Diarrhea and the sudden onset of passing loose motion are common occurrences in our daily lives. According to the World Health Organisation (WHO), diarrhea occurs when one passes three or more watery stools in a day. As stool frequency varies among individuals, it can also be understood as more frequent stools depending on what is the normal frequency in an individual. A simple guide to determine if you have normal or watery stools is by looking at the Bristol Stool Chart. If your stools are mushy with ragged edges or have a liquid consistency with no solid pieces, then you likely have diarrhea. While it is not commonly recommended to stop diarrhea using medications, there are several treatments available for severe diarrhea. Visit Doctoroncall for more information.
Before we dive into the treatment for diarrhea, it is useful to determine the cause. Diarrhea can be caused by a variety of bacterial, viral, or parasitic organisms. Travelers’ diarrhea (TD), as its name suggests, is a travel-related illness where individuals ingest contaminated water or food while traveling. Food poisoning is the term used when groups of people get sick after the consumption of the same food or food from the same place. Rotavirus and Escherichia coli (E.coli) are the two commonest organisms known to cause diarrhea. Aside from contaminated food and water, the organisms that cause diarrhea can also be transmitted via poor personal hygiene, via the fecal-oral route, or even food stored in unhygienic conditions.
Rehydration Therapy
The most important treatment for diarrhea is to ensure adequate hydration, as one is losing a large amount of water through the loose motion. Symptoms of dehydration include lethargy, sunken eyes, and the feeling of thirst. The Oral Rehydration Salt solution (ORS) contains electrolytes such as sodium, potassium, chloride, and glucose, which work to replenish the fluids and electrolytes lost. It comes in a sachet and is given after every loose motion. For adults, it is recommended to take 1-2 sachets (in 200-400ml clean drinking water) after every loose stool. In children, half the dose is required – 1 sachet (200ml) after every loose motion. A homemade ORS can also be made using 1 liter of boiled then cooled water, 1 teaspoon of salt, and 8 teaspoons of sugar.
For individuals who experience severe dehydration and experience symptoms such as fainting or passing out, it is recommended to seek IV fluid therapy in healthcare settings.
Antimotility Agent
Loperamide is one of the most commonly used antipropulsive agents, as it works to decrease intestinal motility and reduce diarrhea. It is useful in treating Traveller’s diarrhea as it eases symptoms, but it is not commonly recommended in severe gastric infections otherwise known as invasive enteritis. Invasive enteritis presents with high fever, chills, bloody diarrhea, and abdominal pain. These agents may help the infectious organisms invade other organs as it stays longer in the gastrointestinal tract. Diphenoxylate is another common medication that also slows down the movement of the intestines.
Intestinal Absorbents
Medications such as activated charcoal and Pectin absorb the harmful substances released by the infectious organisms and aid in their excretion. Bismuth salicylate works similarly, with the additional benefit of reducing watery stools.
For travelers who developed bloody diarrhea and fever, it might indicate a bacterial infection, and antibiotic therapy may benefit. Studies have found that antibiotic therapy shortens the illness duration, which is ideal for travelers. The regime includes antibiotics such as Azithromycin, Ciprofloxacin, and Levofloxacin taken over three days. These antibiotics require a prescription, therefore it is recommended to seek advice from a healthcare provider before starting any of these medications.
There are many medications available for the treatment of diarrhea. In most cases, diarrhea occurs in a short duration and self-resolve before dehydration occurs. In severe cases of bloody diarrhea, antimotility agents are not recommended and may warrant treatment with antibiotics instead. Consult your healthcare provider before starting any of these medications.