Diarrhoea

Everyone will be touched by diarrhoea at some point in their life. From the very old to the very young, no one gets to escape having loose, watery stools from time to time. … Read More See less

There are many different causes of a stomach ache and diarrhoea, most of which tend to clear up on their own within a few days. But whatever the reason for having diarrhoea, it’s a clear indicator that something in your body isn’t quite right, especially if you tend to have bouts of diarrhoea regularly.

Let’s explore what’s actually happening in your body when you have diarrhoea, the causes of diarrhoea and how to stop diarrhoea. Because no matter how common it is, it can be unpleasant and even distressing. So, let’s get to the bottom of it, together.

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What is diarrhoea?

Diarrhoea occurs when your intestines push stools through before the bowel has absorbed excess water, which leads to loose, watery stools.^1–3 It is defined by the World Health Organisation as 'the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual)’.⁴

Usually, it is mild and goes away on its own within a few days, but it can sometimes be a sign of something more serious.¹Based on how long it lasts, diarrhoea can be defined as:^1,4

Acute – less than two weeks of diarrhoea
Persistent – more than two weeks of diarrhoea
Chronic – more than 4 weeks of diarrhoea

When to see a GP for diarrhoea

You should arrange an appointment with your GP if you or your child:^2,3

Have had diarrhoea for more than three days
Have severe pain in the abdomen or rectum
Have a high temperature
Have bloody or black and tarry looking stools
Have signs of dehydration (e.g. fatigue, peeing less than usual, dry skin, feeling lightheaded or dizzy, dry mouth and thirst)
Have sickness and diarrhoea at the same time
Have stopped drinking fluids / are unable to keep fluids down

Diarrhoea symptoms

The signs and symptoms of diarrhoea include:^1,2,5

Loose, watery stools
Cramping and abdominal pain
Bloating
A strong and urgent need to use the bathroom
Nausea
Headache
Loss of water

Complications of diarrhoea

The biggest complication diarrhoea can cause is dehydration.^1,7,8 This is particularly dangerous in children, people aged over 65 and those with weakened immune systems.^1,7.8

If left untreated, dehydration can lead to kidney failure, stroke, heart attack or even death.^1,7,8

Signs of dehydration include:^2,3,5

Fatigue and a lack of energy
Peeing less than usual
Dry skin
Dry mouth
Thirst
Loss of appetite
Nausea
Feeling lightheaded or dizzy
Sunken eyes
Muscle cramps
Rapid heartbeat

Symptoms of dehydration due to diarrhoea in infants and young children include:⁷

Not having a wet diaper in three or more hours
Having a dry mouth and tongue
A fever above 39°C
Crying without tears
Sleepiness, unresponsiveness and irritability
A sunken appearance to the belly, eyes or cheeks

Causes of diarrhoea

Acute diarrhoea is normally caused by gastroenteritis, due to an infection triggered by:^2,3,5,8

Viruses –g., norovirus, sapovirus and rotavirus
Bacteria –g., Salmonella, Campylobacter jejuni, Shigella species, and Escherichia coli (E. coli). These are often spread through food-based sources
Pathogens – g., protozoa including Cryptosporidium, Giardia, Entamoeba histolytica, and Cyclospora. These tend to contaminate water

Infections tend to thrive in areas with poor standards of public hygiene, meaning they often affect people who are travelling in developing countries.^5,7

Acute diarrhoea can also be the result of:^1,5,6

Feelings of anxiety
Drinking too much alcohol
A food allergy (e.g. lactose or gluten)
Medication (e.g. antibiotics and antacids)
Surgery (e.g. gallbladder removal)
Damage to the intestines due to radiotherapy
Appendicitis
Menstruation (if you have a condition that causes diarrhoea during menstruation, like endometriosis)

Chronic diarrhoea, however, is normally caused by disorders like:^1,2,5,7–13

Irritable bowel syndrome (IBS) – regular episodes of bowel disturbance potentially caused by increased bowel sensitivity or abnormal muscle activity in the bowel wall
Inflammatory bowel disease – a group of conditions, such as Crohn’s disease and ulcerative colitis, that occur when your immune system attacks your bowl
Coeliac disease – a digestive condition caused by an inability to digest gluten
Chronic pancreatitis – when the pancreas has become permanently damaged by inflammation and stops working properly
Diverticular disease – where small bulges or pockets develop in the walls of the intestine (diverticular)
Bowel cancer – cancer in the large bowel (including the colon and rectum), which can cause diarrhoea and bloody stools
Gastrectomy – a surgical procedure to remove part of your stomach

How to treat diarrhoea

Most cases of acute diarrhoea will clear up on their own without any treatment, including diarrhoea caused by gastroenteritis.^3,14

However, you should:^3,14,15

Drink plenty of water to replace any fluids lost and avoid dehydration
Take paracetamol to help ease any stomach cramps or bring down a fever
Get plenty of rest
If you get diarrhoea after eating and are wondering what to eat when you have diarrhoea, you can try small amounts of plain foods like soup, rice, pasta and bread
Use oral rehydration solutions made from sachets if you or your child have signs of dehydration
Take diarrhoea tablets (loperamide) for short-term relief if you need to

If you have chronic diarrhoea, your GP will work with you to discover the cause.¹⁶ Treatment will therefore revolve around the cause of your diarrhoea.¹⁶For example, if you have coeliac disease, you will need to follow a strict gluten free diet.¹⁷

How to prevent diarrhoea

As diarrhoea is often caused by an infection, you can reduce your risk of getting it by:^1,3

Washing your hands thoroughly with soap and warm water after going to the toilet and before eating or preparing food
Cleaning the toilet, including the handle and the seat, with disinfectant after each episode of diarrhoea
Avoiding sharing towels, flannels, cutlery, or utensils with other members of your household
Storing food properly and cooking it to the correct temperatures
Avoiding untreated tap water when travelling abroad
Avoiding raw or undercooked food when travelling abroad
Getting vaccinated for illnesses that can cause diarrhoea, such as rotavirus and COVID-19