Diarrhoea is a common symptom experienced by everyone at some point in their lives. To each person, a diarrhoeal episode can have different definitions. However, for the majority of people, diarrhoea is often loosely defined as:
Diarrhoea can be associated with symptoms such as:
This is the commonest cause of diarrhoea and also the cause that most people will think of.
Infective diarrhoea can be caused by either bacterial or viral causes. Some common bacterial causes include E.coli, Salmonella (typhoid fever), Campylobacter among many others. The common viral causes include enterovirus and rotavirus.
Most cases of infective diarrhoea are caused by ingestion of contaminated food or water, or what is commonly known as Food Poisoning
Thankfully, most cases of Infective Diarrhoea are self limiting and will resolve in a few days. The most important thing to note is to keep onself hydrated during the period of diarrhoea.
This is the second most common cause of diarrhoea and is related to dietary intake. The common culprits include dairy products (lactose intolerance) and spicy food. This is usually self limiting and carries no long term sequelae.
Celiac disease is a condition that is associated with the ingestion of Gluten. Individuals with celiac disease are intolerant of Gluten and will develop diarrhoea and abdominal bloatedness and pain together with nausea and vomiting. Unlike other dietary-related causes, celiac disease can result in long term complications like malabsorption and nutrition deficiency-related complications. Complete avoidance of Gluten is the only definitive preventive measure.
Bacterial overgrowth can occur in the small intestine. This can occur in the context of long term antibiotic usage and celiac disease among others.
With bacterial overgrowth, the digestion and absorption of nutrition is affected, leading to a watery and explosive diarrhoea that persists.
Irritable Bowel Syndrome is a non-cancerous condition affecting the gastrointestinal tract. It is often characterised by a change in bowel movement habits and abdominal bloatedness and pain.
The change in bowel habit can take the form of Diarrhoea (IBS-Diarrhoea) or Constipation (IBS-Constipation)
In the diarrhoea form of IBS, the individual can experience frequent bowel movements and watery stools. This often takes place in the presence of dietary or stress-related triggers.
The diarrhoeal related symptoms in IBS an often be mistaken for the more serious condition of Colorectal cancer
Diarrhoea can be a symptom of Colorectal cancer and can mistaken for other causes of diarrhoea.
In Colorectal cancer, diarrhoea arises due to a near-obstructing tumour that is preventing normal passage of stools. The stool stasis in turn results in the liquefaction of the stools leading to diarrhoea.
The diarrhoea associated with Colorectal cancer can often be misdiagnosed as IBS-Diarrhoea. It is important that all cases of diarrhoea be properly investigated before diagnosing as IBS
Inflammatory Bowel disease is a chronic inflammation of the gastrointestinal tract. There are two entities associated with IBD, namely Crohn's Disease and Ulcerative Colitis.
Individuals with undiagnosed IBD will present with symptoms of chronic diarrhoea that can be bloody in nature, weight loss, anemia and nutritional deficiency.
Any diarrhoea persisting beyond 2 weeks requires a specialist consult. This is particularly so in individuals who are in their 30s and older. It is important to exclude life-threatening conditions such as IBD and Colorectal cancer among others. A Colonoscopy will be required to exclude life-threatening conditions.
In individuals with acute onset diarrhoea, it is important that the individual can keep hydrated with adequate fluid intake. In the event that there is vomiting preventing fluid intake or if the episodes of diarrhoea are too frequent, then intravenous fluids and anti-vomiting medications will be required.
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