Diarrhoea is the passing of looser and/or more frequent stools than normal for you. ‘For you’ is important here, because normal bowel movements can vary hugely from person to person. However, if you notice increased trips to the loo, and a change in consistency, then it could be that your digestion needs a helping hand. There may also be an increased sense of urgency surrounding bowel movements.
A change in bowel movements may be due to an acute, short-term infection that typically lasts less than 10 days. Chronic diarrhoea is any change lasting more than four weeks. Please contact your GP if you have diarrhoea lasting more than 14 days, or the appearance of blood in your stools.
What causes diarrhoea?
As a ‘normal’ stool passes through the colon, water contained within it is reabsorbed back into the body along with nutrients and electrolytes. With diarrhoea, the transit time is decreased. This means that there is not the same opportunity for the reabsorption to take place, leading to loose stools.
With acute diarrhoea this may be a result of a bacterial food poisoning, a viral infection such as gastroenteritis, certain medications, or acute anxiety and/or stress.
Chronic diarrhoea may also be caused by ongoing stress and medications, as well as:
- food intolerances or sensitivities
- coeliac disease
- irritable bowel syndrome (IBS-D)
- inflammatory bowel disease
- bile acid malabsorption
- bowel cancer
Are there different types of diarrhoea?
Diarrhoea can either be watery, or fatty, and the causes behind diarrhoea may vary depending on the type.
Watery diarrhoea is often seen with IBS-D, laxative use, and may be caused by alcohol, caffeine or other food sensitivities or intolerances. It is often experienced at night.
Fatty diarrhoea is frequently the result of bile acid malabsorption, or reduced digestive enzyme production. It is a sign of poor or impaired digestion.
What should I do if I have diarrhoea?
The most important consideration whether you have acute or chronic diarrhoea is to stay well hydrated. This may mean drinking more than you would normally, and often feels counterintuitive. However, if you are losing more water than normal through your stools, it is important to replace this. Remember to drink enough so that your urine is a pale straw colour.
For acute cases of diarrhoea, the recommendation is to follow the BRAT diet for a few days to see if symptoms decrease. BRAT stands for bananas, rice, apple (puréed or stewed) and toast, all foods that are easy to digest and soothing for an irritated gut lining.
For chronic diarrhoea, once the GP has ruled out more serious underlying conditions, the goal is always working to understand what might be the cause. A restrictive diet such as BRAT could lead to more problems in the long term, so it’s important to keep as many foods as possible in the diet. A food diary, with a note of symptoms, is key in piecing together possible triggers for the diarrhoea. You could also try:
- supplementing with the probiotic Saccharomyces boulardii, which has been shown in studies to support diarrhoea
- looking at possible food sensitivities/intolerances – including dairy, caffeine, alcohol, spicy foods, sugar alcohols (anything ending in -ol eg. sorbitol, xylitol)
- reducing stress
- eating smaller, more frequent meals or snacks
- working to improve overall digestion
The causes can vary significantly from one person to the next, so a personalised approach is always required. As mentioned above, working with a nutrition professional to understand your own triggers is key to improving symptoms and avoiding long term dietary restrictions.
Book a health review
If you try all of these and are still not seeing signs of improvement then it might be time to delve a little deeper to see what might be causing your symptoms. I offer a free, no-obligation health review to everyone, so book a time that suits you; I’d love to discuss it with you further.