Almost everyone has had to deal with an upset stomach or the stomach flu. The consequences are usually abdominal pain and diarrhea, and both may be accompanied by nausea, vomiting and fever. However, if the diarrhea becomes chronic, a whole host of other causes may be behind it.
What is chronic diarrhea?
By definition, the term chronic diarrhea is used when defecation occurs more often than three times a day and the consistency of the stool is mushy or liquid. Diarrhea is not only unpleasant, but also upsets the energy balance. One speaks of chronic diarrhea when the symptoms do not subside after two weeks and therefore no longer indicate an acute infection. Diarrhea itself is not a disease, but a symptom. By definition, the term is used when defecation occurs more often than three times a day and the consistency of the stool is mushy or liquid. Often, the amount of stool is increased. In many cases, the symptoms are episodic and subside after a few weeks. However, the symptomatology depends on the underlying disease. Chronic diarrhea should in any case be clarified by a doctor, because in addition to stress, infections and chronic or malignant intestinal diseases can be the cause.
Causes
However, other causes can also lead to chronic diarrhea. The most common causes are the so-called irritable bowel syndrome, in which the intestine reacts sensitively to stress, and a wide variety of food intolerances. Lactose intolerance, i.e. the intolerance to lactose, should be mentioned in particular. But gluten intolerance (celiac disease) is also not uncommon. Other causes can be chronic intestinal diseases such as Crohn’s disease or ulcerative colitis, in addition to new medications that are not tolerated. These are chronic intestinal inflammations that occur in episodes and, depending on their course, may be accompanied by ulcers. In addition, in cases of chronic diarrhea, it is important to be able to rule out benign or malignant tumors in the gastrointestinal tract before any other diagnosis can be made.
Diseases with this symptom
- Irritable bowel syndrome
- Food intolerance
- Food poisoning
- Fish tapeworm
- Celiac disease
- Crohn’s disease
- Lactose intolerance
- Colon cancer
- Ulcerative colitis
- Gastrointestinal flu
- Drug allergy
- Small intestine cancer
Diagnosis and course
The diagnosis is initially made through in-depth discussions. Usually, the doctor can already make a guess about the cause of diarrhea based on this. Other symptoms that may accompany it can help in making the diagnosis. Usually, in addition to a blood test, a stool sample is tested for bacteria, viruses and parasites. If these initial steps do not reveal any results, testing for food intolerances should be performed. The tests are carried out either by means of certain markers in the blood or by ingesting a concentrated amount of the alleged allergen. If diarrhea, stomach pain or general malaise occurs as a result, the diagnosis can be made. Depending on the case, an ultrasound, a computer tomography or a sonography of the abdominal cavity may also help to establish the diagnosis. If inflammatory bowel disease or tumors are suspected, or if the other tests do not yield results, colonoscopy is resorted to. If no physical causes for the diarrhea are found, psychosomatic factors may be assumed.
When should one go to the doctor?
As soon as diarrhea, also called diarrhea, lasts longer than about 10 to 20 days, a doctor should generally be consulted. Otherwise, there may be a dangerous loss of fluids, which is often associated with a loss of electrolytes. If the diarrhea is associated with cramping abdominal pain and/or circulation problems, it is high time to talk to a doctor about the problem. If the problems occur in connection with the individual meals during the day, this should be logged, including the food consumed, because a medical diagnosis is inevitable so that the problem does not increase.This is the only way to exclude a possible food intolerance as the cause of chronic diarrhea. In the case of additional vomiting, there is an increased risk of serious illness. Especially in children, and even more so in babies and toddlers, there is a risk of “dehydration” due to extreme loss of water and salt. Sustained or severe weight loss is life-threatening for babies and toddlers. So is the collapse of the fontanelles. In this case, the emergency physician should be called. In the elderly, chronic diarrhea can become dangerous within a very short time. The reason lies in a reduced pumping capacity of the heart, a reduced elasticity of the blood vessels as well as a lower power reserve. But it is precisely these characteristics that are required in the case of acute diarrhea. The low water content in the bodies of older people combined with a decreased sense of thirst means that the increased loss of water and salt during diarrhea puts people’s health at risk even more quickly.
Treatment and therapy
Treatment is usually given for the underlying disease, not the diarrhea itself. This is only the case when there is no other treatment option. For example, in irritable bowel syndrome, there is no underlying physical cause. In that case, only stress reduction can be done, which in severe cases should be psychologically supported. In acute cases, anti-diarrheal medications can provide relief. In the case of food intolerances, treatment involves a change in diet. The person affected should draw up a plan with foods that trigger the symptoms and avoid them as far as possible. In many cases, this is sufficient to combat the symptoms. If it is a side effect of a medication that is not tolerated, this should be discontinued or exchanged for a preparation with other active ingredients. In the case of infections or parasitic infestations, appropriate medications are used. Chronic inflammatory bowel diseases are classified as autoimmune diseases and are therefore difficult to treat. A cure is not possible, but the course of the disease can be attenuated with appropriate medication. The treatment depends on the severity of the disease. In mild cases, therapy of the symptoms is sufficient, and in some cases cortisone is used. In addition, there is usually a nutritional therapy, which is quite important for the treatment of Crohn’s disease and ulcerative colitis. In severe cases, especially ulcers, surgery is necessary. Otherwise, the administration of antibodies helps to inhibit the inflammatory factors. Tumors in the intestinal area are already removed during endoscopy, depending on their size. Further treatment depends on the type of tumor.
Outlook and prognosis
The prognosis for chronic diarrhea depends on the cause of the diarrhea. Sometimes the triggering diseases are incurable. However, the associated symptoms can be treated. Depending on whether the chronic diarrhea is due to irritable bowel syndrome, food intolerance, or inflammatory bowel disease such as ulcerative colitis or Crohn’s disease, the prognosis varies. In the first case, symptoms can usually be alleviated – provided the irritable bowel diagnosis is not an embarrassment. In the case of food intolerances, the triggers must be identified. Subsequently, foods containing this substance must be consistently avoided. If this can be implemented, the prognosis is good. If this cannot be consistently implemented, diarrhea may continue to occur. In inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease, the prognosis is less good. Ulcerative colitis occurs in episodes or chronic-recurrent. If the course is chronic-continuous, the prognosis is good. However, a fulminant course can be fatal. The prognosis for Crohn’s disease is similar. For chronic diarrhea, amoebic infections, diseases of the liver or pancreas, or, in bad cases, colon cancer may also be to blame. Prognosis varies. Infections can usually be treated well with antibiotics. For liver and pancreatic diseases, the prognosis depends on the underlying disease. For colorectal cancer, the chances of cure increase greatly with early detection measures.
Prevention
Measures to prevent chronic diarrhea do not exist.There is only the possibility of preventing individual clinical pictures in which the diarrhea occurs. In addition to avoiding stress, this includes above all a healthy and varied diet. In addition, especially to avoid infections, attention should be paid to appropriate hygiene in sanitary facilities.
What you can do yourself
For chronic diarrhea, various self-help measures can be resorted to. The cause of the chronic diarrhea should always be considered. If a food intolerance is the cause of chronic diarrhea, a diet can relieve the symptoms. In the case of lactose intolerance, lactose should be avoided as far as possible. In the case of gluten intolerance, foods containing gluten such as bread, cereals, pasta, cakes and beer should be avoided. Patients with chronic diarrhea should change their diet to a predominantly high-fiber diet. In addition, adequate fluid intake (at least two liters a day) is recommended. Alcohol, coffee and nicotine should not be consumed at all or only in small amounts. Instead of a sumptuous dinner, it is better to eat several meals spread throughout the day. In general, those affected should take enough time to eat and chew their food carefully. Herbal teas can also provide relief from chronic diarrhea. St. John’s wort, raspberry or blackberry leaves have an anti-inflammatory and drying effect. Chamomile tea can also be very soothing. Regular exercise is important for patients with chronic diarrhea. In addition, stress in professional and private life should be avoided as much as possible. Exercises to reduce stress, such as autogenic training, yoga or progressive muscle relaxation, provide psychological balance and help to get chronic diarrhea under control.
