General Practice 2022

Chronic diarrhea: 8 main causes (and what to do)

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Chronic diarrhea: 8 main causes (and what to do)
Chronic diarrhea: 8 main causes (and what to do)

Chronic diarrhea is one in which the increase in the number of bowel movements per day and the softening of the stool lasts for a period greater than or equal to 4 weeks and which can be caused by microbial infections, food intolerance, intestinal inflammation or use of medication.

To identify the cause of chronic diarrhea and start appropriate treatment, the person should go to the gastroenterologist so that the symptoms are evaluated and tests are requested that can help in the identification of the cause. and blood tests.

Chronic diarrhea occurs as a result of irritation in the gastrointestinal system that can be caused by several causes, the main ones being:

1. Food intolerances or allergies

Some intolerances such as lactose or gluten, or milk protein allergy, can cause irritation and inflammation in the intestine and result in chronic diarrhea, as the diagnosis of this type of condition can take time. In addition, depending on the cause, other symptoms associated with diarrhea may appear.

What to do: It is important to consult the gastroenterologist so that an evaluation of the symptoms is carried out and that tests are carried out, such as a blood test, determination of IgE antibodies or antigliadins, skin and stool tests. In addition, the oral provocation test can also be performed, which consists of the ingestion of the food that is suspected of intolerance or allergy and then it is observed if any symptoms appear.

2. Intestinal infections

Some intestinal infections caused by parasites such as giardiasis, amoebiasis or ascariasis, for example, as well as infections by bacteria and viruses, mainly rotavirus, can cause chronic diarrhea when not detected quickly.In general, intestinal infections can also cause other symptoms such as abdominal pain, increased gas production, fever, vomiting, among others.

What to do: In general, treatment for intestinal infections consists of rest, hydration with homemade saline or oral rehydration serums, and eating easily digestible foods. However, depending on the cause of the infection, the doctor may also indicate the use of drugs to combat the infectious agent, and antibiotics or antiparasitics may be indicated.

Therefore, if the symptoms persist for more than 3 days or if a high fever or blood in the stools is observed, it is important to consult the gastroenterologist or general practitioner so that the symptoms are evaluated and the most appropriate treatment is indicated. adequate. See more details of treatment for intestinal infection.

3. Irritable Bowel Syndrome

Irritable bowel syndrome is a disease in which inflammation of the intestinal villi is verified, which can cause chronic diarrhea, excess gas, pain and abdominal inflammation.These symptoms may vary according to their intensity, and may appear from one moment to another, remain for a period and then disappear.

What to do: It is important in these cases to look for a gastroenterologist so that it is possible to arrive at the diagnosis by evaluating the symptoms and performing some tests such as colonoscopy, computed tomography and stool examination.

In general, the treatment consists of a specific diet, low in fat and sugars, and, in some cases, the doctor may also indicate the use of some medications. See more details on treatment for irritable bowel syndrome.

4. Use of some medications

There are some drugs that can alter bacterial flora, intestinal motility and intestinal villi, resulting in a laxative effect and leading to diarrhea as a side effect, which can cause this gastrointestinal upset due to toxicity when the drug is used at doses higher than recommended.

Some of these drugs are antibiotics, some antidepressants, drugs to treat cancer, antacids and proton pump inhibitors, such as omeprazole and lansoprazole, among others.

What to do: If diarrhea is caused by antibiotics, the best way to fight the symptoms is with the consumption of probiotics, a supplement that can be found in pharmacies and which contains bacteria responsible for regulating intestinal functioning.

In case it is caused by other medications, it is best to consult the doctor who prescribed the medication and report the side effect. In addition, it is also important to have an easily digestible diet and stay hydrated to improve diarrhea.

5. Intestinal diseases

Diseases of the intestine, such as Crohn's disease, ulcerative colitis, enteritis or celiac disease, can also cause chronic diarrhea, as they produce chronic inflammation in the intestine causing not only diarrhea but also others symptoms according to the disease present.

What to do: In these cases, it is recommended to consult the gastroenterologist so that an evaluation can be carried out and diagnostic tests can be indicated to identify the disease and start the most appropriate treatment. In addition, once the diagnosis is obtained, it is important to consult a nutritionist, as food plays a fundamental role in relieving the symptoms associated with this type of disease.

See the following video for some bowel diseases that can cause diarrhea:

6. Pancreas diseases

In diseases of the pancreas, such as pancreatic insufficiency, chronic pancreatitis or in cases of pancreatic cancer, this organ has difficulties to produce or transport sufficient amounts of digestive enzymes to allow digestion and subsequent absorption of food in the intestine. This causes changes mainly in the absorption of fats, causing chronic diarrhea, which can be pasty, shiny or greasy.

What to do: In these cases, it is important to consult a nutritionist to prepare a nutritional plan adapted to the person's conditions, which will improve the absorption of nutrients, avoid weight loss and eventual malnutrition and alleviate the discomfort that these diseases can cause.

In addition, it is possible that supplementation of some vitamins and minerals is necessary, whose absorption was impaired by the frequency of liquid bowel movements, in addition to being indicated by the doctor to pancreatin, which is a medication that replaces digestive enzymes and helps improve digestion and absorption of food, improving diarrhea.

7. Cystic fibrosis

Some genetic diseases can also cause changes in the tissue of the digestive tract, such as cystic fibrosis, a disease that affects the production of secretions from various organs, mainly in the lungs and intestine, causing them to be more thick and slimy, which can result in alternating periods of diarrhea and constipation.

In addition, other associated symptoms may appear, such as shortness of breath, persistent cough, frequent lung infections, fatty and foul-smelling stools, poor digestion, weight loss, among others.

What to do: In general, this genetic disease is identified at birth through the heel prick test, however it can also be detected by other genetic tests that identify the mutation responsible for this disease.

Cystic fibrosis treatment is usually done with the use of medication prescribed by the doctor, respiratory physiotherapy sessions and nutritional monitoring to control the disease and improve the person's quality of life.

8. Bowel cancer

Intestinal cancer can cause symptoms such as frequent diarrhea, weight loss, abdominal pain, tiredness and the presence of blood in the stool, which may vary according to the location of the cancer and its severity. Here's how to recognize the symptoms of bowel cancer.

What to do: If the person has these symptoms for more than 1 month, is over 50 years old or has a family history of bowel cancer, it is important to consult the gastroenterologist. The doctor will evaluate the symptoms and may recommend carrying out diagnostic tests, such as a stool test, colonoscopy or CT scan to identify the cancer and start the most appropriate treatment immediately afterwards.

How the treatment is done

To treat chronic diarrhea, initially, the doctor may indicate ways to prevent dehydration or malnutrition, providing guidelines on how to increase fluid consumption and daily food.

Next, definitive treatment is based on the cause of the diarrhea, which may include the use of antibiotic or deworming drugs to treat infections, removal of drugs that may have a laxative effect, or drugs with anti-inflammatory effects for illnesses autoimmune, for example.

What to eat in chronic diarrhea

When you have chronic diarrhea, it is important to look for a nutritionist to not only adapt the diet to the underlying disease, but also to assess the need to start using nutritional supplements to help maintain or regain weight, as well as such as the intake of vitamins and minerals, if necessary.

It is important that food is easily digested and absorbed, and may include:

  • Soups and purees of cooked vegetables, which do not stimulate the intestines, such as pumpkin, carrot, zucchini, chayote, potato, sweet potato;
  • Green banana and cooked or baked fruit such as apple, peach or pear;
  • Rice or corn porridge;
  • Boiled rice;
  • White meats cooked or grilled, such as chicken or turkey;
  • Boiled or grilled fish.

In addition, it is essential to drink about 2 liters of liquids a day such as water, tea, coconut water or strained fruit juices, and take homemade serum or oral rehydration serum that can be found in pharmacies.These serums should be taken immediately after each bowel movement, about the same amount as fluid loss, this will prevent mineral loss and dehydration.

Check out, in the following video, guidelines from our nutritionist with some tips on what to do to stop diarrhea

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