diarrhea and its treatment

"by Diane K. Newman, RNC, MSN, CRNP, FAAN

Most individuals will have a "diarrhea" attack for maybe 1 or 2 days each year. These attacks are the passage of frequent, watery bowel movements. The symptoms disappear quickly and are more an inconvenience than an illness, but in certain cases, diarrhea may persist for days, weeks and even months and may be caused by a major disorder. If this occurs, you may have viral or bacterial diarrhea due to exposure to the flu, a virus, or food poisoning.

Diarrhea can be caused by an infectious process and raises particular concern in the institutional setting, such as hospitals or nursing homes, where an infection may spread among the resident population. Usually the Clostridium difficile bacteria, which causes diarrhea, is treated effectively with medications.

Another cause of diarrhea, especially in the older adult, is laxative abuse. Regular, frequent use of laxatives disrupts the nerves to the colon, dulling the sensation for bowel elimination. Natural emptying mechanisms fail to work as the body becomes dependent on laxatives and enemas. Symptoms such as abdominal cramping, frequent passage of thin, watery stool, change in color and odor of stool, nausea and vomiting and even fever may occur. If your doctor feels that your diarrhea is from an infection, you may be asked to have your stool checked for bacteria. This test is called a stool culture. Prolonged diarrhea can cause skin irritation and breakdown around your anal area. You should clean this area after each movement with mild soap and water, pat it dry, and apply petroleum jelly or some type of cream. Good skin care protects the skin and helps relieve discomfort.

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Treatment

Establish a bowel regimen of fiber to add bulk to decrease the amount and frequently of watery liquid. Fiber's function is to bind with water in the intestine to form a gel. This prevents its overabsorption from the large bowel and insures that the fecal content of the large bowel is both bulky and soft.
Avoid eating foods that contain caffeine (tea, coffee, chocolate.) Caffeine consumption causes an increase of fluid secretion in the intestine, thus increasing amount of diarrhea.
Talk with your doctor or nurse about the medications you are taking. Some cause diarrhea. Use of antacids containing magnesium and antibiotics may result in development of diarrhea.

References

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Last updated February 2003