• Wash your hands often, especially after going to the bathroom and before eating.

• Teach children to not put objects in their mouth.

• When taking antibiotics, try eating food with Lactobacillus acidophilus, a healthy bacteria. This helps replenish the good bacteria that antibiotics can kill. Yogurt with active or live cultures is a good source of these healthy bacteria.

• Use alcohol-based hand gel frequently.

When traveling to underdeveloped areas, follow the steps below to avoid diarrhea:

• Drink only bottled water and do NOT use ice.

• Do NOT eat uncooked vegetables or fruits that do not have peels.

• Do NOT eat raw shellfish or undercooked meat.

• Do NOT consume dairy products.

Dehydration occurs when there is excessive loss of fluids and minerals (electrolytes)
from the body due to diarrhea, with or without vomiting.

• Dehydration is common among adult patients with acute diarrhea who have large

amounts of stool, particularly when the intake of fluids is limited by lethargy or is
associated with nausea and vomiting.

• It also is common in infants and young children who develop viral gastroenteritis

or bacterial infection.

• Patients with mild dehydration may experience only thirst and dry mouth.

• Moderate to severe dehydration may cause orthostatic hypotension with syncope

(fainting upon standing due to a reduced volume of blood, which causes a drop in
blood pressure upon standing), a diminished urine output, severe weakness,
shock, kidney failure, confusion, acidosis (too much acid in the blood), and coma.
Electrolytes (minerals) also are lost with water when diarrhea is prolonged or severe, and
mineral or electrolyte deficiencies may occur. The most common deficiencies occur with
sodium and potassium. Abnormalities of chloride and bicarbonate also may develop.
Finally, there may be irritation of the anus due to the frequent passage of watery stool
containing irritating substances.

Treatment is ideally directed toward correcting the cause; however, the first aim should
be to prevent or treat dehydration and nutritional deficiencies. The type of fluid and
nutrient replacement depends on whether oral feedings can be taken and on the severity
of fluid losses. Oral rehydration solution (ORS) or intravenous fluids are the choices;
ORS is preferred if possible.
A physician should be notified if a person is dehydrated. If oral replacement is suggested
then commercial (Pedialyte and others) or homemade preparations can be used. The
World Health Organization (WHO) has provided this easy recipe for home preparation,
which can be taken in small frequent sips:

• Table salt, 3/4 tsp

• Baking powder, 1 tsp

• Orange juice, 1 c

• Water, 1 qt

When feasible, food intake should be continued even in those people with acute diarrhea.
A physician should be consulted regarding what type and how much food is permitted.
Anti-motility agents (loperamide, diphenoxylate) are useful for those with chronic
symptoms; their use is limited or even contraindicated in most individuals with acute
diarrhea, especially in those with high fever or bloody bowel movements. They should
not be taken without the advice of a physician, and should not be used in children.
Other treatments are available, depending on the cause of symptoms. For example, the
bulk agent psyllium helps some people by absorbing excess fluid and solidifying stools;
cholestyramine, which binds bile acids, is effective in treating bile-salt-induced diarrhea.
Low fat diets or more easily digestible fat is useful in some people. Antidiarrheal drugs
that decrease excessive secretion of fluid by the intestinal tract are another approach for
some diseases. Avoidance of medications or other products that are known to cause
diarrhea (such as lactose) is curative in some people but should be discussed with a
physician.
Alternative treatment
It is especially important to find the cause of diarrhea, since stopping diarrhea when it is
the body's way of eliminating something foreign is not helpful and can be harmful in the
long run.
One effective alternative approach to preventing and treating diarrhea involves oral
supplementation of aspects of the normal flora in the colon with the yeasts Lactobacillus
acidophilus, L. bifidus, or Saccharomyces boulardii. In clinical settings, these
"biotherapeutic" agents have repeatedly been helpful in the resolution of diarrhea,
especially antibiotic-associated diarrhea.
Nutrient replacement also plays a role in preventing and treating episodes of diarrhea.
Zinc especially appears to have an effect on the immune system, and deficiency of this
mineral can lead to chronic diarrhea. Also, zinc replacement improves growth in young
persons. To prevent dehydration, individuals suffering from diarrhea should take plenty
of fluids, especially water. The BRAT diet also can be useful in helping to resolve
diarrhea. This diet limits food intake to bananas, rice, applesauce, and toast. These foods
provide soluble and insoluble fiber without irritation. If the toast is slightly burnt, the
charcoal can help sequester toxins and pull them from the body.
Acute homeopathic remedies can be very effective for treating diarrhea especially in
infants and young children.

Most cases of acute diarrhea never need diagnosis or treatment, as many are mild and
produce few problems. But patients with fever over 102°F (38.9°C), signs of dehydration,
bloody bowel movements, severe abdominal pain, known immune disease, or prior use of
antibiotics need prompt medical evaluation.
When diagnostic studies are needed, the most useful are stool culture and examination for
parasites; however these are often negative and a cause cannot be found in a large
number of patients. The earlier cultures are performed, the greater the chance of
obtaining a positive result. For those with a history of antibiotic use in the preceding two
months, stool samples need to be examined for the toxins that cause antibiotic-associated
colitis. Tests are also available to check stool samples for microscopic amounts of blood
and for cells that indicate severe inflammation of the colon. Examination with an
endoscope is sometimes helpful in determining severity and extent of inflammation. Tests
to check changes in blood chemistry (potassium, magnesium, etc.) and a complete blood
count (CBC) are also often performed.
Chronic diarrhea is quite different, and most patients with this condition will receive
some degree of testing. Many exams are the same as for an acute episode, as some
infections and parasites cause both types of diarrhea. A careful history to evaluate
medication use, dietary changes, family history of illnesses, and other symptoms is
necessary. Key points in determining the seriousness of symptoms are weight loss of over
10 lb (4.5 kg), blood in the stool, and nocturnal diarrhea (symptoms that awaken the
patient from sleep).
Both prescription and over-the-counter medications can contain additives, such as lactose
and sorbitol, which will produce diarrhea in sensitive individuals. Review of allergies or
skin changes may also point to a cause. Social history may indicate if stress is playing a
role or identify activities which can be associated with diarrhea (for example, diarrhea
that occurs in runners). A combination of stool, blood, and urine tests may be needed in
the evaluation of chronic diarrhea; in addition a number of endoscopic and x-ray studies
are frequently required.

A doctor should be called if a person becomes dehydrated. Signs of dehydration
include decreased urination, lethargy, poor skin tone, and generalized weakness. In very
young children, the parents should call a doctor if they observe these symptoms of
dehydration:

• Dry mouth or tongue

• Few or no tears when crying

• No wet diapers for three hours or more

• Sunken eyes, cheeks, and fontanel (soft spot on the head of infants)

• Irritability and listlessness

• Skin that flattens slowly when pinched

Parents should also call the doctor if a child is vomiting so often that he or she cannot
keep fluids down, has a high fever, complains of severe abdominal pain, or shows no
improvement in symptoms after 24 hours.

• Drink plenty of fluid to avoid becoming dehydrated. Start with sips of any fluid other than caffeinated beverages. Milk may prolong loose stools, but also provides needed fluids and nourishment. Drinking milk may be fine for mild diarrhea. For moderate and severe diarrhea, electrolyte solutions available in drugstores are usually best.

• Active cultures of beneficial bacteria (probiotics) make diarrhea less severe and shorten its duration. Probiotics can be found in yogurt with active or live cultures and in supplements.

• Foods like rice, dry toast, and bananas can sometimes help with diarrhea.

• Avoid over-the-counter antidiarrhea medications unless specifically instructed to use one by your doctor. Certain infections can be made worse by these drugs. When you have diarrhea, your body is trying to get rid of whatever food, virus, or other bug is causing it. The medicine interferes with this process.

• Get plenty of rest.

If you have a chronic form of diarrhea, like the one caused by irritable bowel syndrome, try adding bulk to your diet to thicken the stool and regulate bowel movements. Such foods include fiber from whole-wheat grains and bran. Psyllium-containing products such as Metamucil or similar products can also add bulk to stools.

The most common cause of diarrhea is viral gastroenteritis, a mild viral infection that
goes away on its own within a few days. This condition is often called the stomach flu.
Viral gastroenteritis often occurs in mini-epidemics in schools, neighborhoods, or
families.
Food poisoning and traveler's diarrhea are two other common causes of diarrhea. They
occur as a result of eating food or drinking water contaminated with bacteria or parasites.
Medications, especially antibiotics, laxatives containing magnesium, and chemotherapy
for cancer treatment, can also cause diarrhea.
The following medical conditions can also lead to diarrhea:

• Celiac disease

• Inflammatory bowel diseases (Crohn's disease and ulcerative colitis)

• Irritable bowel syndrome (IBS)

• Malabsorption syndromes such as lactose intolerance

Other less common causes of diarrhea include:

• Carcinoid syndrome

• Nerve disorders like autonomic neuropathy or diabetic neuropathy

• Radiation therapy

• Partial removal of the stomach (gastrectomy)

• Zollinger-Ellison syndrome

Diarrhea is loose, watery, and frequent stool. Diarrhea is considered chronic (long-term)
when you have had loose or frequent stools for more than 4 weeks. Also known as Stools- watery; Frequent bowel movements; Loose bowel movements.
Diarrhea in adults is usually mild and goes away quickly without complications. In
infants and children (especially under age 3), diarrhea can cause dangerous dehydration
fairly quickly.