DIARRHEA:

What is it?

Diarrhea is defined as an increase in frequency, fluidity and volume of bowel movements. It is

usually loose, watery stools occurring more than three times in one day. It is a common symptom
and usually goes away by itself in a day or so.

OR

Diarrhea--loose, watery stools occurring more than three times in one day--is a common problem
that usually lasts a day or two and goes away on its own without any special treatment. However,
prolonged diarrhea can be a sign of other problems. People with diarrhea may pass more than a
quart of stool a day.

What causes diarrhea?

Diarrhea may be caused by a temporary problem, like an infection, or a chronic problem, like an
intestinal disease. A few of the more common causes of diarrhea are:
• Bacterial infections: Several types of bacteria, consumed through contaminated food or water,
can cause diarrhea. Common culprits include Campylobacter, Salmonella, Shigella, and
Escherichia coli.
• Viral infections: Many viruses cause diarrhea, including rotavirus, Norwalk virus,
cytomegalovirus, herpes simplex virus, and viral hepatitis.
• Food intolerances: Some people are unable to digest some component of food, such as
lactose, the sugar found in milk.
• Parasites: Parasites can enter the body through food or water and settle in the digestive
system. Parasites that cause diarrhea include Giardia lamblia, Entamoeba histolytica, and
Cryptosporidium.
• Reaction to medicines: such as antibiotics, blood pressure medications, and antacids
containing magnesium.
• Intestinal diseases, like inflammatory bowel disease or celiac disease.

Some foods that can cause or make diarrhea worse:

• High fiber foods.

• Spicy, fatty or fried food.
• Food that is too hot or cold.
• Milk and dairy products.
• Alcohol.
• Drinks or foods with caffeine such as coffee, tea, colas or chocolate.
• Nutritional supplements such as Ensure or Boost. If you use a supplement and notice more
diarrhea, talk to your nurse, dietitian or doctor.
Signs & symptoms:

1) High fever
2) Rectal pain
3) Significant abdominal pain
4) Signs of dehydration (dry mouth, excessive thirst, exhaustion)
5) Frequent, loose, watery stools
6) Abdominal cramps
7) Abdominal pain
8) Blood in the stool
9) Bloating

Types of diarrhea:

Secretory:

Secretory diarrhea means that there is an increase in the active secretion, or there is an inhibition
of absorption. There is little to no structural damage. The most common cause of this type of
diarrhea is a cholera toxin that stimulates the secretion of anions, especially chloride ions.
Therefore, to maintain a charge balance in the lumen, sodium is carried with it, along with water.
In this type of diarrhea intestinal fluid secretion is isotonic with plasma even during fasting.It
continues even when there is no oral food intake.

Osmotic:

Osmotic diarrhea occurs when too much water is drawn into the bowels. This can be the result of
maldigestion (e.g., pancreatic disease or celiac disease), in which the nutrients are left in the
lumen to pull in water. Osmotic diarrhea can also be caused by osmotic laxatives (which work to
alleviate constipation by drawing water into the bowels). In healthy individuals, too much
magnesium or vitamin C or undigested lactose can produce osmotic diarrhea and distention of
the bowel. A person who has lactose intolerance can have difficulty absorbing lactose after an
extraordinarily high intake of dairy products. In persons who have fructose malabsorption,
excess fructose intake can also cause diarrhea. High-fructose foods that also have a high glucose
content are more absorbable and less likely to cause diarrhea. Sugar alcohols such as sorbitol
(often found in sugar-free foods) are difficult for the body to absorb and, in large amounts, may
lead to osmotic diarrhea.Osmotic diarrhea stops when offending agent (e.g. milk, sorbitol) is
stopped.

Exudative:

Exudative diarrhea occurs with the presence of blood and pus in the stool. This occurs with
inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis, and other severe
infections such as E. coli or other forms of food poisoning.
Motility-related:

Motility-related diarrhea is caused by the rapid movement of food through the intestines
(hypermotility). If the food moves too quickly through the gastrointestinal tract, there is not
enough time for sufficient nutrients and water to be absorbed. This can be due to a vagotomy or
diabetic neuropathy, or a complication of menstruation Hyperthyroidism can produce
hypermotility and lead to pseudodiarrhea and occasionally real diarrhea. Diarrhea can be treated
with antimotility agents (such as loperamide). Hypermotility can be observed in people who have
had portions of their bowel removed, allowing less total time for absorption of nutrients.

Inflammatory:

Inflammatory diarrhea occurs when there is damage to the mucosal lining or brush border, which
leads to a passive loss of protein-rich fluids, and a decreased ability to absorb these lost fluids.
Features of all three of the other types of diarrhea can be found in this type of diarrhea. It can be
caused by bacterial infections, viral infections, parasitic infections, or autoimmune problems
such as inflammatory bowel diseases. It can also be caused by tuberculosis, colon cancer, and
enteritis.

Dysentery:

Generally, if there is blood visible in the stools, it is not diarrhea, but dysentery. The blood is
trace of an invasion of bowel tissue. Dysentery is a symptom of, among others, Shigella,
Entamoeba histolytica, and Salmonella.

Different method used for the treatment of diarrhea:

Following are the some methods used for the treatment of diarrhea.

1) Probiotics
2) Medicines
3) Diet and food
4) Home treatment method

I will discuss treatment of diarrhea through probiotics.

What is Probiotics?
Probiotics are live microorganisms (in most cases, bacteria) that are similar to beneficial
microorganisms found in the human gut. They are also called “friendly bacteria” or “good
bacteria.” Probiotics are available to consumers mainly in the form of dietary supplements and
foods. They can be used as complementary and alternative medicine.

Probiotics are available in foods and dietary supplements (for example, capsules, tablets, and
powders) and in some other forms as well. Examples of foods containing probiotics are yogurt,
fermented and unfermented milk, miso, tempeh, and some juices and soy beverages. In
probiotic foods and supplements, the bacteria may have been present originally or added during
preparation.

Most probiotics are bacteria similar to those naturally found in people’s guts, especially in those
of breastfed infants (who have natural protection against many diseases). Most often, the bacteria
come from two groups, Lactobacillus or Bifidobacterium. Within each group, there are different
species (for example, Lactobacillus acidophilus and Bifidobacterium bifidus), and within each
species, different strains (or varieties). A few common probiotics, such as Saccharomyces
boulardii, are yeasts, which are different from bacteria.

Some probiotic foods date back to ancient times, such as fermented foods and cultured milk
products. Interest in probiotics in general has been growing.

Uses for Health Purposes :

There are several reasons that people are interested in probiotics for health purposes.

First, the world is full of microorganisms (including bacteria), and so are people’s bodies—in
and on the skin, in the gut, and in other orifices. Friendly bacteria are vital to proper development
of the immune system, to protection against microorganisms that could cause disease, and to the
digestion and absorption of food and nutrients. Each person’s mix of bacteria varies. Interactions
between a person and the microorganisms in his body, and among the microorganisms
themselves, can be crucial to the person’s health and well-being.

This bacterial “balancing act” can be thrown off in two major ways:

1. By antibiotics, when they kill friendly bacteria in the gut along with unfriendly bacteria. Some
people use probiotics to try to offset side effects from antibiotics like gas, cramping, or
diarrhea. Similarly, some use them to ease symptoms of lactose intolerance—a condition in
which the gut lacks the enzyme needed to digest significant amounts of the major sugar in
milk, and which also causes gastrointestinal symptoms.
2. “Unfriendly” microorganisms such as disease-causing bacteria, yeasts, fungi, and parasites can
also upset the balance. Researchers are exploring whether probiotics could halt these
unfriendly agents in the first place and/or suppress their growth and activity in conditions
like:
• Infectious diarrhea
• Irritable bowel syndrome
• Inflammatory bowel disease (e.g., ulcerative colitis and Crohn’s disease)
• Infection with Helicobacter pylori (H. pylori), a bacterium that causes most ulcers and
many types of chronic stomach inflammation
• Tooth decay and periodontal disease
• Vaginal infections
• Stomach and respiratory infections that children acquire in daycare
• Skin infections.

Another part of the interest in probiotics stems from the fact there are cells in the digestive tract
connected with the immune system. One theory is that if you alter the microorganisms in a
person’s intestinal tract (as by introducing probiotic bacteria), you can affect the immune
system’s defenses.

Uses of probiotics:

1) To treat diarrhea (this is the strongest area of evidence, especially for diarrhea from
rotavirus)
2) To prevent and treat infections of the urinary tract or female genital tract
3) To treat irritable bowel syndrome
4) To reduce recurrence of bladder cancer
5) To shorten how long an intestinal infection lasts that is caused by a bacterium called
Clostridium difficile
6) To prevent and treat pouchitis (a condition that can follow surgery to remove the colon)
7) To prevent and manage atopic dermatitis (eczema) in children

Some Other Points To Consider

1) If you are thinking about using a probiotic product as CAM, consult your health care
provider first. No CAM therapy should be used in place of conventional medical care or to delay
seeking that care.
2) Effects from one species or strain of probiotics do not necessarily hold true for others, or
even for different preparations of the same species or strain.
3) If you use a probiotic product and experience an effect that concerns you, contact your
health care provider.