Acute Diarrhea

Symptoms

Acute diarrhea is defined as frequent bowel movements with a liquid or mushy stool consistency (≥ 3 voidings within 24 hours, stool weight > 200 g/day). It usually does not last longer than a week and often passes on its own. If it lasts longer than two weeks, it is referred to as a persistent or chronic course. Possible accompanying symptoms include abdominal cramps, nausea, vomiting, lack of appetite, fever, flatulence, fatigue, and blood in the stool. Large fluid loss can lead to dangerous dehydration and is acutely life-threatening (e.g., cholera).

Causes

Diarrhea (“flowing through”) is not a disease but a symptom that arises as an expression of numerous diseases and conditions:

Chronic recurrent diarrhea should be considered, among others, irritable bowel syndrome, inflammatory bowel disease, tumors, lactose intolerance and metabolic disorders.

Diagnosis

Diagnosis is made by medical treatment. It is important to estimate the patient’s hydration. Acute diarrhea is not always self-treatable. Medical consultation is recommended for the following signs and patients, among others:

  • Dehydration or increased risk of dehydration, especially in infants, children, and the elderly
  • Blood in the stool
  • Fever
  • Long duration > 7-14 days
  • Yellowing of the skin and conjunctiva of the eyes (jaundice).
  • Constant discharge of small amounts of stool
  • Poor general condition, severe pain and other concomitant symptoms.
  • Pregnancy
  • Chronic underlying disease
  • Diarrhea after long-distance travel (traveler’s diarrhea)
  • Diarrhea after antibiotic treatment

Non-drug treatment

  • Adequate fluid intake
  • Food abstinence
  • Light diet: soups, carrots, grated apples, mashed bananas, oatmeal. Restorative food, such as Milupa Aptamil HN 25 (vitamins, minerals, proteins, fats, carbohydrates).
  • Heat pads, eg hot water bottles against cramps.

Drug treatment

Oral rehydration solution (ORS) replaces the lost fluid and electrolytes:

Peristaltic inhibitors bind to μ-opioid receptors in the intestinal wall, thereby inhibiting intestinal movements and prolonging the retention time of stool. Loperamide, unlike other opioids such as codeine, is characterized by the fact that it is predominantly locally active and has very little central nervous system penetration:

Probiotics are used to prevent and treat diarrheal diseases. They normalize the intestinal flora by colonizing the intestine or promote the development of healthy intestinal flora. They can be used even in infants:

Anti-infectives are causally effective against the causative infectious agents. They are rarely used in defined clinical pictures. Nonspecific use is not indicated:

  • Antibiotics
  • Antifungals
  • Antiprotozoal agents

Enkephalinase inhibitors:

Herbal medicines:

  • Charcoal (eg, activated charcoal, coffee charcoal, birch charcoal) is an old home remedy for diarrhea that adsorbs toxins in the intestine. Other drugs must be administered at a time interval of at least two hours, because charcoal inactivates them.
  • Dried apple powder (Aplona), pectin.
  • Mineral substances: Healing earth (clay, eg Luvos), white clay (kaolin).

Tannins have an astringent, tanning and antiseptic effect and can thus possibly reduce the excessive secretion of the fluid. Warm teas have a positive effect on abdominal cramps:

  • Black tea: steep for 10 min
  • Raspberries, blackberries
  • Blueberries
  • Tannin buminate, gelatin tannate

Swelling agents bind water and thus solidify the stool:

  • Indian psyllium husk
  • Psyllium

Herbal motility inhibitors:

Antispasmodics are used to treat the accompanying intestinal spasms:

Digestive enzymes: