Acute and chronic diarrhea

Diarrhea, or diarrhea – increase in stool volume by increasing the water content to more than 300 g/day. However, understanding of this indicator varies.

Stool consists of 60-90% water. In Europeans, stool volume is 100–300 g/day in adults and 10 g/kg/day in infants, depending on the amount of food ingredients (mainly carbohydrates) that are not absorbed in the intestine.

Causes of diarrhea

• consuming stale or contaminated food or water
• allergic reaction to medications
• individual intolerance to any substance included in the product
• intestinal infections of viral, bacterial or parasitic etiology
• nervous tension, stress
• irritable bowel syndrome. This phenomenon is most often associated with emotional stress, poor quality nutrition, consumption of too fatty foods, large amounts of caffeine, overeating, and alcohol abuse.
• inflammation of the large and small intestine (enterocolitis), can be both acute and chronic
• insufficient absorption of substances in the small intestine (develops in diseases such as pancreatitis, hepatitis, gastritis, colitis, enteritis). The syndrome of impaired absorption of substances is associated with disturbances in the metabolism of proteins, fats, carbohydrates, minerals, vitamins, as well as water-salt balance.

Green diarrhea

Green diarrhea occurs when there is a problem with the gastrointestinal tract and may be a sign of poisoning of the body or infectious diseases. It should be noted that the phenomenon of green diarrhea may be a reaction of the body to the consumption of colored drinks containing artificial colors. Also, a green tint may appear in the stool when taking antibacterial drugs to treat an intestinal infection. During the digestion of foods, fermentation increases, during which substances are formed that give stool a green color. With a disease such as dysentery, stool may also acquire a green tint. Associated symptoms when stool turns green may include acute abdominal pain, fever, nausea, vomiting, and a general state of weakness. Liver pathologies can also cause green diarrhea – the breakdown of red blood cells leads to the formation of bilirubin in the liver, which, when it enters the intestines, gives the stool a green color. For diagnosis, a general stool analysis and bacterial culture of stool are performed. In infants, diarrhea with a green tint can be caused by food rejection. In this case, blood streaks, foam and mucus may appear in the stool. If you have any symptoms accompanying diarrhea in your baby, you should immediately consult a doctor.

Diarrhea with blood

Diarrhea with blood can occur with a disease such as hemorrhoids – the formation of nodes near the rectum associated with the expansion of hemorrhoidal veins. Blood in diarrhea can appear when the colon is damaged by pathogenic strains, anal fissures occur, or oncological pathologies of the rectum. Blood in bright red stool may be released when bulging of the intestinal wall occurs. Bloody diarrhea may occur due to stomach or intestinal bleeding. Polyps in the intestines can also cause bloody diarrhea. Concomitant symptoms of diarrhea with blood may be pain in the rectal area during or after bowel movement, the presence of mucus in the stool, vomiting, nausea, fever, and abdominal pain. To diagnose the disease, radiography and endoscopy are performed; in case of heavy bleeding, emergency medical care is required.

Black diarrhea

Black stool can be observed after taking activated charcoal and some vitamin-mineral complexes. The appearance of black diarrhea can be a consequence of internal bleeding – from the esophagus, stomach or intestines, which could be caused by various severe pathologies – ulcers, cancer, polyps or enlarged veins of the esophagus. Associated signs of internal bleeding may include impotence, pale complexion, dizziness, and anemia. If black diarrhea appears, you should immediately consult a doctor. For diagnosis, fibroesophagogastroduodenoscopy (examination of the esophagus, gastric cavity and duodenum using a gastroscope, which is inserted into the stomach through the mouth and esophagus) or colonoscopy (probing of the colon) may be prescribed.

Diarrhea and vomiting

Diarrhea and vomiting are the main symptoms of food poisoning. Acute food intoxication develops as a result of eating foods that contain microorganisms or toxic substances of non-microbial origin. In addition to microbial poisoning, intoxication with poisons is also distinguished. In most cases, after one or two hours after eating contaminated food, diarrhea and vomiting begin, headache, weakness, and dizziness may occur. To normalize the condition, first of all, it is necessary to enhance the removal from the body of harmful substances that have not yet been absorbed, and to neutralize the influence of those substances that have already been absorbed, to resume the normal functioning of the intestines, liver and cardiovascular system. In cases of food poisoning, gastric lavage is prescribed and sorbents are taken orally. The stomach is washed with a large amount of a two to five percent soda solution, taking three to four glasses of this solution orally. To bind and remove harmful substances from the body, they take activated carbon, smecta, enterosgel, and to prevent dehydration of the body and restore acid-base balance – rehydron. Adults should take Enterosgel in paste form one tablespoon three times a day, on average from seven to fourteen days. Rehydron is diluted in a liter of boiled water, cooled until warm and taken in small portions after each loose stool; the solution is shaken before use. Within one hour, drink approximately ten milliliters per kilogram of body weight. After the symptoms of intoxication have weakened, the dose of the drug is reduced to 5-10 ml/kg of body weight after each bowel movement.

Chronic diarrhea

Chronic diarrhea in most cases is caused by intestinal dysbiosis, in which the composition of the microflora is disrupted. Dysbacteriosis can manifest itself both in the form of mild ailments and more serious disorders. With dysbacteriosis, the intestinal walls become vulnerable to various allergens and toxins, and the protective functions of the liver are also reduced. The body absorbs vitamins and minerals worse, metabolic processes worsen, and liver and pancreas disorders occur. The following factors can provoke the development of chronic diarrhea:

• Diseases of the gastrointestinal tract.
• Frequent ARVI.
• Presence of allergic reactions.
• Age-related factors contributing to changes in the properties of microflora.
• Stress, emotional overstrain.
• Unbalanced diet.
• Infectious pathologies of the intestine.
• Long-term use of medications, in particular antibacterial ones.
• Long-term treatment with hormonal drugs and NSAIDs.
• Immunodeficiency states.

Associated symptoms of chronic diarrhea are lack of appetite, nausea, unpleasant taste in the mouth, belching, pain and bloating in the abdomen, weakness, and sleep disturbances. To diagnose the disease, a microbiological examination of stool is carried out, as well as a scatological examination to determine the state of the digestive system. Treatment of chronic diarrhea is aimed primarily at eliminating the causes that cause it.

Diarrhea with mucus

Diarrhea with mucus can be caused by a violation of the intestinal microflora, in which mucus helps eliminate pathogenic microorganisms. Mucus in the stool can appear with polyps or hemorrhoids. With this disease, mucus is a shell for feces and does not form a homogeneous mass with them. Additional symptoms for this pathology are itching in the posterior perineum and bloody discharge from the anus. Intestinal diverticulitis can also cause mucus to be released during bowel movements. The accompanying symptoms in this case are pain in the lower abdomen, localized mainly in the left part, bloating and excessive gas formation.

Diarrhea with mucus in children can appear as a result of insufficient bowel function. This is usually associated with an incorrect and unbalanced diet. This condition is usually accompanied by general malaise, nausea, and rumbling in the stomach. Liquid stool with mucus can also be released with irritable bowel syndrome. To differentiate the disease and prescribe treatment, it is necessary to consult a doctor and conduct a bacteriological examination of stool.

Diarrhea during pregnancy

Diarrhea during pregnancy, which occurs mainly in the early stages, may be associated with hormonal changes in a woman’s body due to pregnancy. To alleviate the condition in such cases, it is recommended to eat boiled rice, blueberries, and bananas. Dried viburnum fruits can also alleviate the condition. A glass of viburnum fruits should be poured with a liter of boiled hot water and cooked for another ten minutes, then strain and add two or three tablespoons of natural honey to the resulting broth. This medicine should be taken three times a day, 1/3 cup, in the absence of allergic reactions. If the cause of diarrhea during pregnancy is food poisoning, you need to drink plenty of fluids, you can take rehydron, lactosol, and complete fasting is recommended on the first day. After improvements occur, you can eat some crackers with tea without adding sugar. There is an opinion that diarrhea during pregnancy can be caused by taking vitamin-mineral complexes or drinking inappropriate water. To accurately determine the causes of diarrhea, it is necessary to consult a doctor. Diarrhea with foam

Foamy diarrhea may indicate infectious intestinal pathologies and be accompanied by general malaise, vomiting and temperature reaction. Diarrhea with foam can be the result of intestinal dysbiosis, the development of enterocolitis, or the presence of worms in the body. In infants, this disorder can occur when the intestines reject any food. In addition to foam, mucus or a green tint may appear in the stool. To alleviate the condition, it is necessary to balance the diet and exclude irritating foods from the diet. Consulting a doctor if foam appears in the stool is necessary.

Diarrhea, vomiting, fever

Diarrhea, vomiting, and fever are the main signs of an intestinal infection, the causative agents of which can be bacteria or viruses. An accurate diagnosis can only be made after examining stool, vomit, blood, and water released after gastric lavage. In the first few hours after the onset of alarming symptoms, it is necessary to drink large amounts of liquid, thereby inducing vomiting and helping to cleanse the stomach. To cleanse the large intestine, an enema is given with cooled, boiled water. Dark color of urine may indicate a lack of fluid in the body. Normalization of water-salt balance during intestinal infection is extremely important. For this purpose, you can use, for example, rehydron or ordinary decoctions of rose hips and raisins. The temperature of the liquid must be equal to the temperature of the body. In case of repeated spontaneous vomiting, you should drink often, but little by little, so as not to cause distension of the stomach. Refusal of food and drinking plenty of fluids during diarrhea, vomiting and fever are a necessary condition. If you experience diarrhea, vomiting and fever, call a doctor immediately. Drug treatment of intestinal infections is carried out in a hospital under the strict supervision of a doctor.

Severe diarrhea

Severe diarrhea can occur with small intestinal diarrhea. It can occur both due to food intoxication and intestinal infections. Often, such stools are watery, may contain food debris and occur without pain in the abdominal area. Bile acids and peptide molecules can enhance the release of water and ions. Severe diarrhea can occur when the absorption of bile and fatty acids is impaired, for example, with Crohn’s disease.

How is diarrhea recognized?

Water-electrolyte status and degree of dehydration should be assessed. A complete examination is necessary with examination of the abdomen and digital examination of the rectum for the integrity of the sphincter, obvious and hidden blood in the stool. Extra-abdominal findings that help establish the etiology include lesions or redness of the skin (labrocytosis), thyroid nodules (medullary thyroid carcinoma), right heart murmur (carcinoid), lymphadenopathy (lymphoma, AIDS), and arthritis (inflammatory bowel disease).

Instrumental research

Acute diarrhea (> 4 days) usually does not require investigations. Exceptions include patients with signs of dehydration, bloody stools, fever, severe pain, hypotension or intoxication, and especially young or very elderly individuals. These patients should have a complete blood count and determination of electrolytes, blood urea nitrogen, and creatinine. Stool samples should be collected for microscopy, culture, stool white blood cell testing, and, if antibiotics have been recently used, Clostridium difficile toxin testing.

Chronic diarrhea (< 4 недель) требует определения этиологии у пациентов с нарушением иммунитета или с признаками тяжелого заболевания, поскольку в других случаях проявляется более короткими (1-3 недели) приступами диареи. Начальное исследование стула должно включать посев, лейкоциты в стуле (выявляются с помощью мазка или определения лактоферрина в стуле), микроскопическое исследование на яйца и паразиты, определение рН (бактериальная ферментация неабсорбированных углеводов понижает показатель рН стула Giardia и Aeromonas, Plesiomonas, кокцидии и микроспоридии. Сигмоскопия или колоноскопия с биопсией выполняются с целью выявления воспалительной этиологии заболевания.

If the diagnosis is not confirmed and the Sudan stain is positive for fat, stool fat excretion should be determined, followed by radiocontrast studies of the small intestine and CT scan of the abdomen (structural abnormalities) and endoscopic biopsy of the small intestine (mucosal disease). If the assessment does not lead to a positive result, it is necessary to examine the structure and function of the pancreas.

The stool osmotic interval [290 – 2 x (Na in stool + K in stool)] indicates whether the diarrhea is secretory or osmotic. An osmotic gap of less than 50 mEq/L indicates secretory diarrhea; a longer interval suggests osmotic diarrhea. The cause of osmotic diarrhea may be the secret use of Mg-containing laxatives by patients (determining Mg levels in stool), which cause carbohydrate malabsorption (diagnosed by hydrogen breath test, lactose determination and nutrition survey).

Secretory diarrhea, the cause of which is unclear, requires further investigation [eg, plasma gastrin, calcitonin, VIP, histamine and urinary 5-hydroxyindole acetic acid (5HI-UA) levels] due to possible endocrine disruption. An analysis should be made of the symptoms and signs inherent in diseases of the thyroid gland and adrenal insufficiency. The secret abuse of laxatives must not be forgotten; this can be ruled out by examining stool for the presence of laxatives.

Diarrhea: folk remedies

When treating a disorder such as diarrhea, folk remedies can be quite effective. For this purpose, you can use, for example, rye bread crackers softened with warm water. The crackers are left in the water for fifteen to twenty minutes, after which the resulting mixture is taken orally throughout the day. Shelled walnuts can also be used as a remedy for diarrhea. One tablespoon of nuts is placed in half a liter of boiled hot water and filtered after twenty to twenty-five minutes, after which approximately 150 grams of decoction is taken once a day. Oak bark also has astringent properties and can help with diarrhea. One teaspoon of oak bark is diluted with one and a half glasses of water and boiled over low heat for ten minutes until a homogeneous liquid is obtained. The resulting decoction is taken three times a day, one tablespoon.

Diet with pride

The diet for diarrhea is designed to restore the normal metabolism of fats, proteins and carbohydrates and the condition of the intestinal mucosa. It is recommended to eat pureed rice and buckwheat cooked in water, steamed meat, and vegetable broths. The consumption of dairy products, spicy and fried foods, smoked meats, alcoholic beverages, juice, soda, and cabbage is prohibited. There is no doubt that proper nutrition is important in the treatment of diarrhea. An approximate diet for a condition such as diarrhea may be as follows:

• First breakfast – oatmeal cooked in water
• Second breakfast – infusion of dried blueberries
• Lunch – meat broth + semolina or steamed meatballs, rice porridge pureed in water + jelly
• Afternoon snack – infusion of rose hips without added sugar
• Dinner – steamed omelette + grated buckwheat and tea.