diarrhea

• Diarrhea after eating
• Diarrhea in babies and young children

Synonyms

Med. = Diarrhea, Diarrhea

definition

Under diarrhea one understands frequent stool evacuations with an unformed or liquid consistency as well as an increased amount. Both exist acute as well as chronic Forms, whereby chronic diarrhea, by definition, lasts longer than 2 weeks.

Diarrhea after eating - what can it be?

If diarrhea occurs in relation to food consumption, there is much to suggest that it is a direct intolerance reaction to the food consumed.

Diarrhea after eating is not uncommon and sometimes "self-limiting" (ends on its own).

With regard to the cause, doctors generally differentiate between so-called maldigestion and malabsorption.

• Maldigestion describes the condition when the food cannot be broken down correctly. This can be the case, for example, with an enzyme deficiency, which in turn can occur after operations on and in chronic diseases of the organs of the gastrointestinal tract.
• Malabsorption describes the process when the absorption of the already split food through the intestinal tract is not guaranteed. This is the case with common food intolerances, such as lactose intolerance, gluten intolerance, but also with chronic inflammatory bowel diseases (and less often with hormone-active malignant tumors). All of these are based on the fact that the mucous membrane of the intestine is so damaged that the food components cannot be absorbed.

In both the process of maldigestion and malabsorption, water is drawn from the cells of the intestine into the interior of the intestine, which then causes diarrhea.
If you have diarrhea after eating that only occurs once or twice, the cause may be more of a harmless infection and the toxins of the pathogens are flushed out directly. The doctor divides this into the group of secretory diarrhea, better known as "food poisoning" (e.g. by E. coli).

More rarely, the cause of diarrhea after eating can also lie in an organ that is further away:
If the thyroid is overactive, its metabolically active hormones can stimulate the intestines to overact.
This is called hypermotile diarrhea and has nothing to do with the type of food or the texture of the intestinal lining. If the diarrhea only ever occurs in connection with the consumption of certain foods, these can be omitted on a trial basis.

Learn more about possible causes, symptoms and treatment options for Diarrhea after eating.

Diarrhea after taking antibiotics

Diarrhea after taking antibiotics strongly suggests an infection with the pathogen "Clostridium difficile". The symptoms of the intestine are called "pseudomembranous colitis". This is not a new infection with an external pathogen, but an endogenous, i.e. internal, infection of an already incorporated pathogen.

Clostridium difficile occurs "ubiquitously", i.e. everywhere in the environment. Transmission is "fecal-oral", e.g. about the food intake of intestinal bacteria. A common route of transmission is in the hands of hospital staff, which puts hospitalized patients at greater risk of infection.

While this pathogen can be detected very frequently in children and does not cause any symptoms, it is less common in adults.When antibiotics are given (e.g. after an operation or in the event of tonsillitis), the intestinal flora is changed in such a way that an imbalance arises in favor of clostridia.

The pathogen "overgrows" the other, now suppressed bacteria, so to speak, and then occurs in such high numbers that the person affected develops diarrhea (so-called "selection advantage" of the pathogen).

The antibiotics with the highest risk of causing this type of diarrhea are

• Fluoroquinolones,
• Cephalosporins,
• Clindamycin and A
• moxicillin-clavulanic acid.

If drugs of the groups PPIs and NSAIDs (e.g. Pantozol and Ibuprofen) are taken at the same time, these have an additional positive effect on diarrhea. This type of diarrhea is characterized by the fact that it is bloody and particularly offensive.

People also suffer from a high fever and cramping abdominal pain. (In the majority of cases, however, Clostridium difficile infections are without symptoms.) As a therapy, it is sometimes a good idea to stop taking the causative antibiotic or drug and replace the fluid that has been lost.

Otherwise, the drug of choice is one or two specific antibiotics that act on exactly these bacteria: metronidazole and vancomycin. They should mainly be taken as tablets and only given as plan B via the vein.

The third possibility, which is also available as an additional option at any time, is to build up the natural dam flora with a stool transplant.

Clostridium difficle diarrhea can become life-threatening if there is a strong loss of fluid or the development of the disease "toxic megacolon". Clarification of the described circumstances and symptoms as well as immediate therapy are therefore absolutely necessary.

Read more on the subject at: Pseudomembranous colitis and toxic megacolon

Diarrhea after exercise

Sport stimulates general bowel activity, but is not causally related to diarrhea.
Rather, what happened around the sport should be critically examined as a possible cause.

Many sports drinks contain sweeteners instead of sugar, which has a laxative effect. Food supplements can also lead to hypersensitivity reactions due to their constituents and concentrated ingredients.

Are you interested in this topic? For detailed information, see: Diarrhea after exercise

Diarrhea when taking the pill

This section is not about the fact that the pill can trigger diarrhea, but that in the case of severe diarrhea the effect of the pill can be weakened or even eliminated.
In addition to diarrhea, vomiting has a similar effect. The pill is taken orally for contraception and the active ingredients of the pill are absorbed through the mucous membranes in the gastrointestinal system so that they can enter the blood and be distributed throughout the body. If vomiting or diarrhea occurs shortly after taking the pill, within about three to four hours, this process can no longer proceed properly because the active ingredients of the pill are then lost with the diarrhea or vomit. If this is the case, action should be taken, i.e. whether the pill was forgotten.
As a rule, a new pill should be taken - but this is still different from preparation to preparation. Information about diarrhea and vomiting while taking the pill can usually also be found on the package insert for the pill. However, if the pill was taken more than four hours before the onset of diarrhea, it can be assumed that the body has had enough time to absorb the active substance and it can be dispensed with an additional intake. If the diarrhea is more severe and if the subsequent pill intake is probably not effective, you should consult your gynecologist about how to proceed.

Read our article on this: Pill doesn't work

Diarrhea after coffee

Coffee stimulates the intestinal activity immensely, so that consuming just one sip of coffee can often lead to an urge to defecate.
Coffee cannot liquefy stool in such a way that one can speak of real diarrhea. However, those affected often refer to the very soft stool as diarrhea.

Also read: Diarrhea after coffee

Rather, one should consider whether the coffee was consumed with milk and perhaps there is more of a lactose intolerance

Also read: Diarrhea after consuming milk - what's behind it?

Magnesium diarrhea

In high doses, magnesium causes loose stools, but not actual watery diarrhea that occurs several times a day.

In this respect, a soft stool caused by magnesium would not have any serious disease value.

If the person concerned has continence problems at the same time, this loose stool could aggravate the incontinence and represent a counter argument for the consumption of magnesium.

Alternatively, apple powder could also be taken, which makes the bowel movement harder again.

What does the color say about the cause of the diarrhea?

The color of the diarrhea can provide information about the cause of the diarrhea.

• Yellow diarrhea strongly suggests an overproduction of bile, which occurs with bile acid loss syndrome or with an enzyme deficiency for the breakdown of fats. S.see also: Yellow diarrhea
• If the stool is only discolored, the cause can also lie in the liver area (liver inflammation, gallstone disease).
• Green diarrhea can result from the excessive consumption of green foods or from the ingestion of iron tablets, whereby the color is more black and green.
• Pea pulp-like diarrhea in connection with a trip to tropical countries with poor hygiene strongly suggests a cholera infection. Here there are up to 20 diarrhea per day and their pea-like appearance is groundbreaking for the suspected diagnosis.

The examination of the color of the stool can only be included in the considerations in connection with other diagnostics, but is rarely clearly indicative.

Read more on the subject at: cholera

Epidemiology and frequency distribution

30% of all Germans suffer from diarrhea once a year. It is estimated that this affects around 4 billion people worldwide. About 7.5 million people die, especially children.

Other poisonings (Intoxications) are possible. Think of metals such as copper or mercury. But poison mushrooms are also considered in this regard.

Furthermore, allergies to certain foods are conceivable as a cause of diarrhea.

Another cause of diarrhea can be inflammatory bowel disease. These include Crohn's disease and ulcerative colitis. These diseases are characterized by recurrent or constant inflammation of the intestinal lining.

Certain forms of cancer (tumor) can also cause diarrhea. The same goes for the common irritable bowel syndrome, which is a functional disorder of the bowel movement.

Furthermore, diarrhea can be caused by hormonal changes. These include, for example, an overactive thyroid, which leads to a general increase in metabolism, or hormone-releasing cancer cells.

In addition, diseases with impaired absorption of food components in the intestine cause (Malabsorption) Diarrhea; also diseases with impaired breakdown of food in the context of digestion (Maldigestion).

Malabsorption diseases are, for example, gluten intolerance (Celiac disease or Sprue) or lactase deficiency. Maldigestion disorders, among other things, lead to impaired function of the pancreas (Pancreatic insufficiency), as this results in the substances required for food splitting (Enzymes) are not formed.

The most common causes of acute diarrhea include pathogens, their toxins and drugs.

Read more on the topic: How do you recognize colon cancer?

What pathogens are there that can cause diarrhea?

In general, one can differentiate between bacterial, viral, parasitic and opportunistic pathogens. The latter are a group of pathogens that only cause problems when the immune system is severely weakened.

Bacteria:

• Campylobacter jejuni (most common)
• Salmonella
• Shigella
• cholera
• E. coli (e.g. EHEC)
• Yersinia
• typhus
• Clostridia (associated with antibiotics)
• (very rare: Tropheryma whipplei)

Viruses:

• Noroviruses
• Rotaviruses

Parasites:

• Amoeba
• Lamblia
  Read more about the lamblia at: Giardiasis - diarrhea caused by parasites

special parasites (worms):

• Ascaries
• Toxocaria
• Enterobiosis pathogen
• Trichinodes
• Taenia infections
• Ancylostomatidosis pathogen
• Dyphyllobothriasis pathogen

Opportunists:

• CMV
• Cryptococci
• Microspirodies
• Cryptospirodies
• Isosporidia
• Aspergillus

Read more on the subject at: Infectious diarrheal diseases

How do I know if diarrhea is contagious?

In principle, only a medical interview with a subsequent medical laboratory examination of a stool sample can provide information about whether you are suffering from contagious, i.e. infectious, diarrhea.

However, common sense can be used to form suspicion.

If several people in their immediate vicinity develop diarrhea after eating together, it is very likely that it is an infectious pathogen (from the food).

For more information, read on: Which diarrhea is contagious?

Symptoms

Symptoms include frequent bowel movements, more than three times a day. There is also an increased amount of stool, namely over 250g per day. The consistency of the stool is also changed - towards liquid or reduced.

The acute diarrhea is often accompanied by vomiting and abdominal pain.

Chronic diarrhea can be accompanied by fever, weight loss, and fatigue (see also: Fever and diarrhea).

The occurrence of frequent, small, liquefied, foul smelling stool marks a special form of diarrhea, the paradoxical diarrhea. This is caused by constrictions (Stenoses) in the colon, which prevent the normal movement of stool in the intestine. Rather, only small amounts get past the constriction. This is characteristic of tumors of the large intestine that narrow the inside.

Another special form is the so-called false diarrhea, which occurs in irritable bowel syndrome. The frequency of defecation is increased, but not the amount and usually not the consistency.

Read more on the topic: Symptoms of diarrhea

fever

Diarrhea in combination with a fever strongly suggests that it is an infectious pathogen.

The substances (toxins) formed by bacteria, viruses or parasites trigger the body's temperature regulation, which leads to an increased core body temperature.

This reaction of the body should have the consequence that the respective pathogens are killed. If you have a fever of over 40 ° C, you should definitely consult a doctor, as these high temperatures can also be harmful to your own body.

Also read the article: Diarrhea and fever.

a headache

If you have a headache with diarrhea, it is most likely due to lack of fluids.

If one is able to take in as much fluid through drinking as one is estimated to lose through diarrhea, the body should be able to compensate for the lack of fluid.

If you don't succeed, e.g. Because you also vomit or the diarrhea is long-lasting, it is worth giving an infusion, i.e. liquid, through the vein.

Diarrhea like water

In addition to the frequency per day, the diarrhea is also described using the consistency or water content.
By definition, one speaks of diarrhea when it has an increased water content of at least 75% and is present more than three times a day. With diarrhea that has the consistency of water, the water content is higher than 75%.

If the diarrhea has a water-like consistency, there is a risk of dehydration, i.e. losing too much water and drying out accordingly. Therefore, if you have diarrhea, you have to make sure to replenish as much of the lost fluids as possible by drinking.
Not only is fluid lost, but also important salts, the loss of which can cause the body to become imbalanced. In order to replenish both the fluid and the salt balance, electrolyte solutions sold in the pharmacy (see also: Electrolytes) that can be drunk. This is particularly recommended for very watery diarrhea.

Read more on the subject at: Diarrhea like water

How can such a watery stool develop? There are many reasons for this. On the one hand, food intolerance, especially lacotus intolerance and fructose intolerance, can be associated with a very watery stool.
Of course, infectious diseases are also an important cause of watery diarrhea. In most cases, a bacterial pathogen is responsible for the watery stool, but viruses or parasitic pathogens also play a role. For example, diarrhea, like water, can be triggered by bacterial agitation caused by the Shigella species of bacteria. In addition to Shigella, Escherichia coli, Salmonella and Campylobacter are also known to be triggers (see also: Bacteria in the intestine).
In the case of viruses, the norovirus and rotavirus play a major role. Both go with a massive clinical picture, with both severe vomiting and diarrhea.

In some cases, watery diarrhea can also be followed by a chronic illness (see also: inflammatory bowel disease). The chronic inflammatory bowel diseases ulcerative colitis and Crohn's disease, which damage the intestinal mucosa and occur in phases with diarrhea and other accompanying symptoms, come into question.

Read more on the topic: Crohn's disease attack

In addition, poisoning, for example with the death cap mushroom or drug side effects, for example through antibiotics (see also: Antibiotic side effect), lead to watery diarrhea. The range of possible triggers is accordingly relatively large.
In order to conclude the actual diagnosis, stool samples are usually taken after detailed questioning of the patient in order to be able to determine a potential pathogen. Ultrasound and X-ray examinations are also not infrequently used. An allergy or intolerance test can also be carried out.

Do you have diarrhea combined with stomach cramps? Read more about this under: Intestinal cramps with diarrhea

Diarrhea with blood

In principle, blood in the stool can have several causes.
In addition to inflammatory bowel disease, malignant diseases (e.g. colon cancer) are also among the more serious causes.

Therefore, blood in the stool, as well as blood deposits of any color, should lead to a visit to the doctor.

• If the source of bleeding is in the upper gastrointestinal tract, for example in the stomach, the stool cannot be identified as reddish, but as black. It is also called tarry stool because stomach acid combined with fresh blood makes stool tar-colored.
• If there is a source of bleeding in the middle or lower gastrointestinal tract, such as a cancerous ulcer (carcinoma), the stool can also be reddish. Even bloody diarrhea alternating with constipation should be particularly suspicious.
• Bright red blood deposits on the stool or toilet paper are an indication of hemorrhoids and are then unrelated to the cause of the diarrhea. You still need to be clarified by a doctor. Various infectious diarrheal pathogens cause damage to the intestinal mucosa in their disease process, which can lead to bloody and thin stool.

The most well-known pathogen is the so-called EHEC, as it gained unwanted fame in the public a few years ago (2011). This pathogen can even lead to death via the so-called HUS (hemolytic uremic syndrome) because it also attacks the kidneys and the blood-forming system. Not least because of this one pathogen, bloody diarrhea must always be clarified by a doctor. In general, it can be said that bloody diarrhea is more serious than bloodless diarrhea, because it speaks for a more severe course and a more threatening illness.

Diarrhea with vomiting

Vomiting or vomiting can be an accompanying symptom of diarrhea.
One then speaks of vomiting diarrhea, regardless of whether the cause is an infection or food intolerance.

Vomiting occurs because an irritation in the gastrointestinal tract reports severe nausea to the brain. The stomach and esophagus then react with a backward-facing sequence of movements in order to move the stomach contents out via the esophagus and mouth.

This is a useful protective measure for the body to protect itself against inedible or even dangerous foods. If vomiting is felt to be too tormenting or does not stop on its own, it can be treated with medication.

If vomiting is bloody or persistent, a doctor should be consulted. Young children and old people are particularly at risk for complications of vomiting because of the risk of fluid and electrolyte loss (salt loss).

nausea

Nausea can be an accompanying symptom of diarrheal illnesses, regardless of whether the cause is an infection or food intolerance.

It comes about because the entire digestive system, from the mouth to the anus, is fed by the same nerves.
An irritation in the stomach or intestines, for example by pathogens, can then lead to a feeling of nausea in the brain and reflux (vomiting) from the movements of the stomach and esophagus.

In principle, nausea has an important function, because it reports to the consciousness that something is wrong in the body. The same applies to any resulting vomiting, as the body gets rid of the "bad" food.

If nausea or vomiting persists, a doctor should be consulted.

stomach pain

Abdominal pain is a very common symptom - not only with diarrhea. Therefore, if the symptom is abdominal pain in connection with diarrhea, a physical examination should be carried out by a doctor in order to be able to make more detailed statements about the significance of this pain.

Here are the most important groundbreaking connections with abdominal pain:

• For example, tenderness in the right lower abdomen is most likely to indicate acute appendicitis.
• Diffuse abdominal pain of the entire abdomen below the chest, provided it is cramp-like and persistent, can represent the many contractions of the intestine, regardless of the cause of the diarrhea.
• A wave of pain in the right upper abdomen would tend to suggest a gallbladder infection.
• Liver inflammation is also associated with right-sided upper abdominal pain, but not wavy, but permanent and with fever.

Last but not least, one should pay attention to the psychosomatic projection of negative thoughts or fears onto the stomach.

Read more on the subject at: Appendicitis and gallbladder inflammation

stomach pain

Pain in the right and middle upper abdomen suggests that the stomach is involved in an infection or food intolerance, e.g. Lactose intolerance, because this also manifests itself with gas.

But they can also occur in inflammatory bowel diseases.

Back pain

Back pain is not a common concurrent symptom associated with diarrhea.

In the case of back pain in the sense of general body aches, this would indicate a viral or bacterial infection, especially an increased temperature should occur at the same time.

If the back pain is more of a flank pain (i.e. on the side and on the lower part of the back), this could - in the case of highly acute diarrhea - mean severe fluid loss and the onset of kidney failure.

If there was back pain before the diarrhea, it should not be related to what is happening in the intestine and should be clarified otherwise.

Read more about this under: Kidney failure

Causes of Acute Diarrhea

1. Gastrointestinal infections:
   The most common cause of acute diarrhea is a gastrointestinal infection (gastroenteritis). Both bacteria (e.g. Salmonella, E. coli) and viruses (e.g. rotaviruses, noroviruses) can be the cause of such infections. The transmission is mostly fecal-oral, i.e. from eating contaminated food. An infection with the cholera bacterium (Vibrio cholera) can lead to particularly severe, life-threatening diarrhea. However, cholera rarely occurs in industrialized countries.

2. Poisoning:
   Food poisoning is another cause of acute diarrhea. The cause of this is often a toxin (poison), which is caused by the bacterium Staphylococcus aureus is formed as part of the spoilage of food (e.g. products with yogurt or mayonnaise without appropriate cooling). In addition, certain plants or fungi (e.g. in the death cap mushroom) occur that lead to diarrhea in humans. The contamination of foods with heavy metals (e.g. arsenic) can also cause diarrhea. Incorrectly by children, can lead to diarrhea and other symptoms in addition to vomiting.

3. Medication:
   Taking certain medications can also be a cause of diarrhea. These include laxatives, iron supplements, and certain cancer drugs (CytostaticsBut even taking antibiotics can lead to diarrhea. Here the normal intestinal flora is destroyed by the antibiotic in such a way that the bacterium Clostridium difficile multiplies, leading to what is known as pseudomembranous colitis.Read more on the topic: Abdominal pain from antibiotics

4. Allergies:
   If certain foods are not tolerated, this often manifests itself in abdominal pain and diarrhea. V.a. Lactose intolerance (lactose intolerance due to a lack of the enzyme lactase, which breaks down lactose) and celiac disease (gluten intolerance: gluten is an adhesive protein that occurs in many grain products) can be the cause of diarrhea.

You might also be interested in this topic: Diarrhea from vitamin C.

5. Mental causes:
If there is no other cause for the diarrhea, a psychogenic development must also be considered. Stress or anxiety in particular can lead to indigestion with diarrhea. The diarrhea often ends abruptly on vacation or on weekends, i.e. when the stress-inducing factor no longer applies. Psychological factors also seem to have an influence in so-called irritable bowel syndrome.

For more interesting information about the effects of stress on the gut, see: Stress-related diarrhea

6.Diarrhea during pregnancy:
Particularly at the beginning of a pregnancy, some women suffer from digestive disorders (nausea, vomiting, diarrhea), which usually go away on their own. All of the above are also possible causes of diarrhea in pregnant women, but the risk of excessive fluid loss is increased in pregnant women as in children, which is why a doctor should be consulted at an early stage.

Read more on the topic: Causes of diarrhea and Diarrhea in pregnancy

Causes of Chronic Diarrhea

1. Bowel disease:

diarrhea is next to Stomach ache and Vomit often a first symptom of chronic diseases of the intestine. These include the chronic inflammatory bowel diseases Crohn's disease and Ulcerative colitis, which are often with partly bloody diarrhea accompanied.
These are inflammatory diseases of the gastrointestinal tract, the cause of which is not precisely known. However, it is caused by the chronic inflammation Changes in the lining of the intestinewhich subsequently manifest in chronic diarrhea.

In the Whipple diseasecaused by the bacterium Tropheryma whippelii, leads to infection of Small intestine and other organs and expresses himself i.a. in chronic diarrhea.
But also as part of a Reduced blood flow of Intestine (ischemic colitis) the intestinal lining is damaged in such a way that diarrhea occurs.

Colon cancer, which is one of the most common types of cancer in Germany, can also lead to diarrhea. Even as part of a Radiation for cancer therapy Diarrhea occurs as a result of damage to the mucous membrane in the intestine (radiation colitis).

stress

It has long been assumed that the brain and thus emotions can influence digestion via the so-called vagus nerve and the autonomic (vegetative) nervous system.

For example, high levels of stress and excitement can cause both diarrhea and constipation in some people. The exact relationships are not yet fully understood.

Also read the article on the topic: Diarrhea and psyche

1. Indigestion (Maldigestion, Malassimilation):

In order for the ingested food to be digested correctly, certain substances must be present in order to break down the food components in such a way that they can be absorbed by the intestinal mucous membrane. If these are missing, diarrhea occurs. This includes e.g. a lack of enzymes from the pancreas, especially when the pancreas is destroyed by chronic inflammation (chronic pancreatitis) occurs. The enzymes of the pancreas (lipase, amylase) are especially essential for the digestion of fats, which is why a deficiency of these enzymes leads to fatty stools. Alcohol abuse, i.e. Heavy alcohol consumption over many years often leads to chronic pancreatitis and can subsequently be accompanied by diarrhea.

Read more on the subject at: Abdominal pain from alcohol

A lack of bile acids (e.g. in the case of bile congestion due to gallstones or the loss of bile acids via the intestine in certain small intestinal diseases) leads to diarrhea.

In addition, diarrhea can occur after intestinal surgery if certain parts of the intestine are missing (short bowel syndrome) and thus food components and water cannot be absorbed correctly. The high proportion of water and water-binding substances in the intestine then leads to watery diarrhea.

1. Hormonal causes:

An overactive thyroid (Hyperthyroidism) often manifests itself in chronic diarrhea in addition to weight loss and profuse sweating.

Also certain tumors that falsely produce excessive amounts of hormones (e.g. gastrinoma, VIPoma), which among others Increasing bowel movement or altering the secretion of digestive enzymes can cause diarrhea.

1. Irritable Bowel Syndrome:

The cause of irritable bowel syndrome is not clearly known, so this diagnosis can only be made if other causes of the symptoms (often diarrhea alternating with constipation) have been ruled out.

The symptoms that occur in the context of irritable bowel syndrome can also occur in all other intestinal diseases, which is why it is important to disclose these other, partly dangerous diseases. If the diagnosis “irritable bowel syndrome” is made as the cause of the diarrhea, the prognosis is good. Symptomatic therapy methods with diet and home remedies are often sufficient to relieve the symptoms.

Read more on the topic: Irritable bowel syndrome

Therapy for diarrhea

diarrhea can do both causal as well as symptomatic be treated. Causal means that the underlying cause is eliminated; symptomatic therapy, on the other hand, attacks the diarrhea itself and not the disease causing it.

Causal Diarrhea caused by germs can be treated. Slight forms, however, are not treated, only diarrhea fever, Blood admixture or severe course. In these cases, antibiotics can be given depending on the pathogen (Co-trimoxazole, Quinolones, Metronidazole).

Medicines that cause diarrhea are discontinued and underlying diseases are treated specifically.

Of course, diarrhea can also be treated with homeopathic medication.

Please read on: Homeopathy for diarrhea

Symptomatic therapy includes the administration of fluids and electrolytes to compensate for the substances lost through the stool, so that none Dehydration („Dehydration“) Of the body arises.

In addition, inhibitors of bowel movement (Loperamide / Imodium®) or at Abdominal cramps pain relievers (Antispasmodics how Butylscopolamine) are given.

Medication for diarrhea

As a rule, you can avoid taking medication if you have diarrhea.
However, if the diarrhea has a high frequency per day, if it lasts for several days, or if the diarrhea leads to severe fluid loss, the use of a medication for the diarrhea can be considered.
Medication against diarrhea should be used with caution and even if only for a short time, because diarrhea is usually a cleaning process that serves to transport toxins or pathogens out of the body. This process is limited by the administration of a drug that prevents diarrhea.
A medication for diarrhea is usually used Loperamide recommended. Loperamide (Imodium®) is available from pharmacies without a prescription. Loperamide has an inhibitory effect on the muscles in the intestine, so that the stool is transported less quickly and the intestine has more time to absorb fluid and important ingredients and to thicken the stool accordingly.
Also Perenterol® can be used as part of an infection. It is practically a non-disease-causing yeast that ensures that the growth of the pathogens responsible for diarrhea is inhibited and the natural intestinal flora is restored.
Furthermore can Tannins to calm the intestinal mucosa can be used. These are for example in black tea or other plants contain.
In the case of severe infections or poisoning Activated carbon can be used. Activated charcoal is taken orally in tablet form. Activated charcoal has the special property that it is not absorbed in the gastrointestinal system, but can bind other substances such as toxins from pathogens or other poisonous substances. In this way, activated charcoal can remove harmful substances from the gastrointestinal tract, which are then excreted together with the charcoal. Activated charcoal is also used in poisoning emergencies, albeit in higher doses.

Also read our topic: Medication for diarrhea

Home remedies for diarrhea

If you have an acute diarrheal illness, home remedies can help relieve the symptoms of diarrhea and make up for the loss of fluid and salt.

A mixture of water (approx. 500ml) with a little salt (approx. 1 teaspoon) and some sugar (up to 5 teaspoons of sugar, depending on your taste) is particularly suitable for this. A light vegetable broth is also good.
However, food rich in fat and carbohydrates should initially be avoided.

If the diarrhea subsides, you should pay attention to a slow build-up of food and only eat light, low-fat food at first so as not to irritate the intestinal flora and mucous membrane too much.

Warmth on the abdominal wall can relieve cramping abdominal pain. Hot water bottles or cherry stone pillows are suitable for this. Care must always be taken not to place them directly on the bare skin in order to avoid burns.

One shouldn't forget, herbal teas can also help get rid of diarrhea.

However, if the diarrhea lasts longer than 3 days, if there is mucus or blood in the stool or if diarrhea occurs after a trip, a doctor should be consulted.

Read more on the topic: Home remedies for diarrhea such as Home remedies for a bloated stomach

homeopathy

For a long time, the herbal Iberogast was the standard for diarrhea among doctors who had prescribed naturopathic treatments, but it has fallen into disrepute due to liver damage.

In order to treat diarrhea adequately homeopathically, an exact explanation of the causes must take place beforehand, since homeopathy is based on the principle of “cure like with like”.

In the case of certain causes, for example infections with pathogens and chronic inflammatory diseases, homeopathy cannot bring about a cure according to the current state of knowledge, but - if there are no interactions with the given medication - it can also be administered.

The tried and tested remedies for gastrointestinal complaints are chamomile, fennel and yarrow.
They can be taken as a tea or in the form of globules.

What can you eat if you have diarrhea?

If you have diarrhea, you should pay attention to the right diet. In order not to irritate the already more sensitive intestine, you should Light food can be used.
Since there is usually a loss of appetite in the context of a gastrointestinal infection anyway, this is usually complied with voluntarily. By light food one understands above all that Avoid fatty and spicy food. Also to sweet foods as well as whole grain and dairy products should be avoided. For example, that is cheap Eating rusks, dry bread or pasta, as well as grated apples or pretzel sticks. Pretzel sticks, for example, have the beneficial effect that they also compensate a little for the loss of salt. While the ingredients of the apple have a positive effect on the intestinal mucosa.
A balance of the mineral / salt balance can also be achieved through this Eating bananas because they have a high potassium content. Because just a change in the potassium balance can be harmful.
Since diarrhea is often accompanied by nausea and vomiting, it should be ensured that not too much food at once that overwhelm the stomach. The light food should therefore always be consumed in portions and not in large quantities at once. The same goes for drinking. For extreme complaints, it is recommended to use his Tea or water by the spoon to take in. This is often done in children. Is fluid still water, tea or vegetable stock makes sense. Also cola is suitable due to its high sugar content. Non-fatty soups can also be consumed.
In the case of massive diarrhea with a strong loss of fluid and salt, special Glucose electrolyte solutions can be purchased in the pharmacy, which should balance the mineral balance again.

Rehabilitation / regeneration

The Intestinal lining needed after acute diarrhea some time to regenerate. Usually this happens by itself as part of normal physical repair processes. In some cases supportive yeast can be taken in capsule form (Perenterol, consisting of Saccharomyces).

In the case of chronic diarrhea, on the other hand, the regeneration options depend on the underlying disease.

prophylaxis

The prevention of acute diarrhea is, on the one hand, the observance of hygiene. This includes that Wash your hands/ Disinfect before eating or after contact with sick people.

To a Food poisoning To avoid this, unwashed, unpeeled or raw food should not be consumed in certain holiday destinations. Special attention (everywhere) should be directed to raw poultry meat and raw eggs, which can be contaminated with salmonella. Prophylactic can also be used before a trip Perenterol be taken.

In the case of diarrhea caused by allergies or intolerance, you should avoid the food in question.

Sweeteners should also be left out because of their laxative effect.

forecast

Because of the independent regeneration of the intestinal mucosa in infectious forms, the prognosis in these cases is good.

Otherwise it depends on the underlying disease and is therefore very different from one individual to the next.

In principle, the acute diarrhea usually a more favorable prognosis than chronic ones, since the latter is usually based on a more serious illness.

diagnosis

The Diagnosis initially includes inquiring about the medical history (anamnese) and a physical exam.

A general examination of the blood and stool are also required diagnostic tools.

In addition, a Colonoscopy (Colonoscopy), in which the inside of the intestine with the help of a tube with a camera (endoscope) can be viewed.

If a certain disease is suspected, appropriate special examinations and tests can be carried out.

In unclear cases, a MRT examination according to Sellink help. At a Sellink MRI Contrast agent is administered orally before the MRI examination and then the MRI is performed. In particular, changes in the mucous membrane of the small intestine can be made visible using the Sellink technique.

Duration

The duration of diarrhea depends on its cause. In chronic inflammatory bowel disease (ulcerative colitis, Crohn's disease), the diarrhea is usually permanent.

Even with other autoimmune diseases that affect the intestine, diarrhea can be assumed that does not stop spontaneously, but is either recurring or permanently present.

Post-meal diarrhea can last different lengths of time, depending on whether it is an infectious agent or a food intolerance. In the case of harmless bacterial pathogens that are transmitted through food, the body usually only reacts with one or two diarrhea, immediately after eating and has already got rid of the culprit.

The same applies to diarrhea caused by stress or a very high-fat diet. In the case of food intolerance such as lactose, fructose or gluten intolerance, the diarrhea persists as long as the responsible substrate continues to be supplied to the body through food.

In principle, any diarrhea that lasts longer than 3 days should be clarified by a doctor, especially if other accompanying symptoms occur such as fever, vomiting, headache, etc.

Also read: Duration of diarrhea

Pathogenesis - course of the disease

According to the mechanism by which diarrhea develops, there are four different forms:

1. Osmotic
2. Secretory
3. Flammable
4. Motility disorders

1. Osmotic diarrhea:

Osmotic diarrhea occurs when substances ingested with food inside the intestine (Lumens) To a certain extent passively “attract” water from the cells of the intestine. As a result, there is an influx of water from the cells into the intestine and then liquid stool. This means that the diarrhea is stopped by fasting, because the "water attraction" by the consumed substances is canceled.
This osmotic form occurs after consumption of "water-attracting" substances, but also in malabsorption diseases, whereby substances with a corresponding effect remain in the intestine. Even with excessive consumption of sorbitol-containing (Type of sweetenerThis type of diarrhea occurs with chewing gum.

2. Secretory diarrhea

In the secretory form Electrolytes and water are actively released from the intestinal cells into the intestinal lumen and thus produce liquid stool. In this form of diarrhea, fasting does not stop the diarrhea, since the causes that are recorded do not cause the increased stool volume but processes in the intestinal cells themselves.

This mechanism of diarrhea is triggered by pathogens, their toxins or produced by cancer cells Hormones. In addition, certain laxative, Fatty or bile acids cause secretory diarrhea.

3. Inflammatory diarrhea

The inflammatory form of diarrhea arises from damage to the intestinal lining. Due to the damaged wall of the intestinal cells as a result of inflammation, water and electrolytes also pass into the intestinal lumen. Here the chair are common blood or added mucus. Typically this occurs through special substances produced by bacteria (Cytotoxins) or through their direct invasion of the mucous membrane. Furthermore, this is the diarrhea form of the chronic inflammatory Bowel disease.

4. Motility disorders

The last form is finally through Motility disorders of the intestine. This refers to a change in normal bowel activity, either in the direction of increased or decreased movement. This can include Cancers or with an overactive thyroid.

Diarrhea after eating

If the diarrhea regularly after this eat on, Not but after one Fasting break, this indicates a Food intolerance down. It is helpful to note exactly what was eaten in each case in order to obtain information on the underlying food from this log. In addition to diarrhea, food intolerances can also increase Flatulence, Vomit, Skin changes, to cough, etc. lead.

To the am most common occurring Food intolerance counting:

• Histamine intolerance
• intolerance across from Carbohydrates:
  • Hereditary Fructose intolerance
  • Fructose malabsorption
  • Galactose intolerance
  • Sucrose intolerance
  • Sorbitol intolerance
  • Lactose intolerance

• Celiac disease (Gluten intolerance)

Diarrhea in pregnancy

Diarrhea is not a typical symptom that occurs during pregnancy. The remodeling processes of the body and hormonal influence tend to lead to the opposite, namely constipation.
If diarrhea occurs during pregnancy, it is not always necessary to think about something extraordinary, something that is triggered by the pregnancy or indicates a complication of the pregnancy. In most cases, the conventional causes also come into question, as in non-pregnant women - a gastrointestinal infection, irritable bowel syndrome, food intolerance or the like.
Diarrhea during pregnancy can be harmless and especially occur in early pregnancy as well as nausea and vomiting. The exact cause is not known here, but stress, diet and changes in hormone status have an impact on bowel function.
In the early stages of pregnancy, there is often a slight diarrhea, which is provoked by a change in diet, because when pregnancy occurs, pregnant women often change their diet to healthy foods. The body has to adjust to this so that diarrhea can sometimes occur in the initial phase. The onset of mild diarrhea, however, is not a sign that the healthy diet is not digestible, the intestines are simply not used to it at first. The healthy diet can / should therefore be continued.
If diarrhea occurs initially during pregnancy and then often alternates with constipation and flatulence, this is nothing unusual and is to be seen as a sign of a change in the body during pregnancy.
Especially in late pregnancy there are often changes in bowel movements due to the changed position of the large intestine in the abdominal cavity due to the displacement of the growing embryo in the uterus. Primarily constipation occurs and then episodes with diarrhea (paradoxical diarrhea).
Since the uterus presses more and more on the intestines towards the end of pregnancy, the onset of diarrhea can also speak for the beginning of the birth.
If severe diarrhea occurs during pregnancy, special care should be taken to replenish the lost fluids and salts. For example, a reduced potassium level can be harmful to mother and child (see also: potassium deficiency).
If the diarrhea lasts longer than three days, a doctor should be consulted for clarification. This also applies if there is a suspicion that it is an infection-related diarrhea, which is then usually accompanied by nausea and vomiting. In the case of infections, it must always be prevented that these pass on to the child and trigger a premature birth, for example.
Therapeutically, it is advisable to use home remedies rather than medication during pregnancy. If this does not improve the symptoms, you should discuss with your doctor which medications can be taken during pregnancy.

Read more on this topic at: Diarrhea in pregnancy

Diarrhea in babies and young children

Diarrhea in babies or toddlers is mostly due to one Virus infection or bacteria evoked. Frequently gastrointestinal infections are also associated with children fever socialized what the Fluid requirements additionally increased.

Since above all baby very sensitive respond to severe fluid loss i.e. very fast sleepy and limp should definitely be on a adequate hydration be respected. Suitable for this are Diarrhea in toddlers and child especially mixes Electrolytes (Salts) and Glucose (Sugar), as e.g. can be purchased in pharmacies.
If the children refuse or can one Fluid absorption not ensured the Pediatrician to be visited. He can then decide whether it makes sense to give the child fluids in the clinic using infusions. However, you always have to act with diarrhea in children Food intolerance or one defect at certain Digestive enzymes think. In this case they are Chairs rather pulpy, greasy and mostly foul smellingbecause the food components are not broken down sufficiently and are therefore fermented by the bacteria in the intestine. Also, the affected children show up frequently Failure to thrive due to insufficient supply of Calories and Vitamins. The two most common food intolerances are described in more detail below.

Lactose intolerance: Here the enzyme is missing Lactase, What Lactose (Lactose) split so that the individual products can be absorbed through the intestinal wall. This Enzyme deficiency can innate his or her in the course of the development of the child (usually children between the ages of 3 and 13 years become symptomatic). Because sugar that remains in the intestinal lumen is a lot water and Salts binds, it comes to diarrhea strong liquid- and Salt loss. In addition, the children are malnourished as there is insufficient calorie intake. The therapy consists of one lactose-free diet and the Balance of fluid- and Electrolyte loss.

Celiac disease: There is a Intolerance to gluten. Gluten is a Glutinous proteinwhat in many Cereals occurs (including wheat, spelled, rye, oats, barley). In celiac disease, the upper small intestine affected by a Change in the lining of the small intestine also to Deficiency symptoms i.a. on iron and Folic acid can lead. The diagnosis can be made by the detection of certain antibodies in the blood (Gliadin antibodies) and a tissue sample from the small intestine can be secured.
In therapy there is the gluten free diet first of all. The following product bases do not contain gluten:

• millet
• Corn
• rice
• Buckwheat
• soy

Often, celiac disease also develops due to the faster passage of food through the gastrointestinal tract Lack of vitamins and Mineralswhich absolutely by Medication should be balanced. In addition, certain diseases often occur together with celiac disease. These include Diabetes mellitus (Diabetes), Dermatitis herpetiformis Duhring (a blistering skin condition) and IgA deficiency (an immune system disease).

Diarrhea in the baby

Because babies' immune systems are not fully developed, they are more likely to get infections, like a gastrointestinal infection.
In a baby, one speaks of diarrhea when the child more than five thin stools a day Has. Especially with young children and old people, you have to be careful that diarrhea does not lead to dehydration. As mentioned earlier, the cause of a baby's diarrhea is usually one infection. Mostly viral pathogens play a role. Rota and noroviruses are leading.
As a rule, there is also an additional vomiting and fever in these diseases. If the diarrhea smells particularly strong or is very shiny at the same time, this can also be for one Metabolic disease, as the Celiac disease (Gluten intolerance) speak.
Since babies / children have a high proportion of water in relation to their remaining body weight, they can potentially lose a lot of water, so that there is a particular risk of dehydration. Babies under six months of age are particularly at risk. When dehydration begins, the babies often appear limp and lackluster. The fontanel (not yet ossified area of ​​the skull) has sunken in them. Furthermore, skin folds formed with the fingers remain and do not recede immediately. If you experience these symptoms, you should definitely see a doctor.
If the child is breastfed, it definitely should continue to be breastfed, but in small amounts each time, so that the liquid is not immediately lost. If the child is not breastfed, the baby milk can be used instead tea (e.g. chamomile tea) can be added in portions - the tea can be mixed with a pinch of salt and a little sugar (about per cup).If the child is unable to regain fluids or if the diarrhea persists, a doctor should be consulted.

For more information, see: Diarrhea in the baby

Diarrhea in young children

The causes of diarrhea in young children are similar to those in adults. With small children still more prone to infection because their immune system has not yet come into contact with so many pathogens and is therefore not always able to eliminate the pathogen before an infection breaks out.
Even in small children, noroviruses and rotaviruses are primarily responsible for gastrointestinal infections with severe diarrhea. But you can also Food intolerance cause diarrhea. Also the Switching from breastfeeding to solid foods can be accompanied by diarrhea in the initial phase, as the gastrointestinal tract is not yet used to this task of processing solid food.
In contrast to the baby, one speaks with a toddler from three thin stools per day from diarrhea (the same applies to adults). Care should be taken to ensure that the child drinks enough. It is best to add the liquid in portions with a spoon. This is especially suitable still mineral water and chamomile or fennel tea. Vegetable broths are also suitable to replenish both the fluid and the salt balance.

For more information, see: Diarrhea in toddlers

When do I have to see a doctor?

Not every single diarrhea should involve going to the emergency room.
However, there are some pointers that should at least get one to see a family doctor.

Especially if you belong to a risk group of people who are generally more at risk from illness and fluid loss:

• Baby,
• small children,
• old people,
• immunosuppressed people,
• People with severe chronic illnesses.

As a general rule, excessive fluid loss can be dangerous.

Signs for this are:

• persistent vomiting,
• persistent diarrhea
• A headache,
• Dizziness and standing skin folds.

If a trip to a country of poor hygiene preceded the diarrhea, or if at first glance parasites or worms can even be found in the stool, this should prompt you to see a doctor.

The same applies if people in the immediate vicinity have died of diarrhea or if you yourself were given antibiotics due to another illness.

Summary diarrhea

diarrhea affects a large part of the population and can arise as a result of a variety of causes. Diarrhea is defined as increased evacuation of stool with changed consistency and quantity.

The therapy is designed depending on the trigger; she can either causal or symptomatic respectively.

If the causative factor in acute diarrhea is eliminated, the prognosis is good due to the regenerative capacity of the intestinal mucosa. Otherwise it depends on the underlying disease.

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