Most of us have experienced the pain and distress caused by diarrhoea. That overwhelming desperation to get to a toilet accompanied by the horrendous dread of not being able to make it in time. If that wasnt bad enough there’s also the painful stomach cramps to contend with.
Even though it is a common problem, it’s not one that many people are comfortable discussing. However, it is important to know what bowel movements are considered normal and when you should see your doctor, as repeat or prolonged episodes of diarrhoea could be masking a more serious problem.
People’s bowel movements vary a great deal while going three times a day is perfectly normal for some, others may average just three times a week. The important thing isn’t how often you’re going but that your stools are solid yet easy to pass when you do.
In the case of diarrhoea bowel movements become more frequent than usual and are either loose or liquid. They may also be accompanied by painful stomach cramps, dizziness, nausea and/or vomiting. An episode can either last for a short period, in which case it is labelled acute, or if it goes on for two or more weeks it is defined as chronic.
So when should you consult your doctor?
You should see your doctor after a few days if acute diarrhea is severe and doesn’t settle, especially if youre dehydrated (symptoms of dehydration include excreting small amounts of dark urine, drowsiness and excessive thirst). The elderly and very young (under two years) are particularly at risk of dehydration resulting from diarrhoea and should see their doctor at the earliest opportunity.
You should also seek immediate medical help if your stools contain blood and/or you are losing weight. These symptoms, in addition to prolonged or repeated bouts of diarrhoea, can in some cases signal an underlying condition like ulcerative colitis or bowel cancer (for more examples please see the box below) which obviously needs specific treatment.
In cases where an underlying condition isn’t present, doctors routinely recommend drugs like Diocalm, Imodium and Lomotil for diarrhoea. However, they can cause nausea, constipation and bloating and their long-term use can be dangerous, since they can delay the expulsion of toxic substances from your bowel.
Common culprits that can trigger an attack of diarrhoea
- Viral or bacterial infection (tummy bugs or food poisoning) usually a result of consuming contaminated or undercooked food or drink. It can also be caused by bacteria or viruses that have been transmitted from person to person. For this reason, its important to wash your hands with soap and water after using the toilet and before handling food.
- Side effect of certain medications particularly antibiotics and drugs for diabetes. For example, antibiotics destroy friendly intestinal bacteria that help protect your gut from pathogenic organisms that can cause diarrhoea
- Repeat attacks of diarrhoea over a long period of time are often the result of irritable bowel syndrome, which can result from a number of factors including stress, caffeine and food sensitivities.
- Food intolerance or allergy wheat and lactose (milk sugar) are common culprits.
- Anxiety and stress
- Inflammation of the bowel resulting from conditions like ulcerative colitis (stools often contain blood) or Crohns disease.
- Poor absorption of food caused by conditions like coeliac disease. Hormonal changes such as diabetes or an overactive thyroid gland.
- Some bowel cancers and chronic bowel infections.
How to successfully overcome acute cases of diarrhoea without drugs
In cases of acute diarrhoea you should drink more fluids (3-4 litres a day). In order to avoid dehydration, take ready-mixed rehydration sachets (such as Dioralyte and Rehydrat), which can be easily obtained over-the-counter from most chemists.
A cheaper and equally as effective alternative to these rehydration preparations is to boil some rice in plenty of water, and then drink the water containing the juices of the rice. In addition, rice water contains maltodextrins and L-histidine, which act on the inside lining of the bowel and reduce the inflammatory processes that cause diarrhoea.
Another effective natural remedy for diarrhoea is camomile. In a double-blind, placebo-controlled study, scientists from the Medical Office for Paediatrics and Allergology, in Bonn, Germany, gave camomile extracts to 255 patients suffering from acute diarrhoea.
They found that the extracts were remarkable in their ability to reduce the frequency of stools, relieve associated symptoms and shorten the duration of the diarrhoea Becker B, Kuhn U, Hardewig-Budny B. Arzneimittelforschung. 2006;56(6):387-93). Camomile can be taken in tea form and drunk once or twice a day.
Herbs rich in dietary fibre, such as slippery elm and ispaghula (psyllium), have also been found to be effective in the treatment of diarrhoea, as they absorb any excess fluid in the bowel and help give consistency to stools (Chang HY, Kelly EC, Lembo AJ. Curr Treat Options Gastroenterol. 2006 Jul;9(4):314-23).
Take an alternative approach to end the misery of chronic diarrhoea
Studies have revealed that alternative treatments like hypnotherapy, acupuncture and massage can help benefit cases of chronic diarrhoea (Longstreth GF, et al. Gastroenterology. 2006 Apri130(5):1480-91).
In the case of hypnotherapy, researchers from the Department of Primary Care and General Practice, University of Birmingham, observed the effects of this form of treatment on patients suffering from diarrhoea caused by irritable bowel syndrome.
According to the researchers, three months into the treatment, the patients experienced significantly greater improvements in pain, diarrhoea and overall symptoms. The patients were less likely to require medication, and the majority described an improvement in their condition (Roberts L, Wilson S, Singh S, Roalfe A, Greenfield S. Br J Gen Pract. 2006 Feb;56(523):115-21).
In a recently published scientific paper on the use of acupuncture to combat diarrhoea and other bowel problems, American scientists from the Department of Surgery, Duke University Medical Center in Durham reported: Acupuncture has been used to treat bowel symptoms in China for thousands of years. The inhibitory effects of acupuncture on bowel motility may be beneficial to patients with diarrhoea because increased bowel motility is reported in such patients. In the future, it is expected that acupuncture will be used in the treatment of patients with functional gastric disorders [such as diarrhoea and indigestion] (Takahashi T.J Gastroenterol. 2006 May;41(5):408-17).
In another study, Chinese scientists from the Affiliated Hospital of Liaoning College of TCM, Shenyang, found that massage used alongside acupuncture significantly improved cases of chronic diarrhoea (Wang XF, Teng X.: Zhongguo Zhen Jiu. 2005;25(2):92-4).