Diarrhoea is the frequent and excessive discharge of watery fluid from the bowel. Diarrhoea is really a symptom
of disease rather than a disease itself.
Absolutely everyone experiences diarrhoea at some time. The ten metres of an adult human gut is very
sensitive to irritants, and any irritation of the lower half, particularly the last two metres (the large intestine), will
result in diarrhoea.
Diarrhoea may be considered by a patient to be the more frequent passing of motions that are softer than usual,
but to be medically significant, the motions must be at least part liquid and be passed more than four times a day.
Diarrhoea can be caused by conditions of the intestine, or diseases outside the gut that alter the body’s
chemistry or other functions.
By far the most common cause of diarrhoea is a viral infection of the intestine (viral gastroenteritis). This
infection is passed from one person to another by close contact or on the breath, and usually occurs in epidemics,
often in springtime. The usual symptoms are six to twelve hours of vomiting followed by one to three days of
diarrhoea, and painful gut spasms usually occur.
Food poisoning is due to bacteria, or a toxin produced by bacteria, being present in food. The diagnosis is most
strongly suspected when a whole family or group of people is affected simultaneously. The symptoms and the
severity of the attack will depend upon the bacteria causing the poisoning, the amount eaten, and the age and
general health of the victim. Most attacks of food poisoning occur abruptly, within eight hours (and often one or two
hours) of eating the contaminated food, but some types may take up to 24 hours to give symptoms. The patient
suddenly starts vomiting, and has explosive diarrhoea associated with intermittent belly pain.
Bacterial gastroenteritis is usually more severe than the viral form, and includes infections by bacteria such as
Shigella, Salmonella typhi (causes typhoid) and Yersinia. These are usually responsible for the “Delhi belly” and
“Montezuma’s revenge” suffered by travellers to less developed countries. Vibrio cholerae is the bacteria
responsible for cholera, the most severe of the bacterial gut infections.
Giardia lamblia is a microscopic animal that can easily enter the body and cause an infection (giardiasis) in the
small intestine. It passes from one person to another by poor personal hygiene. The condition is far more common
in children than adults, who may have no symptoms.
Other common intestinal causes of diarrhoea in babies include lactose intolerance (a reaction to the sugar in
milk), food allergies (eg. eggs, milk, chocolate, peanuts), intussusception (an infolding of the gut on itself), surgery
to shorten the intestine (prevents adequate absorption of fluids), and strangely severe constipation may actually
present as diarrhoea because liquid faeces from further up the bowel can seep around the outside of a large faecal
mass in the rectum that is impossible to pass through the anus.
There are many medications that may have diarrhoea as a side effect. Examples include antibiotics (particularly
penicillin),. Over use of laxatives will naturally result in diarrhoea.
There are dozens of other rare causes of diarrhoea.
Faeces may be examined to determine the cause, along with blood tests and sometimes colonoscopy and x-
rays.
Treatment involves determining and treating the cause if possible. Mild attacks are dealt with by diet and fluids,
more serious ones require medication to slow the flow, and severe attacks may need fluids to be replaced by an
intravenous drip.
Dehydration is the main complication, and the risk is much greater in children under five years of age.
of disease rather than a disease itself.
Absolutely everyone experiences diarrhoea at some time. The ten metres of an adult human gut is very
sensitive to irritants, and any irritation of the lower half, particularly the last two metres (the large intestine), will
result in diarrhoea.
Diarrhoea may be considered by a patient to be the more frequent passing of motions that are softer than usual,
but to be medically significant, the motions must be at least part liquid and be passed more than four times a day.
Diarrhoea can be caused by conditions of the intestine, or diseases outside the gut that alter the body’s
chemistry or other functions.
By far the most common cause of diarrhoea is a viral infection of the intestine (viral gastroenteritis). This
infection is passed from one person to another by close contact or on the breath, and usually occurs in epidemics,
often in springtime. The usual symptoms are six to twelve hours of vomiting followed by one to three days of
diarrhoea, and painful gut spasms usually occur.
Food poisoning is due to bacteria, or a toxin produced by bacteria, being present in food. The diagnosis is most
strongly suspected when a whole family or group of people is affected simultaneously. The symptoms and the
severity of the attack will depend upon the bacteria causing the poisoning, the amount eaten, and the age and
general health of the victim. Most attacks of food poisoning occur abruptly, within eight hours (and often one or two
hours) of eating the contaminated food, but some types may take up to 24 hours to give symptoms. The patient
suddenly starts vomiting, and has explosive diarrhoea associated with intermittent belly pain.
Bacterial gastroenteritis is usually more severe than the viral form, and includes infections by bacteria such as
Shigella, Salmonella typhi (causes typhoid) and Yersinia. These are usually responsible for the “Delhi belly” and
“Montezuma’s revenge” suffered by travellers to less developed countries. Vibrio cholerae is the bacteria
responsible for cholera, the most severe of the bacterial gut infections.
Giardia lamblia is a microscopic animal that can easily enter the body and cause an infection (giardiasis) in the
small intestine. It passes from one person to another by poor personal hygiene. The condition is far more common
in children than adults, who may have no symptoms.
Other common intestinal causes of diarrhoea in babies include lactose intolerance (a reaction to the sugar in
milk), food allergies (eg. eggs, milk, chocolate, peanuts), intussusception (an infolding of the gut on itself), surgery
to shorten the intestine (prevents adequate absorption of fluids), and strangely severe constipation may actually
present as diarrhoea because liquid faeces from further up the bowel can seep around the outside of a large faecal
mass in the rectum that is impossible to pass through the anus.
There are many medications that may have diarrhoea as a side effect. Examples include antibiotics (particularly
penicillin),. Over use of laxatives will naturally result in diarrhoea.
There are dozens of other rare causes of diarrhoea.
Faeces may be examined to determine the cause, along with blood tests and sometimes colonoscopy and x-
rays.
Treatment involves determining and treating the cause if possible. Mild attacks are dealt with by diet and fluids,
more serious ones require medication to slow the flow, and severe attacks may need fluids to be replaced by an
intravenous drip.
Dehydration is the main complication, and the risk is much greater in children under five years of age.
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