Diarrhea is loose, watery stools three or more times a day. Diarrhea may be acute, persistent, or chronic
Diarrhea is a common problem. Acute diarrhea is more common than persistent or chronic diarrhea. Researchers estimate that about 179 million cases of acute diarrhea occur in the United States each year.1
Diarrhea may cause dehydration, which means your body lacks enough fluid and electrolytes to work properly. Your body loses more fluid and electrolytes in loose stools than solid stools. See a list of the symptoms of dehydration.
Diarrhea may cause malabsorption. If people do not absorb enough nutrients from the food they eat, they may become malnourished. Certain conditions that cause chronic diarrhea—such as infections, food allergies and intolerances, and certain digestive tract problems—may also cause malabsorption. See a list of the symptoms of malabsorption.
The main symptom of diarrhea is passing loose, watery stools three or more times a day.
People with diarrhea may also have one or more of the following symptoms:
People with diarrhea caused by some infections may also have one or more of the following symptoms:
Diarrhea may cause dehydration and malabsorption.
Dehydration and malabsorption can be serious complications of diarrhea. Their symptoms in adults, infants, toddlers, and young children are as follows.
Symptoms of dehydration in adults may include:
Signs of dehydration in infants, toddlers, and young children may include
Symptoms of malabsorption in adults may include
Symptoms of malabsorption in infants, toddlers, and young children may include
Diarrhea can become dangerous if it leads to severe dehydration. Diarrhea may also signal a more serious problem.
Adults with any of the following symptoms should see a doctor right away:
Older adults and adults with weakened immune systems or other health conditions who have diarrhea should also see a doctor right away.
The parent or caretaker of an infant, toddler, or young child with diarrhea and any of the following symptoms should seek a doctor's care right away:
Acute and persistent diarrhea may have causes that are different from those of chronic diarrhea. In many cases, doctors do not find the cause of diarrhea. Most diarrhea goes away on its own within 4 days, and finding the cause is not necessary.
The most common causes of acute and persistent diarrhea are infections, travelers' diarrhea, and side effects of medicines.
Three types of infections that cause diarrhea include
Many viruses cause diarrhea, including norovirus and rotavirus. Viral gastroenteritis is a common cause of acute diarrhea.
Several types of bacteria can enter your body through contaminated food or water and cause diarrhea. Common bacteria that cause diarrhea include Campylobacter, Escherichia coli (E. coli), Salmonella, and Shigella.
Parasites can enter your body through food or water and settle in your digestive tract. Parasites that cause diarrhea include Cryptosporidium enteritis, Entamoeba histolytica, and Giardia lamblia.
Infections in the digestive tract that spread through foods or drinks are called foodborne illnesses.
Infections lasting more than 2 weeks and less than 4 weeks can cause persistent diarrhea.
Travelers' diarrhea is caused by eating food or drinking water contaminated with bacteria, viruses, or parasites. Travelers' diarrhea is most often acute. However, some parasites cause diarrhea that lasts longer. Travelers' diarrhea can be a problem for people traveling to developing countries.
Many medicines may cause diarrhea. Medicines that may cause diarrhea include antibiotics, antacids containing magnesium, and medicines used to treat cancer.
Some infections, food allergies and intolerances, digestive tract problems, abdominal surgery, and long-term use of medicines can cause chronic diarrhea.
Some infections from bacteria and parasites that cause diarrhea do not go away quickly without treatment. Also, after an infection, people may have problems digesting carbohydrates such as lactose or proteins in foods such as cow's milk, milk products, or soy. Problems digesting carbohydrates or proteins can prolong diarrhea.
Allergies to foods such as cow's milk, soy, cereal grains, eggs, and seafood may cause chronic diarrhea.
Lactose intolerance is a common condition that may cause diarrhea after eating foods or drinking liquids that contain milk or milk products.
Fructose intolerance is a condition that may cause diarrhea after eating foods or drinking liquids that contain fructose, a sugar found in fruits, fruit juices, and honey. Fructose is added to many foods and soft drinks as a sweetener called high-fructose corn syrup.
Sugar alcohols such as sorbitol, mannitol, and xylitol may cause diarrhea in some people. Sugar-free candies and gum often include these sugar alcohols.
Digestive tract problems that may cause chronic diarrhea include
You may develop chronic diarrhea after abdominal surgery. Abdominal surgery is an operation on the appendix, gallbladder, large intestine, liver, pancreas, small intestine, spleen, or stomach.
Medicines that must be taken for a long time may cause chronic diarrhea. Some medicines, such as antibiotics, can change the normal gut flora and increase your chances of infection with Clostridium difficile, a bacterium that can cause chronic diarrhea.
Doctors do not typically need to find a cause of acute diarrhea. If your diarrhea lasts longer than 4 days or you have symptoms such as fever or bloody stools, your doctor may need to find the cause. Your doctor may use information from your medical and family history, a physical exam, or tests to find the cause of your diarrhea.
Your doctor will ask for information about your symptoms, such as
Your doctor will ask about the foods you eat and the beverages you drink. If your doctor suspects you have a food allergy or intolerance, he or she may recommend that you change what you eat to see if your symptoms improve.
Your doctor will also ask about
Your doctor may ask whether anyone in your family has a history of conditions that cause chronic diarrhea, such as celiac disease, Crohn's disease, irritable bowel syndrome, lactose intolerance, and ulcerative colitis.
During a physical exam, your doctor may
Sometimes, doctors perform a digital rectal exam. Your doctor will have you bend over a table or lie on your side while holding your knees close to your chest. After putting on a glove, the doctor will slide a lubricated finger into your anus to check for blood in your stool.
Your doctor may use the following tests to help find the cause of your diarrhea.
Stool tests can show the presence of blood, bacteria, or parasites; or signs of diseases and disorders. A health care professional will give you a container for catching and storing the stool. You will receive instructions on where to send or take the container for analysis.
A health care professional may take a blood sample to test for certain diseases or disorders that can cause diarrhea.
This test is used to diagnose lactose intolerance by measuring the amount of hydrogen in your breath. Normally, little hydrogen is detectable in your breath. With lactose intolerance, undigested lactose produces high levels of hydrogen in your breath.
For this test, you will drink a beverage that contains a known amount of lactose. You will then breathe into a balloon-type container that measures your breath hydrogen level. If the hydrogen level is high, your doctor will diagnose lactose intolerance.
To find out if a food intolerance or allergy is causing your diarrhea, your doctor may ask you to avoid foods with lactose, carbohydrates, wheat, or other ingredients to see whether your diarrhea responds to a change in diet.
Your doctor may use endoscopy to look inside your body to help find the cause of your diarrhea. Endoscopic procedures include
In most cases, you can treat your acute diarrhea with over-the-counter medicines such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol, Kaopectate). Doctors generally do not recommend using over-the-counter medicines for people who have bloody stools or fever—signs of infection with bacteria or parasites. If your diarrhea lasts more than 2 days, see a doctor right away.
When you have acute diarrhea, you may lose your appetite for a short time. When your appetite returns, you can go back to eating your normal diet. Learn more about eating when you have diarrhea.
Over-the-counter medicines to treat acute diarrhea in adults can be dangerous for infants, toddlers, and young children. Talk to a doctor before giving your child an over-the-counter medicine. If your child's diarrhea lasts more than 24 hours, see a doctor right away.
You can give your child his or her usual age-appropriate diet. You can give your infant breast milk or formula as usual.
How doctors treat persistent and chronic diarrhea depends on the cause. Doctors may prescribe antibiotics and medicines that target parasites to treat bacterial or parasitic infections. Doctors may also prescribe medicines to treat some of the conditions that cause chronic diarrhea, such as Crohn's disease, irritable bowel syndrome, or ulcerative colitis. How doctors treat chronic diarrhea in children also depends on the cause.
Doctors may recommend probiotics . Probiotics are live microorganisms, most often bacteria, that are similar to microorganisms you normally have in your digestive tract. Researchers are still studying the use of probiotics to treat diarrhea.
For safety reasons, talk with your doctor before using probiotics or any other complementary or alternative medicines or practices. If your doctor recommends probiotics, talk with him or her about how much probiotics you should take and for how long.
You can prevent certain types of diarrhea, such as those caused by infections—including rotavirus and traveler's diarrhea—and foodborne illnesses.
You can reduce your chances of getting or spreading infections that can cause diarrhea by washing your hands thoroughly with soap and warm water for 15 to 30 seconds
Rotavirus, which causes viral gastroenteritis, was the most common cause of diarrhea in infants before rotavirus vaccines became available. The vaccines have reduced the number of cases of rotavirus and hospitalizations due to rotavirus among children in the United States.1
Two oral vaccines are approved to protect children from rotavirus infections:
For the rotavirus vaccine to be effective, infants should receive all doses by 8 months of age. Infants 15 weeks of age or older who have never received the rotavirus vaccine should not start the series.
Parents or caregivers of infants should discuss rotavirus vaccination with a doctor.
To reduce the chances of getting travelers' diarrhea when traveling to developing countries, avoid
You can drink bottled water, soft drinks, and hot drinks such as coffee or tea made with boiling water.
If you are worried about travelers' diarrhea, talk with your doctor before traveling. Doctors may recommend taking antibiotics before and during a trip to help prevent travelers' diarrhea. Early treatment with antibiotics can shorten a case of travelers' diarrhea.
You can prevent foodborne illnesses that cause diarrhea by properly storing, cooking, cleaning, and handling foods.
To treat or prevent dehydration, you need to replace lost fluids and electrolytes—called rehydration therapy—especially if you have acute diarrhea. Although drinking plenty of water is important in treating and preventing dehydration, you should also drink liquids that contain electrolytes, such as the following:
If you are an older adult or have a weak immune system, you should also drink oral rehydration solutions, such as Pedialyte, Naturalyte, Infalyte, or CeraLyte. Oral rehydration solutions are liquids that contain glucose and electrolytes. You can make oral rehydration solutions at home (PDF, 90KB) .
To treat or prevent dehydration, give your child liquids that contain electrolytes. You can also give your child an oral rehydration solution, such as Pedialyte, Naturalyte, Infalyte, or CeraLyte, as directed. Talk to a doctor about giving these solutions to your infant.
If you have diarrhea, you may lose your appetite for a short time. In most cases, when your appetite returns, you can go back to eating your normal diet. Parents and caretakers should give children with diarrhea their usual age-appropriate diet and give infants breast milk or formula.
Your doctor may recommend changing your diet to treat some causes of chronic diarrhea, such as lactose intolerance or celiac disease.
You should avoid foods that may make your diarrhea worse, such as
Research shows that following a restricted diet does not help treat diarrhea in most cases. Most experts do not recommend fasting or following a restricted diet when you have diarrhea.