Diarrhoea

Liquid motions that occur if the bowel fails to reabsorb fluid.

Causes of Diarrhoea

For much of its passage through the intestinal tract food moves as a liquid slurry, totalling about 8 litres/VA gallons a day. Water is reabsorbed in the large intestine until the motions are solid or semi-solid. This process is affected by infection, inflammation or growths in the bowel. The overwhelming majority of cases of diarrhoea are caused by minor and self-limiting infection.

Infection and inflammation

Many germs can cause a temporary inflammation of the bowel, which interferes with fluid absorption. Even the common cold viruses do this, especially in children. More serious infections such as cholera or typhoid are unusual in the developed world. These lead to dangerously high fluid loss in a very short period of time.

Food poisoning may be caused by a definite germ or by poisons (toxins) within the food that do not infect the bowel but cause it to be overactive. The terms gastroenteritis and food poisoning largely overlap. Chronic diarrhoea is a feature of inflammatory bowel disease.

Growths

Growths, benign or cancerous, in the bowel cause diarrhoea by interfering with its normal function. Much less common than gastroenteritis, these bear consideration if an older person has diarrhoea lasting more than a couple of weeks.

Miscellaneous causes

Less common reasons include worry (‘my bowels turned to water’), malabsorption (as in coeliac disease) or an overactive thyroid gland (see Thyroid problems). In the elderly diarrhoea often coexists with constipation.

Symptoms of Diarrhoea

The motions are semi-formed if not pure liquid. Abdominal cramps are relieved by opening the bowels urgently many times a day. Blood is not uncommon with gastroenteritis; recurrent blood loss or mucus in the motions suggests inflammatory bowel disease or a growth, as does persistent diarrhoea, diarrhoea at night, abdominal pains and weight loss. Thirst and tiredness with prolonged diarrhoea suggest serious fluid and mineral loss and require medical attention.

Treatment

The vast majority of cases of diarrhoea settle without any medication over a few days. The individual should simply drink 2-3 litres/3.5 to 5 pints a day of bland drinks such as water, tea, or fizzy drinks gone flat. It is best to avoid milk and sweet drinks, which can make diarrhoea worse. It is especially important for both the elderly and children to take extra fluids containing the minerals lost in diarrhoea, such as potassium.

Various antidiarrhoea remedies work on the nervous system, which controls the bowels, slowing it down. They are useful for short-term control but see a doctor for diarrhoea lasting more than a few days. Drugs include loperamide and codeine. Analysing a stool sample may reveal infection treatable by an antibiotic. Antibiotics such as ciprofloxacin are helpful if diarrhoea acquired abroad is persistent and severe.

Complementary Treatment

Most complementary therapists will offer dietary advice along with treatment: nutritional therapists and naturopaths can be especially helpful. Commonly used acupuncture points are Stomach 25, on the abdomen, and Stomach 36, below the knee. Chinese herbalism remedies to strengthen a weak digestive system include Dang Shen and Bai Zhu, both part of the formula called Si Jun Zi Tang (four noble formulae). Other therapies to try: homoeopathy; Western herbalism; shiatsu-do; cymatics; hypnotherapy; auricular therapy; Ayurveda; chakra balancing.