Diarrhea is very unpleasant. The increased evacuation of thin to liquid stool causes discomfort and disrupts fluid and energy balance. Frequent watery diarrhea can weaken the body within hours. Possible causes include infections, hormonal imbalances, stress, and sometimes chronic and malignant diseases.
Read all you need to know about diarrhea!
Treatment: Replacement of fluid and salt loss, light diet, home remedies as needed, medications for cramps, pain or certain pathogens as needed, specific therapy for triggering diseases.
Causes: Infections (bacteria, viruses, fungi, parasites, toxins), medications, food intolerances or allergies, irritable bowel syndrome, chronic bowel disease, cancer, stress.
When should I see a doctor? Severe, persistent, or chronic diarrhea, diarrhea with abdominal cramps, circulation problems and/or blood in the stool, diarrhea in infants, young children, and the elderly.
Diagnosis: Medical history, clinical examination, blood tests, stool tests, imaging, special tests.
What to do?
In adults, acute diarrhea is usually harmless and does not initially require treatment. Home remedies are often enough to relieve the symptoms. However, good hygiene is important to protect others from infection with potential pathogens.
Hygiene is especially important
If possible, use your own toilet during diarrhea, or clean and disinfect it thoroughly after each use. This will reduce the risk of infecting others. Be sure to wash your hands thoroughly after using the toilet.
Medication for diarrhea: Use with caution
People who have constant or even daily diarrhea usually want something to stop it. Several diarrhea medicines are available at pharmacies. They can usually be used to quickly relieve diarrhea symptoms. However, the medications do not treat the cause of the diarrhea.
It is best to use diarrhea medicines cautiously and only for a short time. In acute diarrhea, the body tries to get rid of pathogens or toxins quickly. If this natural process is suppressed, the cause of the illness will remain in the intestines longer and there is a risk of additional damage.
Some diarrhea caused by bacterial infections requires treatment with antibiotics. If a patient simply takes a diarrhea medicine on his or her own, the diarrhea may go away at first. However, there is a risk of delaying needed treatment.
It is important to watch for symptoms of infection, such as blood or mucus in the stool or high fever.
Will antibiotics and other medicines work if I have diarrhea?
If you have severe diarrhea, oral medicines may not work as well as they should. Always tell your doctor or health care professional if you have diarrhea while taking any medicine by mouth.
Active ingredients used
In acute diarrhea, agents such as the widely used loperamide slow the increased movement of the intestinal wall. This helps keep food in the intestines longer. This gives the body time to absorb water and electrolytes from the stool.
Loperamide also inhibits the release of water and electrolytes into the intestine. This release is abnormally increased in diarrhea caused by pathogens or toxins.
Do not take loperamide for longer or in higher doses than recommended! Otherwise, there is a risk of severe constipation and, in extreme cases, intestinal obstruction.
Electrolytes help with traveler's diarrhea
If, despite all precautions, you get sick, drink plenty of fluids! Electrolyte solutions from the pharmacy are particularly suitable. If you don't have one on hand, you can make your own anti-diarrhea cocktail. Dissolve one teaspoon of salt and two tablespoons of sugar in one liter of orange juice. Black tea with salt, sugar, and the juice of two oranges will also replenish fluids and replace lost electrolytes.
There are other medications that may help treat diarrhea. For example, antispasmodics are sometimes useful for severe, colicky cramps. Pain relievers are also used. It is a good idea to talk to your doctor or pharmacist before taking any medication.
Chronic diarrhea requires treatment of the underlying disease by a doctor.
Home remedies for diarrhea
For adults with acute diarrhea, home remedies can often help relieve symptoms.
If acute diarrhea is not accompanied by nausea or vomiting, the first step is to replenish fluids and electrolytes. The best home remedy for diarrhea is then Dissolve half a teaspoon of salt and five teaspoons of sugar in half a liter of boiled water and drink.
In addition, various remedies are used to relieve the acute symptoms. These include the right foods for diarrhea and various teas. Other home remedies for diarrhea are heat treatments, which can be easily done at home.
Home remedies have their limitations. If the symptoms persist for a long time, do not improve, or even get worse, you should always consult a doctor.
Food for diarrhea
What to eat when you have diarrhea? When the stomach and intestines are upset, few people have an appetite or a strong sense of hunger. It is not medically proven that eating the right foods during diarrhea affects the duration of the illness. However, many doctors recommend a light, gentle diet during diarrhea or a gentle, restorative diet after diarrhea.
If you are hungry despite having diarrhea, the following foods may help. They bind free fluid in the bowel and help solidify the stool:
Potatoes: Potatoes are high in potassium and are easy to digest. They can be mashed with a fork to make puree. Chopped potatoes boiled in plenty of water are also good for diarrhea.
- Oatmeal: Oats contain fiber, minerals, and vitamins. Therefore, oatmeal can help prevent electrolyte loss during diarrhea. Oats are also easy to digest, especially when cooked in water to make oatmeal.
Rusk: This twice-baked yeast-raised baked good is low in fat and easy on the digestive tract. For diarrhea, choose the classic version without chocolate icing or coconut flakes.
Rice gruel: This is a classic for diarrhea. It strengthens the stool and soothes irritated intestinal lining. To make it, cook a cup of husked rice until soft, then mash it and dilute it with a little boiled water if necessary. Eat small portions of the rice gruel several times a day.
Yogurt: Probiotic foods (like plain yogurt) sometimes shorten diarrhea. The lactic acid bacteria they contain settle in the intestines and help displace diarrhea germs. It is best to eat plain yogurt.
Pectin for diarrhea
A time-honored remedy for diarrhea is foods that contain pectin. Pectin is a bulking agent that binds toxins from some diarrhea bacteria and fluid in the intestines. It swells and acts as a kind of "gelling agent.
These pectin-containing foods are recommended for diarrhea:
Grated apple: A grated apple is very digestible for diarrhea. Grating makes the apple pectin easily accessible to the body.
Carrot: A tried and true remedy for diarrhea is carrot soup. Peel 500 grams of carrots, cut into small pieces, and boil in a liter of water for about an hour until soft. Puree the soup, fill up to a liter with boiled water, and add a teaspoon of salt. Consume small portions several times a day.
Banana: Mashed or pureed bananas also contain pectin. They also provide magnesium and potassium. This makes bananas especially effective against diarrhea. During diarrhea, the body flushes these minerals out of the body. Eating a banana for diarrhea counteracts this.
Healing clay for diarrhea
Healing clay is a special, very fine sand (loess) of various minerals and trace elements. It is suitable for self-treatment of mild diarrhea. The healing clay powder absorbs fluids and binds toxins. Stir one to two teaspoons of healing clay into half a glass of water or tea.
Since the composition of products varies, check the package insert or ask a pharmacist for the exact preparation. Drink the mixture in small sips. The healing clay is more effective when taken dry, that is, mixed in the mouth only with saliva.
Unsuitable foods for diarrhea
People with diarrhea should avoid the following foods:
Spicy fried foods
Strongly seasoned or spicy foods
Sauerkraut and sauerkraut juice are also unfavorable - they have a mild laxative effect. Although the herb has intestinal cleansing properties, it is not recommended to eat sauerkraut if you have diarrhea.
Sweets such as jelly beans or chocolate are also not good for diarrhea. The sugar they contain puts additional stress on the damaged intestinal lining.
What to drink if you have diarrhea?
Drinking plenty of fluids is the best remedy for diarrhea. The best drinks are non-carbonated, such as still water or herbal teas. If you have diarrhea, it is important to replace lost electrolytes. Certain powders from the pharmacy that can be dissolved and drunk are suitable for this purpose.
Which tea for diarrhea?
Blackberry leaf tea: Pour about 150 milliliters of boiling water over two heaping teaspoons of dried, chopped blackberry leaves (1 teaspoon = about 0.6 g). Allow the tea to steep, covered, for ten minutes, then strain. Drink a cup several times a day between meals.
Chamomile Tea: Pour 150 milliliters of boiling water over one heaping tablespoon of dried chamomile flowers. Cover and allow to steep for ten minutes, then strain. Drink three to four sips between meals.
Oak bark tea: For one cup, brew half a teaspoon of dried oak bark (about 1 gram) with one cup of cold water. Cover and allow to steep for five minutes, then strain. Drink one cup three times a day, preferably half an hour before a meal.
Vervain tea: Pour one cup of boiling water over one teaspoon (about 1.5 g) of dried vervain. Cover and allow to steep for five to ten minutes, then strain. Drink one cup up to three times daily.
Fennel tea: Crush one teaspoon of fennel with a spoon or in a mortar and add 150 milliliters of hot water. Steep covered for ten to 15 minutes, then strain. Drink one cup two to three times daily. For infants and toddlers, use a little fennel tea to dilute milk or pap.
Blueberry tea: Add two teaspoons of dried and crushed berries to 150 milliliters of boiling water, cover and steep for ten minutes, then strain. Drink up to six cups a day. It is also possible to chew the dried berries; fresh, on the other hand, sometimes cause diarrhea!
Ginger tea: Among other things, ginger is an intestinal cleanser and expectorant. Peel and grate a thumb-sized piece of fresh ginger. Pour a quart of boiling water over it and let it steep, covered, for ten minutes. Then strain. Sweeten to taste with 1-2 tablespoons of sugar or honey.
Blackcurrant leaf tea: For one cup, pour about 150 milliliters of boiling water over two to four grams (2 to 4 teaspoons) of dried leaves. Let the tea steep, covered, for ten minutes, then strain. Drink one cup several times a day, but no more than 6-12 grams of leaves per day.
Peppermint tea: Pour about 150 milliliters of hot water over one and a half to three grams of peppermint leaves (1-2 tablespoons). Let the tea steep covered for ten minutes, then strain. Drink a freshly brewed cup of tea several times a day. The recommended daily dose is 3-6 grams of leaves.
Sage tea: Pour 150 milliliters of boiling water over two grams of finely chopped sage leaves. Cover and steep for five minutes, then strain. Drink warm, preferably half an hour before meals.
Black tea: Also often recommended for diarrhea. The tannins it contains have astringent, anti-secretory, anti-irritant, and anti-inflammatory effects, among others.
The above dosages are for adults.
Unsuitable drinks for diarrhea
Milk is generally not recommended for diarrhea. If you have diarrhea after getting up in the morning (and preferably throughout the day), you should also avoid coffee - it further irritates the lining of the digestive tract. Other unfavorable drinks are
Salt sticks and cola for diarrhea?
Because of its high sugar and low salt content, cola is not a good choice for treating severe diarrhea. Pretzel sticks are easy to digest, but they do not contain potassium - a very important salt for the body. Potassium is lost in large amounts during diarrhea.
Heat for diarrhea discomfort
Sometimes diarrhea is accompanied by abdominal cramps. Heat has a relaxing effect, relieves pain and improves circulation. In some cases, heat can help relieve abdominal pain associated with diarrhea. Try these warming home remedies:
Potato wrap: Boil 500 grams of potatoes until tender. Place on a cloth, mash with a fork and wrap in the cloth. At an appropriate temperature, apply this compress to the skin. Cover with an outer cloth and leave on for 30 to 60 minutes. Then rest.
Warm a cereal pillow (such as a cherry pit pillow): A cereal pillow gives off heat for a long time. Heat the pillow on the stove or in the microwave according to the manufacturer's instructions and place it on the affected area. Leave on as long as the heat is comfortable.
Hot water bottle: Fill a hot water bottle with hot water and apply to the affected area. If the bottle is too warm, place a tea towel between the skin and the hot water bottle. Use the bottle for as long as is comfortable.
Repeat if necessary.
Diarrhea Treatment for Infants & Toddlers
There are some special tips for feeding diarrhea in babies and toddlers:
For the first six hours, replace fluid and salt loss with an electrolyte-glucose mixture. A ready-made mixture from the pharmacy is best for this purpose. It contains the most important substances in the right proportions.
For the rest of the diet, the usual milk food is useful. However, it is advisable to enrich it with binding foods such as carrots, grated apple, banana, rice or potatoes.
Mothers who are breast-feeding can continue to do so. After consultation with a doctor, a special diarrhea food can be given for the first six hours, such as a rice gruel electrolyte solution or tea. During the first few hours of diarrhea, it is recommended to dilute formula with water or tea.
A low-fat diet is recommended for babies with diarrhea. Carbohydrates, especially long-chain carbohydrates such as those found in rice, potatoes, and some fruits, can help meet caloric needs.
Adequate fluid intake is especially important for infants and young children. Teas such as chamomile, peppermint, and fennel or plain water are good choices.
Homemade juice-water mixtures with sugar and salt are not recommended for children under five. They should be given special electrolyte solutions from the pharmacy, which have optimal levels of important substances.
Sometimes burning diarrhea occurs: Ointments are usually helpful for the burning sensation on the buttocks.
If diarrhea affects infants or young children, a visit to the doctor is always recommended.
If a doctor is not available, self-treatment with an antibiotic from your first-aid kit is sometimes possible. It is best to check with your health care provider before traveling about the appropriateness of the diarrhea product. Follow dosage instructions and recommendations for duration of treatment.
Keep in mind that antibiotics are only effective against bacteria. They are not effective against viruses and most parasites.
See your doctor as soon as possible to determine the exact cause of your diarrhea!
Preventing traveler's diarrhea
Before traveling abroad, take some precautions to prevent diarrhea:
Food hygiene: Wash, peel, or cook fruits and vegetables before eating. Cook meat thoroughly (boil, broil).
Hand hygiene: Wash hands thoroughly before each meal.
Disinfect drinking water: Boil or disinfect drinking water before use.
Vaccination: If certain diarrheal diseases, such as typhoid or cholera, are common in the area where you will be traveling, get vaccinated against them well before your trip. Vaccination against general diarrheal diseases is not possible due to the diversity of the pathogens.
If you follow these tips, you have a good chance of traveling without diarrhea, even in countries with lower standards of hygiene.
Diarrhea: Types, causes and diseases
What are the different types of diarrhea?
Even if it feels different: Diarrhea is not a disease, but a symptom-a sign that something is wrong in your body. But what exactly is diarrhea? Doctors use the term "diarrhea" to describe
Bowel movements that occur more than three times a day,
A change in stool consistency from mushy to liquid,
An increased amount of stool over 200 grams per day.
It is sometimes mushy, watery, or even foamy. Sometimes the color of the diarrhea is also significant: it varies from green to yellow, rarely orange diarrhea. Black diarrhea sometimes indicates bleeding in the upper digestive tract. Red diarrhea may occur when bleeding has occurred in the lower intestinal tract. White diarrhea, or discolored stools, occurs when bile pigment is absent.
Not all diarrhea is the same
How does diarrhea develop? There are different mechanisms by which diarrhea develops. Doctors distinguish between five mechanisms by which stool becomes liquid.
When the body does not absorb certain food components, medications, or other physically active substances, fluid flows in the opposite direction through the intestinal lining into the bowel. There it liquefies the contents, and the diarrhea is thin to watery. Doctors call this osmotic diarrhea.
The mechanism of fluid entry into the bowel is also used by certain laxatives.
In secretory diarrhea, the intestinal mucosa actively releases water into the bowel. This is most common in chronic inflammatory bowel disease. It also occurs with food poisoning, toxins from some bacteria, and some laxatives. The diarrhea is often watery.
Some bacteria and parasites cause severe inflammation of the intestinal lining. Mucus and sometimes blood are passed in the stool. Exudative diarrhea sometimes occurs in chronic inflammatory bowel disease and cancer.
In hypermotile diarrhea, the movements of the intestinal muscles (peristalsis) are greatly increased. The intestines do not extract enough fluid from the stool because of the shorter retention time. The stool is often thin or mushy.
A special type of diarrhea called steatorrhea occurs when the small intestine does not release enough bile acids into the stool. Bile acids help break down fats so that they can be absorbed by the intestinal lining. When they are missing, the consistency of the stool is often mushy.
What are some possible causes of diarrhea?
Diarrhea that disappears within two weeks is called acute diarrhea. Chronic diarrhea, on the other hand, develops over months. It often indicates more serious causes or conditions. Diarrhea occurs in both men and women; gender does not affect diarrhea. How long the diarrhea lasts depends largely on the cause.
The main causes of acute diarrhea are
Acute gastrointestinal infections caused by bacteria or viruses: E. coli (coliform bacteria), Salmonella, Campylobacter, Shigella, Staphylococcus and Streptococcus (food poisoning bacteria), typhoid and cholera bacteria, Listeria, Clostridium botulinum, Norovirus, Rotavirus. An indication of infection is that the diarrhea "stinks" or has a foul odor.
Parasitic infections: Amoebas, Lamblia
Poisoning from fungi or chemicals
Medications: Some medicines increase the flow of water into the intestines (e.g., laxatives) and cause diarrhea. Other medications upset the balance of the intestinal flora, such as antibiotics. Individual germs (such as Clostridium difficile) then multiply rapidly and cause diarrhea.
Food allergies or intolerances such as cow's milk allergy, histamine intolerance, lactose intolerance, or gluten intolerance (e.g., celiac disease). Diarrhea after eating is an indication that the person is hypersensitive to certain foods. If these are not avoided, (chronic) diarrhea will recur.
Acute psychological stress (excitement, anxiety, etc.)
Radiation: When cancer patients receive radiation therapy to the abdomen or pelvis, the lining of the intestines is sometimes damaged enough to cause diarrhea.
Exercise: Diarrhea sometimes occurs after exercise, especially after running a marathon or other strenuous activity. Reduced blood flow to the intestines may play a role. Doctors call this phenomenon "runner's diarrhea.
Reduced blood flow to the intestines may also play a role in heat-induced diarrhea.
If diarrhea occurs at night, smoking, drinking alcohol, or eating heavy foods in the evening may play a role.
If diarrhea is caused by bacteria, viruses, or parasites, it is usually contagious.
Chronic diarrhea lasts more than two weeks. Common causes are
Irritable bowel syndrome: Due to irritants or emotional stress, many people have frequent bowel movements and sometimes crampy diarrhea. Irritable bowel syndrome is not dangerous, but it can be very disruptive to daily life.
Chronic inflammation of the stomach lining: Chronic inflammation of the stomach lining (chronic gastritis) means that certain food components are not properly utilized. Sometimes there is also an excess of gastric acid, which irritates the intestines.
Hormonal disorders such as Addison's disease (destruction of the adrenal cortex with cortisol deficiency), hyperthyroidism, or gastrinoma (hormone-producing tumor of the small intestine or pancreas).
Inflammation of intestinal diverticula (diverticulitis): This may cause watery diarrhea or stools with mucus and blood.
Chronic inflammatory bowel disease: Ulcerative colitis (chronic inflammation of the colon), Crohn's disease (chronic inflammation may occur throughout the digestive tract).
Chronic intestinal infections caused by viruses, bacteria, or parasites.
Malassimilation: Food components are not adequately broken down (maldigestion) or are inadequately absorbed (malabsorption). This may occur after stomach surgery or with diseases of the pancreas or gallbladder. Symptoms of malabsorption syndrome include diarrhea.
Tumor diseases: Some cancers are also associated with diarrhea. For example, colon cancer is often associated with alternating diarrhea and constipation. In addition, blood is often found in the stool.
When to see a doctor?
A single episode of diarrhea or diarrhea that lasts only a few days is usually harmless in healthy adults. The body usually does a good job of compensating for fluid loss and rebalancing salt levels within a few days of recovery, but diarrhea is sometimes accompanied by sweating and dizziness, which may indicate circulatory problems. Even then, it is advisable to see a doctor.
If diarrhea - sometimes accompanied by cramping abdominal pain or circulatory problems - occurs in connection with meals, medical advice is needed. It is possible that certain food components cannot be tolerated.
Extreme diarrhea and chronic diarrhea are reasons to see a doctor, as they may indicate a more serious condition. The same goes for bloody or purulent diarrhea.
Infants and toddlers at risk
Infants and young children are more susceptible to diarrhea than older children and adults. They lose a disproportionate amount of fluid and salt for their body weight, especially if the diarrhea is accompanied by vomiting. Their bodies are not yet good at compensating for these losses.
Early signs of critical fluid loss from diarrhea are weight loss (use a baby scale!) and a drop in the fontanelles. These are the soft spots on the baby's head where the bones of the skull are not yet fused together.
Infants and toddlers with diarrhea should always see a doctor.
Diarrhea in the elderly
In older people, the heart is less efficient and the blood vessels are less elastic than in younger people. As a result, the cardiovascular system has less reserve capacity than in young people. In addition, the water content of the body decreases somewhat with age.
At the same time, the sense of thirst is often reduced in the elderly. These are the reasons why diarrhea in the elderly becomes dangerous in a relatively short time.
Severe watery diarrhea lasting several days or chronic diarrhea is always a reason for older people to see a doctor. This is especially true if there are already signs of severe dehydration, such as dry skin with increased wrinkling ("standing wrinkles") or confusion.
Diarrhea is especially unpleasant when it hits you on a (long-distance) trip. This is not uncommon: an altered biorhythm, unfamiliar foods, and sometimes pathogens to which the immune system does not respond make travel diarrhea a common phenomenon.
If symptoms do not improve after three days, or if the illness is unusually severe with fever, blood in the stool, and/or circulatory problems, seek medical attention while still at your destination.
When not to delay medical attention
If you have sudden, severe, or cramping diarrhea with circulation problems that do not improve with fluids, seek immediate medical attention. This emergency often occurs when diarrhea is accompanied by vomiting.
If you suspect a highly contagious intestinal infection (e.g., EHEC or Salmonella), you should also seek medical attention or go to a hospital outpatient clinic. If you have diarrhea and notice blood in the stool, it is important to see a doctor.
It is also important to see a doctor if diarrhea occurs after living in a subtropical or tropical country where diseases such as typhoid or cholera are present.
What does the doctor do?
A detailed history and physical examination are usually enough for a doctor to diagnose the cause of diarrhea. The knowledge that infectious gastrointestinal diseases often occur in temporal and regional clusters also helps in the diagnosis.
In addition, the doctor will perform special tests as needed:
Blood tests: Depending on the suspicion, the patient's blood may be tested for pathogens, antibodies, signs of inflammation, hormonal imbalances, or tumor markers.
Stool tests: A stool sample is analyzed for pathogens, such as viruses or bacteria, that may be causing the diarrhea.
Abdominal ultrasound and x-rays with contrast, if needed
Allergy testing (such as skin testing or challenge testing) if food allergy is suspected (often in people who already have hay fever or asthma)
Lactose tolerance test for suspected lactose intolerance
Small bowel endoscopy (enteroscopy) to confirm suspected gluten intolerance (celiac disease or gluten sensitivity) or to examine the bile ducts and pancreatic ducts (ERCP)
Removing tissue samples (biopsies) from the small intestine, pancreas, colon, or lymph nodes to look for inflammatory changes in the intestinal wall or tumors that may be causing the diarrhea.
These tests will help determine the cause of your symptoms: