serious causes like a blockage or certain bowel diseases, but this is uncommon.

Living with this condition

If you have long-term diarrhoea, it can be challenging. Plan your day with easy access to a toilet. Keep a diary of your symptoms to discuss with your doctor. Stay hydrated and eat small, frequent meals.

Lifestyle tips

• Wash your hands often to avoid spreading infection
• Avoid foods that seem to trigger your symptoms
• Manage stress with relaxation techniques like deep breathing or gentle yoga

Diet and exercise

Eat a gentle diet with foods like bananas, rice, applesauce, and toast (the BRAT diet). Avoid high-fibre foods during a flare. Gentle exercise such as walking can help, but rest when you have symptoms.

Mental health and emotional wellbeing

Dealing with diarrhoea can be stressful and sometimes embarrassing. It may affect your social life and mood. Talking to someone you trust or a counsellor can help. You are not alone.

Prevention

You can reduce your risk by: washing your hands often, cooking food thoroughly, drinking safe water, and being careful with food when travelling. If you take antibiotics, eating yogurt with live cultures may help prevent diarrhoea, but always ask your doctor first.

Vaccines

There is a vaccine for rotavirus in children, but it is not routinely given to older adults. Staying up to date with flu and pneumonia vaccines can help prevent infections that may cause diarrhoea.

Screening programmes

There is no routine screening for diarrhoea. If you have ongoing symptoms, your doctor may suggest tests to check for underlying conditions.

Complications

If left untreated

• Dehydration (loss of fluids)
• Electrolyte imbalances (problems with minerals in your blood)
• Kidney problems
• Malnutrition (not getting enough nutrients)
• Weight loss

Long-term outlook

The outlook for diarrhoea in older adults is very good if it is managed properly. Most people recover fully with rest and fluids. If a long-term condition is the cause, there are effective treatments to help control symptoms and improve quality of life. With the right care, you can get back to feeling normal.

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