- Acute—Occurring suddenly and lasting briefly
- Recurring—Coming and going
- Food intolerance, such as lactose intolerance
- Magnesium-containing antacids
- High blood pressure medications
- Irritable bowel syndrome, which is episodes of diarrhea often alternate with periods of constipation
- Injury to the bowel after radiation treatments for cancer
- Malabsorption syndromes, such as:
- Diseases of the pancreas and/or gallbladder
- Inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease
- Chronic diseases, such as:
- Intestinal surgery
Infections, including food poisoning, such as:
- Bacterial: Campylobacter, Clostridium difficile, Salmonella, Shigella, and Escherichia coli
- Viral: rotavirus, Norwalk virus, cytomegalovirus, herpes simplex virus, and viral hepatitis
- Parasitic: Giardia lamblia, Entamoeba histolytica, Cryptosporidium, tapeworm, roundworm, flukes
- Fungal: Candida—yeast
- Traveling to a developing country where the water and food supply may be contaminated
- Having a severely weakened immune system, such as with AIDS or after an organ transplant
- Taking certain medicines
- Frequent, loose, liquid stools
- Abdominal pain, cramping
- Urgent need to defecate
- Blood and/or mucus in stool
- Nausea, vomiting
- Muscle aches and pains
- Weight loss
When Should I Call My Doctor?
- Have diarrhea that lasts longer than three days
- Are not able to eat or drink to stay hydrated
- Have a fever
- Has diarrhea lasting longer than a day
- Has pus in stool
- Is dehydrated—no wet diapers in three hours, dry mouth, crying without tears, skin that stays up after being pinched
- Is sleepy or irritable
- Has a fever
When Should I Call for Medical Help Immediately?
- Severe abdominal pain and cramping
- Bloody or black stool
- Does anyone else in your family have diarrhea?
- What kinds of food have you eaten recently?
- Do you drink well water?
- Do your children attend daycare?
- Have you traveled recently?
- Do you use laxatives?
- What medicines do you take?
- Do you have any symptoms other than diarrhea, such as fever, rash, or aching joints?
- What is your sexual history?
- Have you ever had abdominal surgery?
- Your bodily fluids, tissues, and waste products may be tested. This can be done with:
- Laboratory analysis of a stool sample
- Blood tests
- You may need to have your rectum and colon examined. This can be done with:
- You may need to have images taken of your colon. This can be done with:
- You may need to have fasting or food elimination tests.
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Drink Lots of Fluids
Ask Your Doctor What You Should Eat
- Drink only clear fluids during severe phases of diarrhea.
- Avoid certain foods, such as: very spicy foods, fatty foods, greasy foods, high-fiber foods, dairy products in large amounts, and caffeinated drinks.
- Eat certain foods, such as: complex carbohydrates like pasta and rice, yogurt, fruits and vegetables, and lean meats
Treat Abdominal Pain With Heat
- Antidiarrheal medicine
- Antibiotics—May be needed if a bacterial infection is causing diarrhea
- Probiotics, such as Lactobacillus casei, Enterococcus faecium, and Saccharomyces boulardii—May be beneficial in some cases
- Zinc supplementation—May be advised in some cases
- Practice good handwashing.
- Practice safe food preparation and food storage.
- If you have diarrhea, do not prepare food for others.
If you are traveling:
- Drink bottled water.
- Use bottled water when brushing your teeth.
- Avoid drinks that contain ice.
- Do not eat food purchased from street vendors.
- Do not eat raw vegetables or fruits. All produce should be peeled and/or cooked.
- Make sure meats are cooked thoroughly.
- Eat only pasteurized dairy products.
- If you eat seafood, make sure it is very hot.
American Academy of Family Physicians http://familydoctor.org
National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/
The College of Family Physicians of Canada http://www.cfpc.ca
Health Canada http://www.hc-sc.gc.ca
Celiac disease. American Gastroenterological Association website. Available at: http://www.gastro.org/practice/resource-library/hot-topics/celiac-disease. Accessed March 4, 2013.
Diarrhea. Family Doctor.org website. Available at: http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/diarrhea.html/. Accessed March 4, 2013.
Diarrhea. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/diarrhea/index.htm. Updated September 24, 2012. Accessed March 4, 2013.
King CK, Glass R, Bresee JS, Duggan C. Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR. 2003 Nov 21;52(RR16):1-16
Kleigman RM, Jensen HB, Behrman RE, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.
Robinson DL, McKenzie C. Primary Care Medicine. 4th ed. Philadelphia, PA: Lippincott, Williams, and Wilkins;2000.
Rotavirus vaccine. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccinesafety/Vaccines/RotaVSB.html. Updated November 9, 2012. Accessed March 4, 2013.
1/4/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Allen S, Martinez E, Gregorio G, Dans L. Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev. 2010;(12):CD003048.
- Reviewer: Daus Mahnke, MD
- Review Date: 09/2012 -
- Update Date: 03/04/2013 -