There are two types of diarrhoea: Acute and chronic
Acute diarrhoea is generally from food poisoning or other infectious agent like a virus, bacteria or parasite. This sort of diarrhoea is self limiting. It’s the body’s way to get rid of something that it’s not happy with. Most times, it’s best to let this diarrhoea run its course.
Chronic diarrhoea is a common sign of food allergy. The ingestion of allergic foods can cause excess release of histamine and other compounds. These compounds can have a laxative effect.
Other causes:
Viral – rhinovirus rotavirus and influenza
Bacterial – e coli, shigella, c diff, toxins that can cause diarrhoea
Parasitic – giardia, cryptosporidium, roundworms, tape worms,
Functional Disorder – like IBS-D
Stress – we have all experienced when the Sympathetic Nervous System is in ‘fight or flight’. You get butterflies and its not uncommon to get diarrhoea when this happens.
Fructose malabsorption – this can be a cause of SIBO (small intestinal bacteria overgrowth) or a consequence of SIBO.
SIBO – Small intestine bacterial overgrowth
Lactose intolerance – a deficiency in the lactase enzyme. This is a common problem world wide 70-90% of adults worldwide lack this enzyme.
Inflammatory bowel disease – ulcerative colitis or Crohn’s disease, diverticulitis.
Travellers diarrhoea – Prevention is better than cure as this can turn into post infectious IBS. Post infectious IBS sufferers are the people that have been to Bali, got Bali belly and never been well since.
Coeliac’s disease – the body cannot absorb the nutrients from the food you are eating.
Inadequate bile secretion, gallbladder issues- ie after fatty meals or after gallbladder removal.
Pancreatic disease – pancreatic tumour, pancreatic insufficiency.
Neurological diseases – Diabetic neuropathy.
Food allergies, laxative abuse, heavy metal poisoning.
Gum or candy – made from the sugar alcohols like erythritol, xylitol, mannitol and sorbitol. These all bring water into the bowel and if you eat too many diarrhoea can be a consequence.
Faecal impaction – when you are constipated the poo can leak from around the constipated mass and be mistaken for diarrhoea.
Cancer – the treatment and the cancer itself can impact bowel.
Medications – antacids, NSAIDS, chemotherapy medications, high blood pressure medications. With medications it will usually start shortly after taking the medication.
Supplementation – magnesium and Vitamin C if you have a high dose.
When to go to the Doctor
- If you have a fever greater than 38 degrees or higher
- You are experiencing abdominal pain
- You have bloody diarrhoea
- Your diarrhoea doesn’t improve within 72 hours
- You can’t keep down fluids and you become dehydrated
- You become listless, weak and confused.
- If you have antibiotics and then the diarrhoea started. You need to be checked to make sure you don’t have clostridium difficile.
- If you have signs of dehydration.
Signs of dehydration are:
- Eyes that look dull or sunken, dry lips and mouth, scant urine, and lethargy.
- Severe hydration can cause fainting, weakness, confusion, kidney failure, shock then into coma.
- Don’t use coffee or alcohol when you have diarrhoea as they are dehydrating.
What to eat
The BRAT diet is a good choice for acute diarrhoea. The Brat diet is Bananas, Rice, Apple Sauce and Toast.
The foods you want to eat are bland and binding foods.
Some good options are: rice pudding, eggs, steamed/stewed apples, green apples grated and left to go brown, chicken and cinnamon. The pectin (fibre) in the apple is helpful for binding you up and slowing transit time.
Avoid dairy products except for yoghurt with probiotics in it. Viral and bacteria infections injure the cells of the small intestines. They cause temporary deficiency of lactase enzymes which can cause lactose intolerance which will cause more diarrhoea.
Carob can be useful for treating kids with diarrhoea.
Use a lactobacillus acidophilus probiotic and saccharomyces Boulardii. It is a yeast that boosts your secretory IgA level which is a protective part of your immune system. It will also slow down the transit time.
Don’t eat solid foods during the acute phase. Focus on replenishing liquids like water, herbal teas, fruit juices, vegetable broths. Coconut water is not an alternate to rehydrate. It does not have the required minerals to be adequate for rehydration.
There are commercial products you can use like pedalyte and gastrolyte though not my first choice due to the colouring and flavouring in them. The bowel is already inflamed and colourings and flavourings can exacerbate this. In Australia there is an Inner health product that you can buy from Chemist or Health Food shop called Rehydrate.
Using olive oil (oleic acid) on your foods has been shown clinically to slow down transit time. Oleic acid is found in olives, avocados and almonds.
Increasing fibre like flaxseeds and acacia these fibres add bulk to the stool and can slow it down.
Testing
In Australia going to the GP to get a PCR stool test is a good idea especially if after 72 hrs there is no sign of the diarrhoea slowing. This test, tests for 10 different parasites and protozoa.
Hydrogen testing for SIBO – I recommend if you do this testing get the lactulose + glucose and fructose testing if you suspect Fructose malabsorption.
IgE and IGG testing if food allergy is suspected.
Do you need more help with your diarrhoea or if you haven’t been well since, get in touch.