The secret to curing diarrhea lies in recognizing the underlying cause.
Probably 95% of the time diarrhea is due to an intestinal virus. There is no medicinal cure, as such, for an intestinal virus. Your body will clear the infection on its own, given enough time – usually a few to several days.
For garden-variety viral diarrhea, what most people want is simply something to stop the diarrhea. Technically speaking, that’s not a cure. But what’s the difference if you feel better?
So, tip #1, to slow down diarrhea, for the most reliable results, use over-the-counter loperamide (Imodium). This medication was by prescription just a few years ago (and higher dosage still remains by prescription). When your immune system kicks in and rids your body of the infection, you can stop taking the medication.
What about the other 5% of the time? Probably the second most common cause of diarrhea that I see as a family physician is “c diff” colitis, also known as “clostridium difficile colitis. This form of diarrhea is caused by a bacteria rather than a virus, and almost always occurs after a patient has taken an antibiotic for a different sort of infection, such as a respiratory infection or bladder infection. Most female patients are aware that taking an antibiotic can predispose to a vaginal yeast infection, but it predisposes to c diff as well. Since common antibiotics kill off many good bacteria, harmful bacteria sometimes take over. In addition to diarrhea, c diff colitis can cause fever, bad-smelling stools, and abdominal pain, and weight loss.
Tip #2 – if you’ve taken an antibiotic recently and develop diarrhea, fever, malodorous stools, and perhaps abdominal pain, contact your doctor. You should not take loperamide in this situation. The diarrhea is part of your body’s attempt to rid you of the infection. You will need to take either metronidazole or vancomycin, both prescription antibiotics, or you run the risk of hospitalization.
Third, for patients with chronic diarrhea previously diagnosed as irritable bowel syndrome, ask your doctor about celiac disease. This problem is being recognized with increasing frequency throughout the medical world, and is caused by an allergic reaction to gluten, found in wheat and other flour. In recent years a blood test has been developed to detect the disease. Earlier an intestinal biopsy was required, and is sometimes still performed. Ask your doctor whether you should receive either or both of these tests.
Or, tip #3, stop all gluten for at least a few weeks and see if your symptoms improve. You might want to switch back and forth a few times, omitting then re-starting gluten. If symptoms occur every time you reintroduce gluten into your diet, you may have found your answer. Visit celiac.org for additional information.
The above does not cover every type of diarrhea. Other causes include true irritable bowel, chronic inflammatory bowel disease, lactose intolerance, food poisoning, parasitic infections, stress-induced diarrhea, and dozens of other less common conditions. See your doctor if diarrhea persists beyond several days, especially if you have additional symptoms such as abdominal pain or cramping, fever, blood or mucus in your stools, weight loss, or dehydration.
Copyright 2010 Cynthia J. Koelker, M.D.
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