Table of Contents
An Overview of Diarrhea
Everyone must have experienced the condition requiring them to visit a toilet multiple times in a day at some point in their life. This condition is commonly referred to as diarrhoea.
Diarrhoea is characterised by an increase in the fluid concentration of stool as a result of an imbalance in the biological functions of both the small and large intestines, which are the in charge of absorbing different ions, other substances, and water. Some of the aetiological agents of diarrhoea include rotavirus and Escherichia coli.
The usual water content in the faeces of infants and toddlers is around 10 mL/kg/day, while that in the faeces of adults and adolescents is 200 g/day.
In diarrhoea, the intestine of a person cannot absorb water, leading to watery stools. Thus, any patient who has diarrhoea should have rehydration treatment, which is crucial for them. Acute diarrhoea is defined as the sudden start of 3 or more sloppy or liquid stools per day that lasts for more or less than 14 days. When such an incident lasts longer than 14 days, diarrhoea is however categorised as a persistent or chronic condition. A diarrhoeal infection frequently results in severe diarrhoea. For chronic diarrhoea, the most frequent agents non-infectious. The distinction between acute and chronic diarrhoea is crucial because the length and exact cause of the condition are used to determine a care plan to manage and treat it. Cholera and shigellosis are two forms of infectious diarrhoea that lack enteritis (inflamed intestines).
Types of Diarrhoea
Irritable bowel illness, serious drug reactions, infections, and stroke are just a few of the circumstances that can cause the intestine to respond in an unspecific way with diarrhoea, which is defined as acute diarrhoea, that has been persistent for 4 weeks.
When diarrhoea is severe, lasts a long time, or patients have unpleasant symptoms like fever, prostration, or gastrointestinal bleeding accompanied by diarrhoea, they must seek medical assistance.
Consuming liquids or foods infected with pathogenic microbes is the main ways through which people contract acute infectious diarrhoea. Once consumed, these microbes overcome host immune responses such as stomach acid (the reduced pH of the regular stomach is bactericidal with most bacterial enteric pathogens), systemic and local immune processes (production of immunoglobulins and defensins, which offer humoral and cellular safety against microbes), and gastric motility, which restricts the capacity of microorganisms.
Although infections cause the majority of instances of diarrhoea, only a small percentage of patients show distinct organisms that can be recognised. In adults and children, acute diarrhoea is a major cause of death and morbidity.
The rates and deaths of acute diarrhoea are highest among children in poor nations. For instance, in the first two years of an infant’s life, roughly 2.7 incidents of diarrhoea have been reported annually in Latin America.
When three or more sloppy stools occur each day for a minimum of 4 weeks, it is considered to be chronic diarrhoea. Diarrhoea that remains persistent for a long time may have several reasons. The treatment plan for chronic diarrhoea focuses on the control of any diarrheal complications as well as the root problem of the condition.
Irritable bowel syndrome (IBS), chronic inflammatory diseases (such as Crohn’s and ulcerative colitis), malabsorption symptoms (celiac in which food cannot be consumed and absorbed), chronic infections, and several other less frequent reasons for chronic diarrhoea are just some of the widespread conditions that can cause chronic diarrhoea.
Individuals’ health and lifestyle quality may be severely affected by chronic diarrhoea. In its mildest form, diarrhoea is a discomfort; in its worst, it could become fatal. Fortunately, almost all the conditions related to diarrheal can be treated successfully.
A common cause of chronic diarrhoea is irritable bowel syndrome. Variations in bowel patterns and cramping abdominal pain brought on by IBS may emerge following an illness.
People who travel or reside in tropical or resource-constrained regions may get chronic diarrhoea as a result of intestinal disorders. Additionally, consuming infected food, consuming contaminated water, or consuming raw milk can lead to intestinal disorders.
Chronic diarrhoea and weight loss might result from a hyperthyroid condition. Chronic diarrhoea brought on by diabetes is also possible if the nerves supporting the digestive system are damaged.
Watery diarrhoea is typically brought on by viruses or short-term disorders like a foodborne disease. However, it might also be brought on by some fundamental medical problem.
Anyone can get watery diarrhoea occasionally. People experience it when they pass liquid rather than solid stools.
When you have diarrhoea, it’s crucial to drink extra water to avoid serious side effects of dehydration since liquid faeces might cause increased water loss from the body.
Liquid bowel motions can have many possible contributing aspects, such as:
Acute disease is brought on by parasites, viruses, or bacteria that affect the gastrointestinal system.
The diseases of the digestive system, such as celiac disorder or inflammatory bowel disease, can lead to diarrhoea. Surgery done on the rectum or anus in the past, such as haemorrhoids removal, tumour removal, or anal infection and fistulas treatment, can cause diarrhoea.
Due to the presence of bile and bilirubin, stools are often brown. However, if an individual has liquid bowel motions, they might notice that the watery stool has a completely different shade. Moreover, black liquid faeces can be concerning since they may be an indication of bleeding from the upper part of the digestive system.
Generally, a normal stool is solid, moist, and brown in colour. Even while diarrhoea is unpleasant, it usually does not indicate a significant problem. Red or bloody diarrhoea, however, may be an indication of a more serious health issue
Because of certain drugs, the colour of digested food, and due to blood present in the stool, diarrhoea may seem red.
Red diarrhoea could be unpleasant, but somehow the colour of the faeces might assist a person to identify the underlying problem.
A person’s faeces may seem red for several reasons and under various circumstances such as:
- Rotavirus is one virus that can cause bloody diarrhoea
- The gastrointestinal system may bleed as a result of diseases like Crohn’s disease and peptic ulcers. Occasionally, this blood will show up in the faeces, turning it blood red coloured.
- Bloody diarrhoea is referred to as dysentery. Shigella bacteria and the parasite Entamoeba histolytica are among the most typical contributors of dysentery. These have the potential to bring on serious infections that can irritate the colon to the point of bleeding.
- It is possible for colon tumour development to bleed, which will present as diarrhoea.
Diarrhoea in Infants and Children/Adolescents
One of the most frequent diagnoses in clinics is acute diarrhoea in the infant aged below 5 years. As rotavirus is the main causative agent in this age group, it is the 6th most common cause of mortality in children younger than 5 years globally.
Norovirus is the primary reason of diarrhoea in nations where rotavirus vaccinations programmes are frequently conducted. The majority of diarrheal diseases may be clinically diagnosed, and lab tests are usually sufficient.
A viral causative agent is indicated by the presence of acute liquid non-bloody diarrhoea, while a bacterial infection is indicated by the presence of blood in the stool and high fever. To prevent fluid retention, imbalance in the body, kidney failure, and sometimes even death of affected children, family doctors must be evaluate and understand the level of water loss in the children.
Oral rehydration treatments are considered the backbone of care for adolescents with moderate to severe water loss caused by diarrhoea.
Risk Factors of Diarrhoea
There are several risk factors contributing to the frequent occurrence of diarrhoea in all age groups.
- Insects and microbes – Diarrhoea results from interaction with parasites or harmful bacteria like Escherichia coli through polluted beverages or food. In poor nations, diarrhoea brought on by parasites and microorganisms is frequently referred to as traveller’s diarrhoea. Some other type of bacteria that can cause diarrhoea is Clostridioides difficile, which can happen after an antibacterial treatment or while you’re in the hospital.
- Consumption of fructose – Honey and fruits contain a naturally existing sugar, fructose. It is occasionally used to add a sweet taste to various foods. In those who struggle to digest it, fructose can cause diarrhoea.
- Viruses – Enteric adenoviruses, astroviruses, cytomegaloviruses, and viral hepatitis are among the viruses that can cause diarrhoea. Norwalk virus, generally known as norovirus, is another factor causing diarrhoea. Acute childhood diarrhoea is frequently brought on by rotavirus. The virus responsible for COVID-19 has also been linked to gastrointestinal symptoms such as sickness, nausea, and diarrhoea, in addition to common viruses like rotavirus.
- Surgical procedures – Surgery done to remove the appendix or a part of the colon can occasionally result in diarrhoea.
- Additional stomach disorders – IBS (irritable bowel syndrome), Crohn’s disease, gastrointestinal disorders, celiac disorder, micro colitis, and small intestine bacterial overgrowth are a few of the additional caused for chronic diarrhoea.
Prevention from Diarrhea
Important steps to control diarrhoea involve
- Employment of more sanitary practices
- Providing education on the transmission of infectious diseases
- Making clean water available to drink
- Washing hands with soap
- Healthy meals and hygienic practices
- Vaccine against rotavirus
- Use of an oral rehydration salts liquid to restore fluids
- Supplementary zinc, which decreases the period of a diarrhoea event by 25% and is linked to a 30% decrease in stool output
In the modern world, diarrhoea is a common disorder. Diarrhoea is brought on by an increase in the liquid concentration of faeces because of a variation in the biochemical functions of the large and small intestines, which are responsible for the absorption of various ions, other metabolites, and eventually water.
Diarrhoea is mostly brought on by several risk factors, including surgery, bacterial infection, fructose consumption, viral infection, and other digestive disorders. The bacterial attack can be inhibited and diarrhoea can be prevented by oral rehydration therapy, eating foods containing zinc, taking natural supplements, and maintaining good personal hygiene.