It’s the topic that nobody likes talking about – and understandably so. But diarrhea can be a serious health problem and cause major disruption to one’s normal routine and lifestyle. Many people only become concerned about it when they’re traveling, especially to another country. However, diarrhea can happen anytime, anywhere, and as we age, we become more susceptible to it because of changes within our body and immune system. Here’s what you need to know. Diarrhea is defined as three or more watery or loose stools over a 24-hour period. Acute diarrhea usually occurs for a few days, while chronic diarrhea lasts four or more weeks. Its causes can be infectious or non-infectious sources. Acute diarrhea may have an infectious cause – viral, bacterial or parasitic. Fever is often present in viral or bacterial infections. Bacterial diarrhea may be bloody and require antibiotic therapy, while viral infections eventually improve on their own. Parasitic infections are uncommon in the US, but have been seen in patients who travel abroad. Non-infectious diarrhea may be either acute or chronic. Some common causes include medications such as antibiotics, herbs and dietary supplements. Antibiotic-associated diarrhea may resolve itself once the offending antibiotic is stopped. However, one may also develop C. difficile colitis (clostridium difficile) and require an oral antibiotic, either Flagyl or Vancomycin, to treat the underlying infection. People most at-risk for developing C. diff colitis are those who have been hospitalized recently or are older, have a weakened immune system, or have suffered previously from this infection.Food intolerances or allergies, such as lactose intolerance, may cause cramping or abdominal pain and gas-like discomfort soon after consumption of certain foods.Inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis, can also cause diarrhea. These types of chronic diarrhea usually are diagnosed in adolescence or early adulthood, but in rare instances, may occur at a later age as well. Typical symptoms include recurrent abdominal pain, diarrhea, weight loss and bouts of unexplained fever.Irritable bowel disease (IBS) is characterized by bouts of constipation or diarrhea or cyclic episodes of both. IBS is one of the most common causes of chronic diarrhea and can lead to cramping and lower abdominal pain.Celiac disease is a gluten-sensitivity disorder. Weight loss, diarrhea, gas and abdominal pain are common features. Avoiding foods with gluten is the only effective treatment.Both chronic and acute diarrhea can cause serious complications, such as dehydration. Drink adequate fluids even if you do not have an appetite. If you can tolerate food, boiled starches and cereals are good options. Consider anti-diarrheal medications (Imodium or Pepto-Bismol) as these may help control frequent bowel movements. These substances should not be taken for longer than four days or if diarrhea is bloody and accompanied by fever. Consult your physician promptly should diarrhea become bloody, last longer than four days or occur with nausea, vomiting or fever.Dr. Lucia Dattoma is a board-certified geriatrician with the UCLA Geriatrics Program, with offices in Santa Monica and Westwood. Info: 310.319.4371.
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