23 Mar
2009

Whereas some people experience one or two bowel movements daily, others may have one only every few days. These patterns are all normal according to each individual. The term diarrhea is usually reserved for bowel movements that are excessively frequent and tend to be watery and poorly controlled. The onset may be sudden or gradual, and the degree of looseness may vary from time to time.

Diarrhea should be considered abnormal when it is different from your usual bowel movement pattern. Even though it may come as a relief after many years of constipation, the experience of new diarrhea should be taken seriously. If it continues for more than three or four days or if it returns frequently, medical advice should be sought. Any degree of diarrhea that begins to interfere with the normal activities of your life or shows mucus or blood must be checked immediately.

One of the common causes of diarrhea is infection. Various viruses (“stomach flu”) and bacteria can infect your bowel and cause diarrhea. Usually you will have other evidence of infection, such as fever and abdominal pain. The diarrhea is usually short-lived and does not recur.

An older person also may suffer from inflammatory bowel disease, even though it is more common in younger people. The diarrhea is often combined with mucus and blood, and you may have other symptoms as well, such as fever. It usually persists, unlike infectious diarrhea, until properly diagnosed and treated.

Malabsorption may appear initially as loose bowel movements. It may take some time before you become aware of weight loss, which is usually associated with poor absorption and digestion of food.

If you have traveled a great deal or lived under unhygienic conditions, you may suffer from parasites, which can cause diarrhea. The diarrhea often contains red blood.

An often overlooked cause of diarrhea in older individuals is lactose intolerance, the result of a lack of the lactase enzyme that normally breaks up lactose, the sugar found in milk. Therefore, milk products are not properly digested and the sugar is fermented by the bacteria in the intestine. The symptoms include bloating, gas, abdominal cramps, and frequent loose bowel movements. You may notice that your symptoms often follow meals in which milk products are eaten. Remember, although you avoid milk, yogurt, and cheese, many packaged foods, including bread, contain milk.

Some people with lactose intolerance may spontaneously improve periodically and may be able to tolerate small amounts of milk products. However, after a bout of stomach flu, you may no longer be able to endure milk products and once again develop bowel symptoms.

If you overuse laxatives, you may develop diarrhea that alternates with constipation. This kind of diarrhea can be a result of excess laxative use and is very common in older people. You should avoid laxatives and seek advice from your physician.

With a bowel obstruction, sometimes the only material that can pass through the blockage is liquid stool, which appears as diarrhea. Medication may relieve the diarrhea but this only exaggerates the obstruction and is dangerous. Diarrhea that alternates with constipation should always be investigated thoroughly.

Because many possible reasons for diarrhea exist, there is no single effective treatment. The most important step is to find the underlying cause, and unless the diarrhea is clearly the result of a temporary problem such as flu, which can be expected to improve within a few days, diarrhea should not be treated with constipating agents except under medical supervision.

The short-term therapy consists of decreasing food intake and eating a primarily liquid diet. Soups, juices, and tea are recommended during the treatment of the kind of diarrhea that often occurs with bowel infections. If you are in the habit of taking laxatives, you should consult your physician about stopping them. If the diarrhea continues despite discontinuing laxatives, your physician should investigate the cause. This should be done without delay if the diarrhea persists.

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