Do you also have constant diarrhea? Let's talk about this 'Chronic Diarrhea'!

We've all had diarrhea at some point in our lives, right? It's very uncomfortable to have loose stools and a sudden need to go to the bathroom with a cramp in your stomach. Usually, it happens after a day or two when you have food poisoning, a cold, or a fever. However, if you have diarrhea that lasts for more than four weeks , we call it 'chronic diarrhea' or persistent diarrhea.

What is this persistent diarrhea? Is it really serious?

Simply put, persistent diarrhea is loose, watery stools that last for more than four weeks. Some surveys suggest that between 1% and 3% of the population has this condition. However, this number may be much higher because many people do not seek treatment for it unless they have other symptoms, such as abdominal pain or bleeding.

Now you're probably wondering, "Is it normal to have diarrhea all day long?" Not really. This is not normal. Your colon, the part where stool is formed, may be reacting to something unusual. For some people, this type of diarrhea can be caused by a bowel condition that can't be cured, but the symptoms can be controlled. However, in most cases, other causes can be treated with the right treatment.

Normally, liquid food waste from your small intestine is gradually absorbed by your large intestine and turned into solid stool. But when you have diarrhea, for some reason this process is interrupted. What happens is that you pass stool that is too liquid. This means that your large intestine has difficulty absorbing water as it normally would, or it is excreting too much water, or both. This can be due to a problem with your large intestine itself, or something abnormal inside it.

Why do we keep getting hungry? What are the main reasons?

Many illnesses can cause persistent diarrhea. But before considering an illness, a doctor will definitely ask you about your eating habits and the medications you are taking. Because these are the causes that we often unknowingly cause ourselves, and which can be easily corrected .

How food and drink affect

Certain foods and drinks can cause diarrhea. If you eat them regularly, in large quantities, or if you are very sensitive to them, they may be causing your diarrhea. Identifying the foods and drinks that cause diarrhea and reducing or eliminating them altogether can help. Consider these things:

• Coffee/Tea: Drinking coffee speeds up your bowel movements, or 'motility'. This means that food waste in the large intestine is forced out of the body quickly before it solidifies. It is not yet clear whether this is due to the 'caffeine' in coffee or other chemicals. Some people may experience the same effects from drinking 'caffeinated' tea as from drinking 'decaffeinated' coffee. This means that different people are sensitive to different chemicals. (The milk or sugar you put in your coffee/tea can also be a cause for this.) If you are a regular drinker, you may experience long-term side effects.
• Alcohol: Alcohol also speeds up the bowels, especially on an empty stomach. However, if you drink too much alcohol, your digestion may slow down, leading to dehydration and constipation. However, if you drink too much alcohol regularly, diarrhea can be caused by a different cause - inflammation. If your colon becomes inflamed, swollen, or injured due to alcohol, it can no longer absorb water and minerals normally. If the lining of your colon is damaged, it can even leak fluids.
• Some sugars: Some sugars are difficult to digest, and if you eat too much of them, they can cause diarrhea. Your intestines may lack the enzymes needed to digest them, or you may not have any of them at all. Artificial sweeteners like sorbitol, mannitol, and lactulose are some of the sugars that the human intestines cannot digest. That's why they don't add calories. When the intestines can't break down these sugars, they draw in more water to help flush them out of the body. Fructose can also have this effect in certain amounts. That's why foods made with high fructose corn syrup can cause diarrhea. Some people can have allergies, or intolerances, to specific types of sugar. Lactose intolerance (difficulty digesting milk and dairy products) is the most common of these.
• Food intolerances: If you have difficulty digesting a certain food, you may have an intolerance to that food. This often means that your digestive system lacks the enzymes needed to digest that food. Common examples include gluten intolerance (a protein found in foods such as wheat), histamine intolerance, and some sugar (carbohydrate) intolerances. Diarrhea is caused by foods that are not digested properly.

Could the medication we take be the cause?

Many medications can cause persistent diarrhea as a side effect. They can cause this condition in different ways. Whether you get it depends on many things, such as the dose of the medication you take, your diet, and other medical conditions you have. Your doctor will review your complete medical history to determine if the medication is causing it. Some medications that can cause persistent diarrhea include:

• 'NSAIDs' `(nonsteroidal anti-inflammatory drugs)` - painkillers, for example aspirin `(aspirin)`, ibuprofen `(ibuprofen)`.
• Proton pump inhibitors (PPIs) - Medications given for gastritis.
• Antibiotics - For example, amoxicillin, cephalexin.
• Some herbal supplements and teas contain ingredients such as senna.
• Taking high doses of certain vitamins and minerals, such as vitamin C and magnesium.
• Antacids containing magnesium.
• Antidepressants - especially those of the selective serotonin reuptake inhibitors (SSRIs) type, e.g. fluoxetine (Prozac®), sertraline (Zoloft®).
• Beta-blockers - Medicines for high blood pressure.
• Metformin - a medicine for diabetes.
• Chemotherapy - Cancer treatment.
• Misuse and overuse of laxatives, especially in conditions such as bulimia nervosa.

Are there different types of diarrhea? What are their causes?

Doctors sometimes divide diarrhea into three or four types to make it easier to find the cause. These types help doctors identify the specific characteristics of the stool. These types represent broad categories of possible causes. The three main types are: inflammatory diarrhea, oily diarrhea, and watery diarrhea. Some people divide watery diarrhea into two more subtypes (secretory and osmotic) and consider them to be four main types.

Watery diarrhea

Watery diarrhea occurs when your colon cannot absorb enough water and electrolytes from your stool, or when it excretes more than it absorbs.

• Osmotic constipation is caused by nutrients that are not properly digested or absorbed. These draw more water into the colon. (This is how some laxatives work.)
• Secretory diarrhea refers to watery diarrhea caused by various diseases.

Some things that could cause this:

• Bile acid diarrhea (this occurs when too much bile builds up in the intestines; also called bile acid malabsorption (BAM)).
• 'Microscopic colitis' `(Microscopic colitis)`.
• Nerve damage caused by diabetes (diabetic neuropathy).
• Vagotomy (surgical removal of the stomach nerve).
• Hyperthyroidism (overactive thyroid gland).
• 'Adrenal gland problems' `(Adrenal disorders)`.
• Neuroendocrine tumors.
• 'Irritable Bowel Syndrome' (IBS).

Fatty Diarrhea / Steatorrhea

Sometimes, your stools can be watery and pass as diarrhea because of too much oil. This happens when your body has trouble breaking down and absorbing fats properly, or when bacteria in your intestines make too many fatty acids. Oily diarrhea may not happen often, but it can happen in large amounts at once. It may smell worse than usual, and it may leave oily stains in the toilet. It can also be accompanied by symptoms such as nausea, indigestion, and weight loss.

Possible causes:

• Malabsorption disorders - This means that nutrients are not absorbed properly. Examples: pancreatic insufficiency (reduced function of the pancreas), celiac disease.
• Small intestinal bacterial overgrowth (SIBO).
• Mesenteric ischemia (blockage of the blood vessels supplying the intestines).
• Gastric bypass surgery (surgery on the digestive tract).

Inflammatory Diarrhea

This type of diarrhea occurs when you have an inflammation of your colon, called colitis. The inflammation affects the lining of your colon. It swells, making it less able to absorb nutrients. Diarrhea that comes with inflammation is frequent but comes and goes. It can also be accompanied by stomach pain, fever, or blood in your stool. Inflammatory conditions that can cause persistent diarrhea include:

• Persistent infections, for example infections caused by parasites, or pseudomembranous colitis caused by the bacteria C. diff.
• Inflammatory bowel disease (IBD) - This refers to inflammatory bowel diseases. Examples: ulcerative colitis, Crohn's disease.
• Ischemic colitis (inflammation caused by decreased blood supply to the large intestine).
• Diverticulitis (inflammation of the small pouches in the large intestine).
• Radiation colitis (inflammation of the colon caused by radiation therapy).
• Cancer.

What are the possible side effects of continuing to eat?

Imagine, you often have to go to the bathroom urgently, or you have difficulty holding in your bowel movements. How much does this condition affect your daily life? It's very annoying to always have to think about the nearest bathroom.

It's hard to keep this habit hidden from others for a long time. It can affect your self-confidence and quality of life. If you have a job, especially one that involves a lot of people, it can also affect that.

Physically, persistent diarrhea can put you at risk of dehydration and its side effects. As diarrhea continues, your body loses a large amount of water, as well as electrolytes, essential minerals found in body fluids.

Electrolyte depletion can have serious consequences. It can affect your heart, lungs, brain, and nervous system. Dehydration can also put pressure on your kidneys, leading to kidney disease.

What can you do at home for this?

You may need medical advice and treatment to stop this. However, there are a few things you can try before then:

• Think carefully about your diet. Consider whether your diarrhea is caused by something you eat or drink regularly. If you drink coffee, tea, alcohol, or anything with artificial sweeteners (such as diet soda), try cutting those out first. If you have oily diarrhea, try eliminating oily foods from your diet to see if that helps. Lactose intolerance is very common, especially among people of African or Asian descent. You can also try cutting out dairy. You can also try a strict elimination diet, such as a low-FODMAP diet, to find out exactly what your food allergies are.
• If you take any medications regularly, ask your doctor if any of them could be causing your diarrhea. If so, ask if you can try an alternative or stop taking it for a while.
• Make sure you stay hydrated when you have diarrhea. Try a hydration solution, a sports drink, or an electrolyte mix mixed with water. Drinking just water won't provide you with electrolytes.

How do I get rid of this constant stomach ache? Do I need to see a doctor?

If you've tried simple changes in your diet and medication and your diarrhea doesn't go away, you should definitely see a doctor. Your doctor will carefully examine the possible causes of your persistent diarrhea and determine the right treatment. Treating the underlying condition may help resolve your diarrhea, or it may not be possible to treat the underlying condition directly. If so, your diarrhea may require specific treatment.

Treatment may include:

• Opiate antidiarrheals: These slow down the action of your colon and increase absorption. Loperamide is often the first choice. It is not addictive and is available over-the-counter (OTC).
• Bile acid binders are prescribed for those with bile acid diarrhea.
• Clonidine for diarrhea caused by diabetes.
• Eluxadoline for diarrhea caused by IBS (irritable bowel syndrome).
• Antibiotics or antiparasitics for infections.
• Fiber supplements, such as psyllium, can help thicken stools and slow down their passage.

When should you definitely see a doctor?

It's never a bad idea to see a doctor if you have persistent diarrhea. If you don't think you can fix it by cutting out something from your diet, you'll likely need treatment. If it's been going on for a long time, you're at higher risk of developing other complications, which may also require treatment. If you have other symptoms like these, seek medical attention right away:

• Fever
• Pain
• Blood in the stool
• Unintentional weight loss
• Paleness
• Weakness or excessive fatigue

Finally, I have to say...

Although diarrhea is common, it usually goes away quickly and without treatment. However, diarrhea that persists for a month or more should definitely be discussed with a doctor. Sometimes the cause may be something simple and easy to fix. In other cases, you may find that you have an underlying medical condition that requires complex treatment. However, don't ignore this symptom. Your doctor can help you.

` Diarrhea, Persistent Diarrhea, Flatulence, Digestive System, Intestinal Diseases, Health, Chronic Diarrhea