By Andrew G. Plaut, MD, Tufts Medical Center
Diarrhea in adults over the age of 18 years is a common problem for otherwise healthy people, and is experienced by everyone on occasion. There are times, however, when diarrhea is more serious, and needs to be evaluated and treated by physicians and nurses. This note will let you know when to look for medical help.
Diarrhea means different things to different people, but a clear change in number of daily bowel movements, and very loose or watery bowel movements is usually what patients notice first. In 90 percent of cases the problem goes away by itself, and most of those adults have infections due to bacteria or viruses that come from unclean food or water. Diarrhea also can occur when one has a cold or flu, and commonly occurs when one is travelling either in the United States or abroad. Sometimes new medicines such as antibiotics or even chewing too much sugar-free gum or eating magnesium in dietary supplements cause diarrhea, and those things should be avoided.
An adult with diarrhea should look for medical help if:
• Diarrhea is of very high volume, where the patient may be losing much water from the body.
• Diarrhea lasting longer than five days or sooner if stool numbers are increasing each day.
• Diarrhea that contains blood. This may indicate an infection requiring medical treatment.
• Diarrhea with fever, severe abdominal pain or vomiting lasting longer than one or two days. Again, the problem here may be excessive fluid loss.
• Diarrhea occurs in old or sick people, or anyone with longstanding diseases of other kinds.
In patients having a few days of diarrhea that seems to be getting better, it is sometimes worthwhile to replace fluids at home. This can be done safely by mixing half a teaspoon of table salt and six teaspoons of table sugar (or honey) with a quart or liter of clean water, and drinking this over a period of one or two hours. This can be repeated if diarrhea continues, and is safe for nearly everyone, even with other illnesses. It is also useful for the person with diarrhea to carefully clean the toilet, wash their hands with soap and water after each bowel movement, not prepare food for others in the family, and not to share towels with others.
Chronic diarrhea that goes on for months or even years is a completely different problem and needs a careful evaluation by a physician.
To emphasize, diarrhea is not often a sign of serious disease and usually clears up on its own. A physician or hospital emergency clinic should be consulted if one notices any problems in the list above.
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