Diarrhea – Diagnosis and Treatment
Diagnosis
Doctors usually start by asking about your health history, medications, and then do a physical exam.
They often order blood tests to check for electrolyte imbalances, kidney issues, or signs of inflammation that could hint at ulcerative colitis or Crohn’s disease.
If symptoms linger or seem unusual, they might run a stool test to look for parasites or bacteria like Escherichia coli, Shigella, or even cholera.
People who get bloated or have watery stools after dairy might need a hydrogen breath test to see if lactose intolerance or another carb issue is the culprit.
When doctors suspect something chronic, like inflammatory bowel disease, microscopic colitis, or even colon cancer, they often recommend a peek inside with a flexible sigmoidoscopy or colonoscopy. These tools can grab tissue samples too.
If they think the upper digestive tract is involved, like with celiac disease, an upper endoscopy lets them look at the stomach and upper small intestine.
They can take small biopsies if needed. Sometimes, youâll need imaging tests to rule out other conditions.
All these results help doctors tell if the diarrhea is acute or chronic, and figure out if itâs caused by food intolerance, an infection like viral gastroenteritis, or something more complicated like malabsorption or malnutrition.
Common assessment tools:
| Test Type | What It Checks For |
|---|---|
| Blood Tests | Infection, kidney problems, anemia |
| Stool Tests | Bacteria, viruses, parasites |
| Breath Tests | Lactose or carbohydrate intolerance |
| Colonoscopy/Sigmoidoscopy | Chronic diseases, inflammation |
| Upper Endoscopy | Celiac disease, upper gut issues |
These tests help spot risks like bloody stools, fatigue, belly pain, and conditions that raise your risk, such as HIV, contaminated food, or not having clean water.
Treatment
Medicines for Bacterial or Parasitic Infections
Sometimes, bacteria or parasites cause diarrhea. In these cases, doctors may prescribe antibiotics or antiparasitic medications. Antibiotics only help if bacteria are to blame, and antiparasitic drugs only work if a parasite shows up in tests.
Most mild or viral cases donât need these medicines, so doctors usually skip them unless theyâre sure.
Key Points:
- Antibiotics wonât help with viruses.
- Tests can guide if medicine is needed.
- Not all bacterial causes need antibiotics.
Restoring Fluids and Electrolytes
Diarrhea can really dry you out and drain your body of minerals like sodium and potassium. Staying hydrated is crucial. Adults should drink water, broth, or drinks with added electrolytes.
Kids often do best with oral rehydration solutions (ORS), which replace both fluids and minerals.
| Fluid Type | Electrolytes Replaced | Best For |
|---|---|---|
| Water | None | Mild cases |
| Juice (except apple) | Potassium | Additional aid |
| Broth | Sodium | Salt replacement |
| ORS (like Pedialyte) | Sodium, Potassium | Children & adults |
If you canât keep fluids down or vomiting wonât stop, you might need IV fluids.
Other support options:
- Zinc supplements can help kids recover faster.
- Avoid juices like apple juiceâthey can sometimes make things worse.
Changing Current Medications
Some medications, including antibiotics or cancer drugs, can trigger diarrhea. If that happens, the doctor may switch you to something else or lower the dose. Itâs important to review your meds with your doctor if things arenât getting better.
Common adjustments:
- Switching medication types
- Lowering the dose
- Pausing certain treatments if itâs safe
Managing Conditions That Cause Diarrhea
If a chronic illness like inflammatory bowel disease is behind your diarrhea, doctors focus on controlling that condition. Sometimes, a gastroenterologist steps in to help build a treatment plan.
Treatment options might include:
- Anti-diarrheal drugs like loperamide
- Bismuth subsalicylate for calming symptoms
- Ongoing treatment for the underlying disease
This way, you target the root problemânot just the symptoms.
Everyday Tips and Simple Remedies
Most people can handle diarrhea at home with a few simple steps. Hydration is key, so drink plenty of water, clear broths, and diluted juices. Skip caffeinated and alcoholic drinksâtheyâll just make dehydration worse.
When youâre ready to eat again, stick with easy foods. The BRAT dietâbananas, rice, applesauce, and toastâis a classic. Plain crackers, eggs, or skinless chicken are also gentle on your stomach.
Hold off on high-fiber foods, spicy meals, greasy foods, and dairy until youâre back to normal.
Try easing back into eating:
| Step | Foods to Choose | Foods to Avoid |
|---|---|---|
| Start with liquids | Water, broth, clear juices | Coffee, soda, alcohol |
| Add bland foods | Bananas, toast, rice, applesauce, boiled potatoes | Dairy, high-fiber, fried foods |
| Return to regular | Lean meats, cooked vegetables | Highly seasoned or spicy foods |
Nonprescription meds like loperamide or bismuth subsalicylate can slow things down, but they arenât for everyone. Theyâre not always safe for kids or for certain infections.
Itâs smart to check with a healthcare provider before using any laxatives or over-the-counter meds.
Adding probiotics might help balance your gut bacteria. Youâll find them in capsules, liquids, and some yogurts, but how well they work depends on the type and dose.
Washing hands often and eating safe foods also go a long way in preventing diarrhea and keeping your gut healthy.
Getting Ready for Your Visit
Steps You Can Take
You can make your appointment go more smoothly by doing a few things ahead of time:
- Check if You Should Prepare: Call the office to see if you need to fast or do anything special before your visit.
- Track Symptoms: Jot down your symptoms, when they started, and any other changesâeven if they seem unrelated.
- List Important Personal Info: Make notes about big stresses, life changes, or recent travel that could affect your health.
- Make a Medication List: Write down every medicine, vitamin, or supplement you take. Donât forget the name and dose. If youâve taken antibiotics lately, include which ones and the dates.
- Prepare Your Questions: Bring questions for your doctor so you donât forget anything important. Hereâs a handy table:
| Question to Ask | Purpose |
|---|---|
| What could be causing my diarrhea? | Helps you understand possible reasons |
| Could any of my medicines be the reason? | Checks for side effects |
| What tests do I need? | Gets clarity on next steps |
| Is this a short or long-term problem? | Helps with planning for care |
| What treatments do you recommend? | Learn about options |
| Are there other treatments I could try? | Explore alternatives |
| Can I manage my other health problems with this? | Combines care steps |
| Are there foods or activities I should avoid? | Adjusts your daily routines |
| Can I try medicine like loperamide? | Addresses symptom control |
| Should I be referred to a specialist? | Considers expert opinions |
It helps to bring a notepad or use your phoneâs notes app.
Questions Your Healthcare Provider May Ask
During your visit, your healthcare team might ask:
- When did your symptoms start?
- How often do you have symptoms? Do they come and go, or are they constant?
- How bad are the symptoms?
- Has anything helped or made things worse?
- Do symptoms wake you up at night?
- Have you noticed blood in your stool, or black stools?
- Have you been around anyone else with diarrhea lately?
- Have you stayed in a hospital or care home recently?
- Have you taken antibiotics lately?
Try to answer honestlyâit helps them figure things out faster.
How to Care for Yourself While Waiting
You can do a few things before your appointment:
- Stay Hydrated: Drink water, clear juice, or broth to replace lost fluids.
- Avoid Foods that Upset Your Stomach: Skip fatty, high-fiber, or spicy foods.
- Rest: Give your body a break and let it recover.
These tips might make you more comfortable and could keep things from getting worse while you wait for more advice.
