Diarrhoea

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Diarrhoea is a term describing the regular passing of particularly watery faeces. It is one of the most common symptoms of a digestive problem. 

Diarrhoea overview

Diarrhoea is caused by one of two possible reasons:

1. Too much fluid has been secreted into the bowel
2. Fluid cannot be sufficiently absorbed back out of the bowl 

According to the World Health Organisation, diarrhoea causes 4% of all deaths worldwide, usually due to resulting dehydration.

Death from diarrhoea usually occurs in less economically developed countries like Africa, where droughts are more common and access to clean water is limited.

In the UK, diarrhoea is very common and usually not a cause for concern. Diarrhoea is usually a symptom of a bowel infection called gastroenteritis, which can be caused by an infection, virus or parasite. Diarrhoea can also be indicative of a range of more serious conditions.

It is therefore advisable to visit a GP if diarrhea occurs for longer than a week.

Identifying the cause of diarrhoea

GP’s assessment

If you are suffering from diarrhoea and wish to visit your GP, it may be useful to prepare for the following questions:

• What does your faeces look like? E.g. very watery/bloody? 

• How often do you experience diarrhoea?

• Have you had physical contact with anyone else who has diarrhoea?

• Do you have any other symptoms such as a fever?

• Have you dined out recently? (In order to determine if diarrhoea is caused by food poisoning)

• Have you been abroad recently? (In order to determine if diarrhea is caused by bug picked up while travelling)

• Have you recently been feeling stressed out or anxious?

• How much alcohol do you tend to drink?

• Are you taking any medication?

• Have you recently changed medication?

A stool sample

You may also be required to provide a stool sample in the event of the following:

• if the diarrhoea has lasted longer than a week 
• if you’ve noticed blood or pus in your faeces
• if you have a record of weakened immune system (from conditions such as HIV)
• if you have recently been abroad
• if you have notice companying symptoms affecting other parts of your body (such as dehydration or fever)
• if you have recently been in hospital or taken antibiotics.

A blood sample

You may also be required to providea blood sample to test for underlying conditions like inflammatory bowel disease. This includes the more serious conditions Crohn’s disease and ulcerative colitis.

Rectal examination

You may be required to undergo a rectal examination, otherwise known as a ‘digital examination’. This is when the GP inserts their finger into the anus in order to diagnose possible problems with the rectum or bowels. This kind of test will be instigated in the event of the following:

• If diarrhoea is persistent
• If you are over 50.

Hospital referral

The GP may refer you to hospital for 2 possible treatments:

• A sigmoidoscopy- this is a process whereby a hose-like camera (called a sigmoidoscopy) is inserted through the rectum and into the bowel.

• A colonoscopy- this is very similar to a simoidoscopy except that the tube is longer in order to reach deeper into the bowel.

Living with diarrhoea 

Living with diarrhoea can be upsetting, frustrating and embarrassing. Severe diarrhoea can occur at any time, whether at home, in bed or out in public. It can make a person feel helpless and out of control. Luckily there are certain measures a sufferer can take to help control or prevent diarrhoea:

Diet

The food you choose to eat can help improve the health of your digestive system. Although a diet high in fibre is usually recommended for lowering cholesterol and improving general health, it can, in some cases, make diarrhoea far worse.

Foods to avoid:
If you have diarrhoea, avoiding certain foods may be able to help reduce symptoms. It is advisable to discuss your condition with a GP before making any changes to your diet.

• wholegrain breads
• vegetables including broccoli, cabbage, cauliflower and beans
• high fibre cereals (like bran flakes)
• nuts
• dried and fresh fruit
• caffein (tea, coffee)
• greasy, fatty or fried foods (full breakfast, take-away etc)
• pickled or spicy food (these can are thought to irritate the digestive tract and may induce diarrhoea).

Foods to include:

• potatoes (without the skin)
• dry crackers
• white bread
• chicken/beef/fish
• baked foods
• rice and pasta.

One useful tip that may help control diarrhoea is to eat several small meals a day instead of three large ones.

Another useful tip is to drink plenty of fluid (while avoiding caffeine). A selection of drinks could include: 

• herbal or fruit teas
• green tea
• clear soups
• water
• non-fizzy drinks
• soy milk.

Being prepared in public

Although people suffering with diarrhoea would probably prefer to be near a toilet at all times, this is not always possible- life has to go on.

Accidents do happen, however, and this can be very upsetting even if nobody else has noticed.

Sufferers can feel uncomfortable, distracted and paranoid that somebody will see or smell it.

Although the diarrhoea itself may be uncontrollable, other factors can be controlled.

• Pack a discrete ‘emergency pouch’. In here you can keep spare underwear, a plastic bag, soothing cream and pads.

• Wear a pad, as this will prevent soiling or staining and just knowing it’s there can relieve anxiety.

• If you have a colostomy bag, always bring a spare. There are also effective smell-masking products available on the market so you won’t have to worry about odours.

• Take a moment to find where the nearest toilet is so you can get there quickly if you need to.

• Try to avoid long journeys in the car or on trains if you can. 

Being prepared at home 

Having an accident at home can be just as horrible as having one in public. There are a number of measures you can take to deal with an accident as quickly and efficiently as possible:

• Place a protective sheet or towel over the bed if you are worried about having an accident during the night.

• Leave night-lights on by your bed or in the hallway to guide a path from the bedroom to bathroom. This will prevent tripping or falling in the dark.

• If you have difficulty walking then place a commode by the bed.

Take rest

Diarrhoea can be exhausting because patients can become dehydrated from the loss of fluid. The stress and anxiety of having the condition itself can also be very tiring.
Ask a family member or friend to help you with housework, cooking or taking children to school. It is very important that you rest until diarrhoea has stopped.

Look after the skin around the anus

The skin surrounding the back passage can become very sore during diarrhoea due to the heat, volume and intensity of passing waste. Here are some simple tips:

• Don’t rub the area when drying after a shower or bath - gently pat with a soft towel.

• If it gets particularly painful, have a warm bath to sooth the area and help speed healing. You can take several baths in one day if you need to.

• Use unscented baby wipes rather than toilet paper to wipe after using the toilet. These are softer and produce less friction.

• Don’t wear tight trousers or underwear as this could irritate the area.

• Choose cotton underwear and avoid nylon. Cotton is soft and provides much needed ventilation.

• Ask GP about soothing creams that can help relieve pain and irritation.

Children with diarrhoea

If your child displays symptoms of diarrhoea, it is advisable to see the GP. Dehydration can occur very quickly so it is important to administer fluid frequently. Risks of dehydration are higher if your child is:

• younger than one- particularly if they are younger than six months old
• less than two years old and born with a low birth weight
• unable to hold down fluids.

Or if you child has:

• had more than 5 bouts of diarrhoea in the last 24 hours
• been sick more than two times in the past 24 hours
• suddenly stopped breastfeeding.

Your child may be dehydrated if he or she:

• acts irritable or seems drowsy
• passes urine less frequently
• has pale and mottled skin
• appears to get more ill
• has cold feet and hands. 

If your child is dehydrated, you are advised to follow these tips:

• If you are breastfeeding or bottle-feeding your child, continue to do so as normal. A GP can also supply oral rehydration supplements (ORS).

• Refrain from feeding you child solids while they are dehydrated.

• If your child refuses to eat solids, offer them liquid instead and wait for their appetite to return. 

• If the dehydration continues, your child should be taken to hospital where nutrients can be pumped directly into the body via an intravenous in the vein.
  

How can a nutritionist help with diarrhoea? 

Diarrhoea can often make you feel helpless and alone. Discussing your problems with a qualified nutritionist is one step towards regaining control of your life.

A nutritionist will apply their expert knowledge by designing a personalised diet plan tailored to individual requirements. Nutritionists understand how conditions like diarrhoea can seriously affect the quality of life and as such, will do all they can to help. 

Becoming educated in all things food will help you lead a healthy life and hopefully prevent nasty symptoms like diarrhoea from reoccurring.

To find out more or to talk to a nutritionist near you, please feel free to search our Nutritionist Directory.

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