Diarrhea means that you have a change in your bowel movements and pass unusually loose stools. Stool is what is left after your digestive system (stomach, small intestine, and colon) absorbs nutrients and fluids from what you eat and drink. Stool passes out of the body through the rectum. If fluids are not absorbed, or if your digestive system produces extra fluids, stools will be loose and watery. Loose stools are larger than usual. People with diarrhea often have frequent bowel movements and may pass more than a quart of watery stool a day.
People who have diarrhea may also have
Also, people with diarrhea may feel sick to their stomach or be dehydrated.
Dehydration means that your body does not have enough fluid to work properly. Every time you breathe out, sweat, urinate, or have a bowel movement, you lose fluid. Diarrhea increases the amount of fluid lost in bowel movements. Along with the fluid, you lose salts-chemicals that your body needs to work properly. The loss of fluids and salts can be serious, especially for babies and young children and for older people.
The signs of dehydration in adults are
In addition, the kidneys could stop working.
The signs of dehydration in babies and young children are
Also, when children have diarrhea, their skin seems to lose its elasticity. It does not flatten back to normal when pinched and released.
Anyone can get diarrhea. This common problem can last a day or two or for months or years, depending on the cause. Most people get better on their own, but diarrhea can be serious for babies and older people if lost fluids are not replaced. Many people throughout the world die from diarrhea because of the large volume of water lost and the accompanying loss of salts.
Diarrhea can be caused by
Sometimes no cause for diarrhea can be found.
Diarrhea often goes away by itself, but it can be a sign of a more serious problem. You should talk to your doctor if your diarrhea lasts for more than 3 days. You should also call your doctor if you have
Children younger than 12 become dehydrated much more easily than adults. If your child does not improve after 24 hours or has any of the following symptoms along with diarrhea, call the doctor. (This is especially important if your child is 6 months old or younger.)
Your doctor may want to perform tests to find the cause of the diarrhea:
For a sigmoidoscopy or colonoscopy, the doctor uses a thin, flexible, lighted tube with a lens on the end.
In many cases of diarrhea, replacing lost fluid and salts is the only treatment needed.
Taking medicine to stop diarrhea can be helpful in some cases. Medicines that are available without a doctor’s prescription include loperamide (Imodium) and bismuth subsalicylate (Pepto Bismol and Kaopectate). Stop taking these medicines if symptoms get worse or if diarrhea lasts more than 2 days.
If a particular food or medicine is the cause, you should avoid it.
Also, while you are waiting for the diarrhea to end, you should avoid foods that can make it worse:
As you feel better, begin eating soft, bland food, such as bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. Children can eat bananas, rice, applesauce, and toast (sometimes called the BRAT diet).
People who are visiting other countries and eat food or drink water contaminated by bacteria, viruses, or parasites can develop traveler’s diarrhea.
You can prevent it by being careful:
You can safely drink bottled water, carbonated soft drinks, and hot drinks like coffee or tea.
Irritable bowel syndrome (IBS) is a digestive disorder that causes abdominal pain, bloating, gas, diarrhea, and constipation—or some combination of these problems. IBS affects people of all ages, including children.
IBS is classified as a functional disorder because it is caused by a problem in how the intestines, or bowels, work. People with IBS tend to have overly sensitive intestines that have muscle spasms in response to food, gas, and sometimes stress. These spasms may cause pain, diarrhea, and constipation.
IBS may be a cause of recurring abdominal pain in children. The diagnosis of IBS is based on having abdominal pain or discomfort plus any two of the following:
The symptoms must be present for at least 12 weeks in the preceding 12 months, and there should be no diseases that might cause the symptoms.
In children and adolescents, IBS affects girls and boys equally and may be diarrhea-predominant, constipation-predominant, or have a variable stool pattern.
Children with IBS may also have headache, nausea, or mucus in the stool. Weight loss may occur if a child eats less to try to avoid pain. Some children first develop symptoms after a stressful event, such as teething, a bout with the flu, or problems at school or at home. Stress does not cause IBS, but it can trigger symptoms.
To diagnose IBS, the doctor will ask questions about symptoms and examine the child to rule out more serious problems or diseases. IBS is not a disease—it is a syndrome, or group of symptoms that occur together. It does not damage the intestine, so if the physical exam and other tests show no sign of disease or damage, the doctor may diagnose IBS.
In children, IBS is treated mainly through changes in diet—eating more fiber and less fat to help prevent spasms—and through bowel training to teach the child to empty the bowels at regular, specific times during the day. Medications like laxatives are rarely prescribed because children are more susceptible to addiction than adults. When laxatives are necessary, parents must follow the doctor’s instructions carefully. Learning stress management techniques may also help some children.
Irritable bowel syndrome is a disorder characterized most commonly by cramping, abdominal pain, bloating, constipation, and diarrhea. IBS causes a great deal of discomfort and distress, but it does not permanently harm the intestines and does not lead to a serious disease, such as cancer. Most people can control their symptoms with diet, stress management, and prescribed medications. For some people, however, IBS can be disabling. They may be unable to work, attend social events, or even travel short distances.
As many as 20 percent of the adult population, or one in five Americans, has symptoms of IBS, making it one of the most common disorders diagnosed by doctors. It occurs more often in women than in men, and it begins before the age of 35 in about 50 percent of people.
Abdominal pain, bloating, and discomfort are the main symptoms of IBS. However, symptoms can vary from person to person. Some people have constipation, which means hard, difficult-to-pass, or infrequent bowel movements. Often these people report straining and cramping when trying to have a bowel movement but cannot eliminate any stool, or they are able to eliminate only a small amount. If they are able to have a bowel movement, there may be mucus in it, which is a fluid that moistens and protect passages in the digestive system. Some people with IBS experience diarrhea, which is frequent, loose, watery, stools. People with diarrhea frequently feel an urgent and uncontrollable need to have a bowel movement. Other people with IBS alternate between constipation and diarrhea. Sometimes people find that their symptoms subside for a few months and then return, while others report a constant worsening of symptoms over time.
Researchers have yet to discover any specific cause for IBS. One theory is that people who suffer from IBS have a colon (large bowel) that is particularly sensitive and reactive to certain foods and stress. The immune system, which fights infection, may also be involved.
Recent research has reported that serotonin is linked with normal gastrointestinal (GI) functioning. Serotonin is a neurotransmitter, or chemical, that delivers messages from one part of your body to another. Ninety-five percent of the serotonin in your body is located in the GI tract, and the other 5 percent is found in the brain. Cells that line the inside of the bowel work as transporters and carry the serotonin out of the GI tract. People with IBS, however, have diminished receptor activity, causing abnormal levels of serotonin to exist in the GI tract. As a result, people with IBS experience problems with bowel movement, motility, and sensation—having more sensitive pain receptors in their GI tract.
In addition, people with IBS frequently suffer from depression and anxiety, which can worsen symptoms. Similarly, the symptoms associated with IBS can cause a person to feel depressed and anxious.
Researchers have reported that IBS may be caused by a bacterial infection in the gastrointestinal tract. Studies show that people who have had gastroenteritis sometimes develop IBS, otherwise called post-infectious IBS.
Researchers have also found very mild celiac disease in some people with symptoms similar to IBS. People with celiac disease cannot digest gluten, a substance found in wheat, rye, and barley. People with celiac disease cannot eat these foods without becoming very sick because their immune system responds by damaging the small intestine. A blood test can determine whether celiac disease may be present. (For information about celiac disease, see NIDDK’s Celiac Disease fact sheet.)
The following have been associated with a worsening of IBS symptoms
Researchers have found that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones can worsen IBS problems.
The colon, which is about 5 feet long, connects the small intestine to the rectum and anus. The major function of the colon is to absorb water, nutrients, and salts from the partially digested food that enters from the small intestine. Two pints of liquid matter enter the colon from the small intestine each day. Stool volume is a third of a pint. The difference between the amount of fluid entering the colon from the small intestine and the amount of stool in the colon is what the colon absorbs each day.
Colon motility (the contraction of the colon muscles and the movement of its contents) is controlled by nerves, hormones, and impulses in the colon muscles. These contractions move the contents inside the colon toward the rectum. During this passage, water and nutrients are absorbed into the body, and what is left over is stool. A few times each day contractions push the stool down the colon, resulting in a bowel movement. However, if the muscles of the colon, sphincters, and pelvis do not contract in the right way, the contents inside the colon do not move correctly, resulting in abdominal pain, cramps, constipation, a sense of incomplete stool movement, or diarrhea.
If you think you have IBS, seeing your doctor is the first step. IBS is generally diagnosed on the basis of a complete medical history that includes a careful description of symptoms and a physical examination.
There is no specific test for IBS, although diagnostic tests may be performed to rule out other diseases. These tests may include stool sample testing, blood tests, and x rays. Typically, a doctor will perform a sigmoidoscopy, or colonoscopy, which allows the doctor to look inside the colon. This is done by inserting a small, flexible tube with a camera on the end of it through the anus. The camera then transfers the images of your colon onto a large screen for the doctor to see better.
If your test results are negative, the doctor may diagnose IBS based on your symptoms, including how often you have had abdominal pain or discomfort during the past year, when the pain starts and stops in relation to bowel function, and how your bowel frequency and stool consistency have changed. Many doctors refer to a list of specific symptoms that must be present to make a diagnosis of IBS.
Unfortunately, many people suffer from IBS for a long time before seeking medical treatment. Up to 70 percent of people suffering from IBS are not receiving medical care for their symptoms. No cure has been found for IBS, but many options are available to treat the symptoms. Your doctor will give you the best treatments available for your particular symptoms and encourage you to manage stress and make changes to your diet.
Medications are an important part of relieving symptoms.
Your doctor may suggest fiber supplements or laxatives for constipation or medicines to decrease diarrhea, such as Lomotil or loperamide (Imodium). An antispasmodic is commonly prescribed, which helps to control colon muscle spasms and reduce abdominal pain. Antidepressants may relieve some symptoms. However, both antispasmodics and antidepressants can worsen constipation, so some doctors will also prescribe medications that relax muscles in the bladder and intestines, such as Donnapine and Librax. These medications contain a mild sedative, which can be habit forming, so they need to be used under the guidance of a physician. Medications available specifically to treat IBS are
With any medication, even over-the-counter medications such as laxatives and fiber supplements, it is important to follow your doctor’s instructions. Some people report a worsening in abdominal bloating and gas from increased fiber intake, and laxatives can be habit forming if they are used too frequently.
Medications affect people differently, and no one medication or combination of medications will work for everyone with IBS. You will need to work with your doctor to find the best combination of medicine, diet, counseling, and support to control your symptoms.
Stress—feeling mentally or emotionally tense, troubled, angry, or overwhelmed—can stimulate colon spasms in people with IBS. The colon has many nerves that connect it to the brain. Like the heart and the lungs, the colon is partly controlled by the autonomic nervous system, which responds to stress. These nerves control the normal contractions of the colon and cause abdominal discomfort at stressful times. People often experience cramps or “butterflies” when they are nervous or upset. In people with IBS, the colon can be overly responsive to even slight conflict or stress. Stress makes the mind more aware of the sensations that arise in the colon, making the person perceive these sensations as unpleasant.
Some evidence suggests that IBS is affected by the immune system, which fights infection in the body. The immune system is affected by stress. For all these reasons, stress management is an important part of treatment for IBS. Stress management options include
For many people, careful eating reduces IBS symptoms. Before changing your diet, keep a journal noting the foods that seem to cause distress. Then discuss your findings with your doctor. You may want to consult a registered dietitian who can help you make changes to your diet. For instance, if dairy products cause your symptoms to flare up, you can try eating less of those foods. You might be able to tolerate yogurt better than other dairy products because it contains bacteria that supply the enzyme needed to digest lactose, the sugar found in milk products. Dairy products are an important source of calcium and other nutrients. If you need to avoid dairy products, be sure to get adequate nutrients in the foods you substitute, or take supplements.
In many cases, dietary fiber may lessen IBS symptoms, particularly constipation.
However, it may not help with lowering pain or decreasing diarrhea. Whole grain breads and cereals, fruits, and vegetables are good sources of fiber. High-fiber diets keep the colon mildly distended, which may help prevent spasms. Some forms of fiber keep water in the stool, thereby preventing hard stools that are difficult to pass. Doctors usually recommend a diet with enough fiber to produce soft, painless bowel movements. High-fiber diets may cause gas and bloating, although some people report that these symptoms go away within a few weeks. (For information about diets for people with celiac disease, please see NIDDK’s Celiac Disease fact sheet.) Increasing fiber intake by 2 to 3 grams per day will help reduce the risk of increased gas and bloating.
Drinking six to eight glasses of plain water a day is important, especially if you have diarrhea. Drinking carbonated beverages, such as sodas, may result in gas and cause discomfort. Chewing gum and eating too quickly can lead to swallowing air, which also leads to gas.
Large meals can cause cramping and diarrhea, so eating smaller meals more often, or eating smaller portions, may help IBS symptoms. Eating meals that are low in fat and high in carbohydrates such as pasta, rice, whole-grain breads and cereals (unless you have celiac disease), fruits, and vegetables may help.
As its name indicates, it is a syndrome—a combination of signs and symptoms. IBS has not been shown to lead to a serious disease, including cancer. Through the years, IBS has been called by many names, among them colitis, mucous colitis, spastic colon, or spastic bowel. However, no link has been established between IBS and inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis.
The NIDDK conducts and supports research into many kinds of digestive disorders including IBS. Researchers are studying gastrointestinal motility and sensitivity to find possible treatments for IBS. These studies include the structure and contraction of gastrointestinal muscles, as well as the mechanics of fluid movement through the intestines. Understanding the influence of the nerves, hormones, and inflammation in IBS may lead to new treatments to better control the symptoms.
Irritable bowel syndrome, or IBS, is a problem that affects mainly the bowel,* which is also called the large intestine. The bowel is the part of the digestive system that makes and stores stool. The word syndrome means a group of symptoms. IBS is a syndrome because it can cause several symptoms. For example, IBS causes cramping, bloating, gas, diarrhea, and constipation.
*Linked terms are defined in the glossary.
IBS is not a disease. It’s a functional disorder, which means that the bowel doesn’t work as it should.
With IBS, the nerves and muscles in the bowel are extra-sensitive. For example, the muscles may contract too much when you eat. These contractions can cause cramping and diarrhea during or shortly after a meal. Or the nerves can be overly sensitive to the stretching of the bowel (because of gas, for example). Cramping or pain can result.
IBS can be painful. But it does not damage the bowel or cause any other diseases.
Emotional stress will not cause a person to develop IBS. But if you already have IBS, stress can trigger symptoms. In fact, the bowel can overreact to all sorts of things, including food, exercise, and hormones.
Foods that tend to cause symptoms include milk products, chocolate, alcohol, caffeine, carbonated drinks, and fatty foods. In some cases, simply eating a large meal will trigger symptoms.
Women with IBS often have more symptoms during their menstrual periods.
The main symptoms of IBS are
Most people have either diarrhea or constipation, but some people have both.
Other symptoms are
The doctor will suspect that you have IBS because of your symptoms. But the doctor may do medical tests to make sure you don’t have any other diseases that could cause the symptoms.
IBS has no cure, but you can do things to relieve symptoms. Treatment may involve
You may have to try a combination of things to see which works best for you.
Some foods make IBS worse.
Here are some foods that may cause symptoms:
If certain foods cause symptoms, you should eat less of them or stop eating them.
To find out which foods are a problem, write down this information:
Take your notes to the doctor to see if you should stop eating certain foods.
Some foods make IBS better.
Fiber reduces IBS symptoms—especially constipation—because it makes stool soft, bulky, and easier to pass. Fiber is found in bran, bread, cereal, beans, fruit, and vegetables.
Here are some examples of foods with fiber:
|Fruits||Vegetables||Breads, cereals, and beans|
Add foods with fiber to your diet a little at a time to let your body get used to them. Too much fiber all at once might cause gas, which can trigger symptoms in a person with IBS.
Besides telling you to eat more foods with fiber, the doctor might also tell you to get more fiber by taking a fiber pill or drinking water mixed with a special high-fiber powder.
How much you eat matters, too.
Large meals can cause cramping and diarrhea in people with IBS. If this happens to you, try eating four or five small meals a day. Or, have your usual three meals, but eat less at each meal.
If necessary, the doctor might give you medicine to help with symptoms:
You must follow your doctor’s instructions when you use these medicines. Otherwise, you could become dependent on them.
Does stress trigger your symptoms? Learning to reduce stress can help. With less stress, you may find that you have less cramping and pain. Also, you may find it easier to manage your symptoms.
Meditation, exercise, and counseling are some things that might help. You may need to try different activities to see what works best for you.