Diarrhea

How does digestion work?

Before we get into diarrhea, it is important to understand how our digestion works. Digestion begins in the mouth, where food is chewed and moistened by saliva. Saliva helps digest the food. It then travels to the esophagus, which moves the food to the stomach.

In the stomach, food is mixed with stomach acid and enzymes, which help digest the food. The stomach then kneads the food. Stomach acid, enzymes and food are called food pulp or chyme. The stomach passes the chyme in small amounts to the duodenum, which is part of the small intestine.

The duodenum contains the pancreas and the gallbladder. The pancreas secretes bicarbonate, which makes the acidic chyme from the stomach much less acidic. Otherwise, it could damage the intestines. The pancreas also secretes digestive enzymes. In addition, bile is added by the gallbladder. Bile helps to digest fats.

In the rest of the small intestine, nutrients and water are absorbed. The food pulp then continues to the large intestine. The food pulp encounters intestinal bacteria here that ensure that the last nutrients are absorbed. In addition, the food pulp is thickened and salts are also absorbed. The remaining waste products are stored in the form of feces until they are excreted via the anus.

This complex system normally works without problems, but sometimes it can go wrong.

What is diarrhea?

With diarrhea, there is an increase in the amount and frequency of feces. This is of course compared to normal bowel movements. The feces are also loose to watery, and it can be accompanied by abdominal pain, cramps and nausea. Normally, diarrhea is a temporary condition that disappears within a few days, but in some cases it can be more serious and require medical treatment.

How does diarrhea occur?

Acute diarrhea usually has the useful function of removing the feces as quickly as possible. In chronic diarrhea, this is usually not the case. Diarrhea can be caused by various causes:

Microorganisms:

• Bacteria: Bacteria, such as Escherichia coli (E. coli) and Salmonella can cause diarrhea by producing toxins that irritate the intestinal wall.
• Viruses: Viruses, such as Rotavirus and Norovirus are often responsible for acute diarrhea.
• Parasites: Parasites such as Giardia lamblia can also cause diarrhea.

Intake related:

• Poor hygiene/poor food: This can cause toxins in the food, which can cause diarrhea.
• Drugs: Certain drugs can cause diarrhea, for example too much alcohol consumption.
• Vitamins: Too much vitamin C or B5 can cause diarrhea in very large quantities.
• Too many sweet drinks

Body:

• There is a problem with food intake: Intolerances to certain food components, such as lactose intolerance or an intolerance to gluten or fructose.
• Poor resistance: This can cause non-harmful microorganisms to suddenly cause diarrhea. Poor resistance can be caused by radiation or immunosuppression, for example.
• Bowel diseases: Including Crohn’s disease, ulcerative colitis, cancer, spastic colon.

Medicines:

• A course of antibiotics: Diarrhea can occur during or shortly after a course of antibiotics.
• Laxatives: Laxatives make bowel movements easier. Too high a dose can lead to diarrhea.
• Medicines for depression

Stress, anxiety, pain:

• Anxiety and tension: Great anxiety and tension cause rapid bowel movements.
• Teething: In young children, diarrhea can be caused by teething.

Complications

Diarrhea does not necessarily have to be a problem. Other problems can occur as a result of diarrhea. For example, abdominal pain, cramps, dehydration, nausea, feeling tired/weak, fever, headache, and weight loss. Nutrient deficiencies can also occur.

In some cases, it can lead to serious complications. With diarrhea, you lose fluid, especially with vomiting, fever and in warm weather. The most common complication is therefore dehydration, where the body loses too much fluid. This can lead to little urination, a lot of thirst, fatigue, dry mouth, drowsiness and in severe cases even loss of consciousness. With severe dehydration, there is also confusion, rapid heartbeat/breathing and the arms/legs are cold.

Diarrhea usually goes away on its own. Contact your GP if you have the above-mentioned symptoms of dehydration. Also call if there is blood or mucus in the stool, there is a lot of weight loss or if the diarrhea lasts longer than 3 days. (see the Thuisarts link for the full overview of reasons to call the GP)

In children and the elderly, diarrhea can lead to severe dehydration more quickly, which can be a medical necessity. With chronic diarrhea, other complications can also occur, such as malabsorption syndrome, where the body does not absorb enough nutrients.

Traveler’s diarrhea

Traveler’s diarrhea is a common problem for people traveling to countries with a different level of hygiene. It is usually caused by bacteria such as E. coli or Campylobacter, which are ingested through contaminated food or water.

Symptoms of traveler’s diarrhea can range from mild to severe abdominal pain, cramps and liquid stools. It is important to drink enough and possibly use ORS (ORS is a solution of salts and glucose in water) to prevent dehydration.

Diarrhea in children

Children are extra susceptible to diarrhea because of their still underdeveloped immune system. Rotavirus is one of the most common causes of diarrhea in children, but other viruses and bacteria can also cause it.

Symptoms in children can be more severe than in adults and include abdominal pain, fever and hypersensitivity. It is important to give children extra fluids and possibly use ORS to prevent dehydration.

Diarrhea in the elderly

Older people are at higher risk of complications from diarrhea due to their weakened immune system and other health problems. Chronic illnesses such as diabetes or heart disease can increase the impact of diarrhea.

Symptoms in the elderly can be milder, but it is important to watch for signs of dehydration such as dry mouth, fatigue and urination. It is advisable to consult a doctor if the symptoms are severe or persistent.

What can you do about diarrhea

Because diarrhea causes a lot of fluid loss, it is important to ensure sufficient fluid intake. So drink extra, especially if you have a fever and/or are vomiting. If you are vomiting, drink small amounts. Do not drink sweet drinks, such as apple juice, milk, energy drinks, soft drinks and diet drinks if the diarrhea lasts longer than a week. As for food, it is not bad to eat less for a few days. For stomach cramps, it is best to eat and drink small amounts. Also, avoid making others sick, so ensure good hygiene.

Regular medication

Medication is often not necessary for diarrhea. For severe diarrhea, you can use ORS so that you do not become dehydrated. Mix ORS with water, not with food or other drinks.

Some regular medications can work less well or not at all due to diarrhea. Other medications can have serious side effects with persistent diarrhea and vomiting. Consult your doctor if you have diarrhea and are taking medication.

Example of homeopathic treatment

A mother came to my practice with a 16-month-old girl who had been suffering from diarrhea and vomiting for a few days. She showed signs of dehydration. Due to the nausea, she was not eating or drinking. The family doctor prescribed medication to suppress the nausea. If that didn’t help, she would be admitted to the hospital.

Thanks to the medication, she started eating again, but unfortunately, she still wasn’t drinking. Because of her lack of thirst combined with vomiting and diarrhea, I prescribed Antimonium Tartaricum 200C (This is specifically prescribed in this case and is not a standard remedy for treating diarrhea). The mother called back within an hour; the girl started taking small sips and became cheerful. After repeating the remedy a few times in the following days, she drank well again.