Diarrhea

What is diarrhea?

Diarrhea means having a loose or watery stool (poop). It’s so common that most people flinch when they hear the word. The thought of thin, sickly-looking poop in the toilet bowl never stops feeling unpleasant. If you have diarrhea, not knowing what’s causing it or how long it’ll last only adds stress to the unpleasant feelings.

The good news is that diarrhea is usually mild (only a few bathroom trips a day) and goes away within a few days.

Sometimes, though, diarrhea is a sign of a serious condition. It can cause you to lose too much fluid (dehydration) or prevent you from getting enough nutrients. It’s important to know what to look out for so you know when to see a healthcare provider about diarrhea and when to wait it out.

Types of diarrhea

Diarrhea goes by different names depending on how long it lasts:

• Acute diarrhea: Acute diarrhea is loose, watery diarrhea that lasts one to two days. It’s the most common type and usually goes away without treatment.
• Persistent diarrhea: Persistent diarrhea lasts about two to four weeks.
• Chronic diarrhea: Chronic diarrhea lasts more than four weeks or comes and goes regularly over a long period. Diarrhea that lasts this long may indicate a more serious condition that warrants a visit with your healthcare provider.

How common is diarrhea?

It’s incredibly common and affects people of all ages. Most adults get acute diarrhea once a year, while children tend to get it twice a year.

What causes diarrhea?

The main cause of diarrhea is a virus that infects your gut (gastroenteritis). Some call it the “stomach flu” or a “stomach bug.” But diarrhea can have lots of causes.

• Infections. Pathogens (viruses, bacteria and parasites) can all cause infections that lead to diarrhea. The most common cause of diarrhea in adults is the norovirus that causes gastroenteritis. Rotavirus is the most common cause of acute diarrhea in children.
• Food poisoning. You can ingest harmful toxins and pathogens from contaminated foods or drinks. Once they’re in your gut, the toxins or germs can cause diarrhea. “Traveler’s diarrhea” is when you get diarrhea while traveling in a new environment with poor hygiene or sanitation. Usually, it’s exposure to bacteria that gives you diarrhea.
• Medications. Diarrhea is a common medication side effect. For example, antibiotics kill harmful bacteria that make you sick, but they can destroy helpful bacteria in the process. Not having enough good bacteria can lead to diarrhea. Diarrhea is also a side effect of antacids with magnesium and some cancer drugs and treatments. Overusing laxatives can also cause diarrhea.
• Foods that upset your digestive system. If you’re lactose intolerant, you get diarrhea because your body struggles to digest lactose, the sugar in dairy. Some people have trouble digesting fructose, a sugar in honey and fruits that’s added as a sweetener to some foods. With celiac disease, you get diarrhea because your body has trouble breaking down gluten, a protein in wheat.
• Diseases affecting your bowels. Diarrhea is a common symptom of conditions that cause irritation and inflammation in your bowels (intestines). Crohn’s disease, ulcerative colitis and irritable bowel syndrome (IBS) can all cause diarrhea. Stress and anxiety can worsen symptoms if you have a condition like IBS.
• Procedures on your bowels. Many people have diarrhea after surgery on their bowels. It may take a while for your digestive tract to absorb nutrients from the foods you’re eating and create firm stools from the waste.

What are the symptoms of diarrhea?

The main sign of diarrhea is loose or watery stool. Other common symptoms include:

• Bloating or cramps in your belly.
• A strong and urgent need to poop.
• Nausea (upset stomach).

These symptoms usually don’t require a provider visit, especially if they only last a few days.

Signs and symptoms of severe diarrhea

Severe cases of diarrhea may signal a medical condition, like a serious infection, that won’t get better without treatment from a healthcare provider.

Contact your provider if you have diarrhea with:

• Fever.
• Severe pain.
• Vomiting.
• Blood or mucus in your stool.
• Weight loss (this can be a sign that your body’s not absorbing enough nutrients).

Contact a provider if you’re experiencing symptoms of dehydration or noticing signs of dehydration in your child, including:

• Headache.
• Flushed, dry skin.
• Irritability and confusion.
• Severe nausea and vomiting.
• Light-headedness and dizziness.
• Fatigue (tiredness that doesn’t improve with rest).
• Dark pee, small amounts of pee or no peeing at all.
• Fewer than six wet diapers a day (infants).
• No wet diapers or peeing for eight hours (toddlers).
• No tears when crying (infants and toddlers).

What are the complications of diarrhea?

Dehydration is one of the biggest concerns with diarrhea. This is especially true among vulnerable populations (infants, people 65 and older and people with compromised immune systems). Without treatment, dehydration can lead to kidney failure, stroke, heart attack or even death.

How is diarrhea diagnosed?

Most cases of diarrhea don’t require a diagnosis or treatment. In more severe cases, your provider will work to determine the cause. They’ll ask about your medical history, family medical history, travel history and any sick contacts you may have.

They may order tests, including:

• Blood tests to rule out certain conditions that cause diarrhea.
• A stool test to check for blood, bacterial infections and parasites.
• A hydrogen breath test to check for lactose or fructose intolerance and bacterial overgrowth.
• An endoscopy of your upper and lower digestive tract to rule out growths or other structural issues that can cause diarrhea, like ulcers or tumors.

How is diarrhea treated?

Usually, you can get rid of diarrhea at home. Over-the-counter (OTC) medicines for diarrhea, like bismuth subsalicylate (Pepto-Bismol® or Kaopectate®), often help people feel better quickly. You’ll need to see a healthcare provider for diarrhea that doesn’t improve or that happens alongside symptoms of severe diarrhea.

Your provider may recommend treatments like:

• Antibiotics or antiparasitics. These drugs kill infection-causing germs.
• Medications that treat chronic conditions. Treating underlying conditions that cause diarrhea, like inflammatory bowel disease (IBD) and IBS, can help.
• Probiotics. Probiotics introduce good bacteria into your gut to combat diarrhea. Your healthcare provider may suggest you try them. Always talk to your provider before starting a probiotic or any supplement.

Can I stop diarrhea without taking anti-diarrhea medicine?

You can often get rid of acute diarrhea through lifestyle changes you can make at home.

• Drink plenty of water and other electrolyte-balanced fluids. These include diluted and pulp-free fruit juices, broths, sports drinks (Gatorade®) and caffeine-free sodas. These drinks replace lost water and electrolytes you’re losing with diarrhea. Electrolytes are substances that help with important processes, like maintaining the balance of fluids in your body.
• Choose foods that can firm your stools. Certain low-fiber foods make stools more solid. Try the BRAT diet: (B)ananas, white (R)ice, (A)pplesauce and (T)oast. Potatoes, noodles, lean beef, fish and chicken or turkey without the skin are also good options. Changing your diet can make a huge difference when it comes to getting relief.
• Avoid caffeine and alcohol. Caffeinated foods and drinks can have a mild laxative effect that worsens diarrhea. Steer clear of coffee, sodas, strong tea/green tea and chocolate. Avoid alcohol, which can lead to dehydration.
• Avoid foods and drinks that give you gas. Avoid beans, cabbage, brussels sprouts, beer and carbonated beverages to prevent stomach cramps. Sometimes, diarrhea can make you temporarily lactose intolerant. Avoiding dairy until your diarrhea clears is a good idea.

How can I relieve discomfort caused by diarrhea?

Diarrhea can cause your anus (butthole) to feel sore, itchy or like it’s burning. It may hurt to poop. You can ease the pain by sitting in lukewarm water in the bathtub or trying a sitz bath. Pat your anus dry instead of rubbing it when you get out of the water. Applying petroleum jelly or a hemorrhoid cream to your anus can keep it from getting too raw.

What do I do if my baby or young child has diarrhea?

Call your child’s pediatrician if they have severe diarrhea. Treatments for diarrhea in children are different from treatments for adults. Over-the-counter medications may be dangerous.

Children are also at a higher risk of dehydration than adults. Your provider will help you determine the best way to keep them hydrated, but options include:

• Breast (chest) milk.
• Formula.
• Electrolyte drinks (Pedialyte®) for older children. (Providers don’t recommend this for babies.)

The best option to keep your child hydrated might change as the child gets older. Always check with a provider before giving your child a new liquid or treatment of any kind.

Can diarrhea be prevented?

​​You can’t always prevent diarrhea, but you can reduce your risk of getting it because of infections or food contamination.

• Practice good hygiene: Wash your hands with soap and water after using the bathroom or preparing and eating food. Another option is to use hand sanitizer.
• Get vaccinated: The rotavirus vaccine prevents rotavirus, a common cause of diarrhea. The vaccine for COVID-19 can reduce your risk of getting COVID and experiencing COVID symptoms, including diarrhea.
• Store food properly: Store food at the correct temperatures, and cook all foods until they reach the recommended temperatures. Don’t take chances by consuming foods or drinks past their expiration dates.
• Watch what you drink when you travel: Don’t drink untreated water when you travel. Avoid tap water, ice cubes or brushing your teeth with tap water. Steer clear of unpasteurized milk or juice products. Pasteurization is a process that kills germs in certain drinks. When in doubt, drink bottled water or something that’s been boiled first (coffee or tea).
• Watch what you eat when you travel. Avoid raw or undercooked meats (and shellfish), as well as raw fruits and vegetables. Fruits and veggies are usually healthy options, but the skin may contain contaminants that can make you sick.

When should I call my doctor about diarrhea?

Call your healthcare provider if you have diarrhea that doesn’t improve or go away within a few days. Reach out if you have a fever, severe pain and a bloody stool in addition to diarrhea.

See a healthcare provider if you’re experiencing symptoms of dehydration, which can be serious without treatment.

A note from Cleveland Clinic

Going to the bathroom, having a bowel movement, pooping — no matter what you call it, stool is a regular part of life. That’s a big reason why diarrhea is so uncomfortable. It messes up our normal. Usually, diarrhea is a short-term thing that resolves in a few days. If it doesn’t, or if you’re experiencing symptoms of severe diarrhea, contact your healthcare provider. And don’t be embarrassed. Diarrhea is a common condition your provider knows all about. They can advise you on the best ways to get relief fast.