Diarrhoea is a condition of passing frequent stools; three or more in a day. The stools passed may be liquid, watery, or semiliquid. There may be no other symptom, or one may suffer from symptoms like abdominal pain, passing frothy stools, passing mucous and or blood in stools, nausea or vomiting, fever, and loss of appetite. While acute diarrhoea usually resolves in a few days, persistent or chronic diarrhoea usually signals a more serious condition. Treatment is aimed at replacing lost fluids and electrolytes with either oral solutions or intravenous fluids. Good hygiene is crucial for prevention. ALSO READ: The hidden risks of refrigerated food Diarrhoea is typically caused by infections from contaminated food and or water, which is the main cause of diarrhoea. Infections are the most common cause of acute diarrhoea. Infections can be bacterial, protozoal, worm infestation, or viral. ALSO READ: Why clean hands shouldn't be a crisis habit Heavy, fatty, and or very sugary foods can cause diarrhoea because the body has difficulty in digesting them and the extra load may not be removed in one go. Some individuals can develop diarrhoea due to an allergy to some food substances. Some antibiotics, anti-depressants, and anti-cancer drugs can cause diarrhoea as a side effect. ALSO READ: Diarrhoea: Why children are the most vulnerable Deficiency of vitamins D3, vitamin A, or zinc can cause recurrent diarrhoea. Overactivity of the thyroid gland is one of the causes of recurrent or chronic diarrhoea. Chronic diarrhoea can be due to diabetic autonomic neuropathy. Serious diseases of the bowel, like tuberculosis, malabsorption, Crohn’s disease, cancer, and others, manifest as chronic diarrhoea. Whatever the cause, diarrhoea causes discomfort and weakness. Cause is diagnosed on the basis of clinical history, relevant history. Treatment is based on the condition of the patient. Severity of symptoms, level of alertness, sense of weakness, and status of hydration are decisive factors regarding whether to give oral treatment or hospitalise for intravenous fluids. Acute diarrhoea usually does not need any medicines, except oral rehydration. The germs or toxins causing diarrhoea are usually eliminated in the stools, hence no other medicines are needed. Severe diarrhoea and or vomiting, severe abdominal pain, passing blood in stools, black tarry stools, high fever, is always an indication to go to any health facility for urgent treatment. For chronic diarrhoea, the underlying cause is identified by relevant investigations, and then it is treated. This helps to cure the disease. First aid includes giving oral rehydrating fluids in sips, like ORS solutions, juices (not orange juice), and weak tea. This helps to replace the lost fluids and electrolytes from the body. Soft foods like rice, bananas, chicken, and boiled eggs, in whatever quantity, can be consumed by the individual. As recovery occurs, gradually other foods can be included, but fatty, greasy food and caffeinated products should be avoided. Prevention is very useful to avoid diarrhoea. Prevention lies in good food and water hygiene. One should always wash hands thoroughly before cleaning, cooking, serving, and eating food. Anyone with diarrhoea should not do the cooking. Raw foods should be washed thoroughly. Green leafy vegetables need to be checked for worms very well before cooking, to ensure their cleanliness and avoid diarrhoea. Similarly, one should be very careful with milk and meat products, as their contamination carries a greater risk of causing infection and diarrhoea. If one has diarrhoea and there are no symptoms suggesting infection, test results are also negative, then food allergy should be suspected. One can observe from their diet if consuming a particular food item or items causes diarrhoea and remain comfortable by avoiding that substance. Mostly, proteins in food and chemicals present as food additives, colouring, flavouring agents, or preservatives, are likely to cause diarrhoea. Some precautionary measures can help prevent diarrhoea, and if it occurs, timely first aid and necessary treatment can prevent its aggravation. Dr Rachna Pande is a specialist in internal medicine.
