About Chronic Diarrhea

Overview

Chronic diarrhea occurs when a person passes loose, watery stools three or more times a day for at least 4 weeks. It can happen non-stop and come and go intermittently. This condition can affect children of any age. It is important to understand the difference between chronic diarrhea and acute diarrhea.

Acute diarrhea typically lasts only a few days and resolves on its own. Chronic diarrhea may be a symptom of an underlying chronic condition or a functional gastrointestinal disorder such as irritable bowel syndrome. It is crucial to diagnose chronic diarrhea in a timely manner. So, it can be effectively treated to prevent complications like malnutrition from occurring. Doctors may perform physical examinations, order blood tests, or even recommend endoscopy to determine the cause of chronic diarrhea so that they can develop an appropriate treatment plan.

Causes and Risk Factors

The common, underlying causes of chronic diarrhea can vary, but they can include:

• Inflammatory bowel disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic inflammation of the gastrointestinal tract, leading to chronic diarrhea.
• Irritable bowel syndrome (IBS): IBS can result in recurrent episodes of diarrhea, often accompanied by abdominal pain and discomfort.
• Celiac disease: People with celiac disease experience chronic diarrhea when they consume gluten-containing foods due to how their immune system reacts to gluten.
• Malabsorption syndromes: Conditions such as lactose intolerance and fructose intolerance can lead to chronic diarrhea due to difficulties in absorbing certain nutrients.
• Microscopic colitis: This inflammatory condition affects the colon and can cause chronic diarrhea.
• Abdominal surgery: Surgical procedures involving the appendix, small or large intestines, pancreas, liver, stomach, gallbladder, or spleen can result in chronic diarrhea.
• Prolonged use of antibiotics: Taking antibiotics for an extended period can disrupt the normal balance of gut bacteria and lead to chronic diarrhea.

Non-modifiable risk factors for chronic diarrhea include:

• Genetic predisposition: Certain genetic factors may increase the likelihood of developing conditions like IBD or celiac disease, which can cause chronic diarrhea.

Modifiable risk factors for chronic diarrhea include:

• Diet: Consuming foods that trigger symptoms in individuals with IBS or food intolerances can contribute to having chronic diarrhea.
• Medications: Long-term use of certain medications, such as antibiotics or pain relievers, may disrupt gut function and lead to a person having chronic diarrhea.

Remember that these risk factors can be changed in your favor. That’s why it is important to consult with a healthcare professional for an accurate diagnosis and personalized advice.

Symptoms

The most common early symptoms a person can experience with chronic diarrhea include:

• Loose or watery stools that persist for weeks
• Abdominal cramps
• Bloating
• Nausea

As chronic diarrhea progresses or becomes more severe, additional symptoms may occur:

• Urgency to have a bowel movement
• Frequent bowel movements (three or more times a day)
• Blood in the stool
• Fever
• Chills
• Loss of control of bowel movements
• Pain or cramping in the abdomen

Keep in mind that chronic diarrhea can be a symptom of serious bowel disorders such as:

• Inflammatory bowel diseases
• Irritable bowel syndrome
• Celiac disease
• Small intestinal bacterial overgrowth.

Those conditions can cause other concerning symptoms like weight loss, fatigue, skin and joint problems, and anemia. If you experience chronic diarrhea along with other symptoms, see a doctor a thorough evaluation and a personalized treatment plan.

Diagnosis

To diagnose chronic diarrhea, doctors commonly perform the following examinations, tests, and procedures:

• Clinical assessment: Doctors evaluate the symptoms and medical history of the patient to understand the underlying cause of chronic diarrhea.
• Physical examination: A thorough physical examination helps doctors identify any visible signs or abnormalities that may be contributing to chronic diarrhea.
• Blood tests: These tests can provide information about potential infections, inflammation, or nutritional deficiencies that may be causing chronic diarrhea.
• Stool tests: Doctors analyze stool samples to check for infections, parasites, or anything out of the ordinary that could be causing chronic diarrhea.
• Food allergy or sensitivity test: This test helps determine if an allergy or sensitivity to certain foods is triggering chronic diarrhea.
• Imaging tests: Radiological examinations like plain abdominal radiology, barium meal study, computed tomography (CT), or magnetic resonance enterography can reveal information about organic causes of chronic diarrhea.
• Gastrointestinal endoscopy: This procedure involves using a flexible tube with a camera to examine the gastrointestinal tract for neoplastic and inflammatory diseases.

To determine the stage or severity of chronic diarrhea, additional examinations and tests may be needed. They can include:

• Biopsy specimens: Obtaining biopsy samples during endoscopy can provide important information to confirm the diagnosis of serious conditions such as microscopic colitis, amyloidosis, eosinophils gastroenteritis, and celiac disease.
• Video capsule endoscopy: This procedure involves swallowing a small camera that captures images of the gastrointestinal tract and can be useful in diagnosing cases with chronic diarrhea.

Remember that the diagnostic yield of these examinations, tests, and procedures may vary depending on individual cases. Consult with your healthcare professional for personalized advice and guidance.

Treatment Options

The goals of treatment for chronic diarrhea are to relieve symptoms, resolve the underlying cause, and improve overall well-being of the individual. Here are some recommended treatment options and how they work to achieve these goals:

Medication types:

• Antidiarrheal medications: These provide short-term relief by reducing the frequency and urgency of bowel movements. However, long-term use of these medications is not recommended.
• Antibiotics: If the diarrhea is caused by a bacterial infection, antibiotics may be prescribed to eliminate the infection.

Therapies:

• Immunomodulators or corticosteroids: These medications may be used to treat underlying inflammatory bowel diseases (IBD) like ulcerative colitis or Crohn's disease by reducing inflammation and improving symptoms.
• Probiotics: These can help restore the balance of gut bacteria and improve stool consistency.

Therapeutic procedures:

• Surgery: In some cases, surgery may be necessary to remove damaged parts of the digestive tract or widen a narrow bowel.

Health behavior changes:

• Dietary modifications: Keeping a food journal can help identify trigger foods that worsen symptoms. Eliminating these foods from the diet, such as gluten or artificial sweeteners, may help effectively treat the diarrhea.
• Hydration: Drinking plenty of clear fluids throughout the day is important to prevent dehydration caused by chronic diarrhea.

Other treatments:

• Lifestyle changes: Avoiding caffeine and alcohol, eating low-fiber foods, and controlling food portions can help treat chronic diarrhea.
• Nutritional support: Special formulas or supplements may be recommended for infants experiencing weight loss or malnutrition due to chronic diarrhea.

Always consult with your doctor before starting any medication or making significant changes to your diet. Medication dosing may be affected by many factors. Check with your healthcare professional about dosing for your individual situation. Other side effects can occur. Check with your healthcare professional or read the information provided with your medication for additional side effect information.