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Priyanka Chugh, MD, is a board-certified gastroenterologist in practice with Trinity Health of New England in Waterbury, Connecticut.
Diarrhea is a common problem that can come on suddenly or be a chronic complaint. Some possible causes of diarrhea include food poisoning, infections, food allergies or intolerances, and medication. There are also some conditions that cause chronic diarrhea that run in families or, rarely, have a genetic basis.
You can reduce your risk of acute diarrhea by learning good food safety and cleanliness habits, whether at home or while traveling.
The most common cause of diarrhea, especially that which starts suddenly (acute diarrhea), is an infection. This can be bacterial, viral, or parasitic and include:
Children are especially at risk for diarrhea as they tend to put objects in their mouths and may not have developed good handwashing habits.
Food poisoning occurs when you eat food that is contaminated with bacteria. The bacteria build up toxins in the food that make you sick.
Causes of food poisoning are poor sanitation, improper food handling, and food being stored at the wrong temperature.
Traveler’s diarrhea is caused by eating food or drinking water that is contaminated with bacteria or parasites. If you have diarrhea and recently traveled or drank untreated water from a stream, river, or pond (in the U.S. or elsewhere), call your healthcare provider.
Stomach flu, also known as gastroenteritis, is caused by a virus, but not the same that causes seasonal flu (influenza). Examples of viruses that can cause stomach flu are rotavirus and norovirus. Gastroenteritis also can be caused by a bacterium or a parasite.
Diarrhea that goes on for weeks or months may be caused by an infection, or it may be caused by an underlying medical condition or one of many other potential causes, some of which include the following:
If you have untreated celiac disease, you may have a hard time linking your symptoms with a specific food because your gut is damaged and you may experience symptoms all the time.
Symptoms of classic Ig-E mediated food allergy begin within minutes to hours of eating a trigger food. It is possible to be allergic to any food, but a few foods cause the most common food allergies.
Food intolerance is caused by a lack of the enzymes needed to digest a specific food. Lactose intolerance, the inability to digest the sugars in milk, is the most common, but it’s possible to be intolerant of other foods as well.
Infants usually show signs of protein intolerance within a few months of birth. Some infants may react to food proteins present in breastmilk while others may react to formulas based on either cow’s milk or soy.
Inflammatory bowel disease (IBD) includes Crohn’s disease and ulcerative colitis, both of which have chronic diarrhea as a symptom. Both are incurable chronic diseases of the digestive tract that may be treated with surgery or managed with medication.
Irritable bowel syndrome (IBS) describes chronic diarrhea, constipation, and abdominal pain that does not have a known disease as a cause.
The American College of Gastroenterology recommends that anyone diagnosed with IBS and diarrhea be tested for celiac disease.
Some medications, in particular antibiotics and chemotherapy, can cause diarrhea, as well as laxatives containing magnesium. You may have a reaction to the medication itself or an additive, such as a flavoring.
A medication may also alter the balance of bacteria in your gut, causing abdominal pain and diarrhea. Sometimes the cause of diarrhea is taking too many laxatives or longer-term abuse of laxatives.
Talk to your healthcare provider if you have diarrhea after starting a new medication.
There are congenital diarrheal disorders linked to specific genes. These disorders usually come on in the first few months of a child's life. They are often most common in certain populations, although congenital chloride diarrhea is one that appears worldwide.
Some other conditions that may cause chronic diarrhea also tend to run in families, including celiac disease, some forms of lactose intolerance, and food allergies.
A change to your diet, such as going on a mostly liquid diet, eating too much fiber, or eating spicy foods may lead to diarrhea.
Beyond examining and, perhaps, adjusting what you eat and rink, other habits and exposures can put you at greater risk for diarrhea:
The bacteria, viruses, and parasites that cause traveler's diarrhea and stomach flu are spread by contact with contaminated surfaces, food, and water. In the medical world, this is called the fecal-oral route. To reduce your risks, wash your hands well after using the bathroom, changing your child's diapers, and before eating. If you don't have access to soap and water, use an alcohol-based hand gel.
Never drink untreated water from a natural source, such as a stream. Even in developed countries, they can be contaminated with diarrhea-causing parasites spread by wildlife, such as Giardia.
When traveling to areas that have a higher risk of contaminated water and food, drink only bottled water and don't use ice unless it is from bottled or purified water. Avoid uncooked vegetables and fruits (unless they can be peeled), raw shellfish, undercooked meat, and dairy products.
Since food poisoning is often caused by improper food handling, it's wise to follow these tips outlined by the Centers for Disease Control and Prevention:
Diarrhea in adults typically goes away on its own, but if it lingers it can lead to dehydration (and related consequences like organ failure, seizures, or even death) or be a symptom of an underlying medical condition.
Seek medical care if you have any of the following:
Diarrhea can be particularly dangerous for infants and young children because dehydration can happen quickly. It's important to make sure your infant is feeding frequently if they have diarrhea and that you seek medical care immediately if your baby or young child has any of the following:
Do not give over-the-counter anti-diarrhea medications to infants or toddlers unless advised by your healthcare provider. These medications can quickly accumulate in young children’s bodies and become dangerous.
Diarrhea may be an inconvenience that is soon gone, or it can be a serious or long-lasting illness. When you have a bout, be sure you are drinking enough fluids and see your healthcare provider if it persists.
Diarrhea that comes on suddenly is typically caused by a bacterial, viral, or parasitic infection. Common sources of infection are food poisoning, traveler’s diarrhea, and viral gastritis, also known as the stomach flu.
Diarrhea that goes on for weeks or months can be caused by an infection, underlying medical condition, or certain foods. Celiac disease, food allergies or intolerances, medications, irritable bowel syndrome, or inflammatory bowel disease can all cause chronic diarrhea and should be evaluated by your healthcare provider.
Diarrhea that lasts more than two days for an adult or more than 24 hours in children should be seen by a healthcare provider. Other symptoms that warrant medical care when accompanying diarrhea include signs of dehydration, a fever of 102 degrees F or higher, frequent vomiting, six or more episodes of loose stools in 24 hours, severe abdominal or rectal pain, stools that are black and tarry, or blood or pus in the stools.
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