Diarrheal Diseases are a Scourge to Humanity

Diarrheal diseases have been a scourge to humanity throughout recorded history all over the world. “Infections are estimated to account for three to four billion cases of diarrhea each year, and up to 4.3 million deaths in children under the age of five years,” says an article in the Canadian Journal of Gastroenterology.

Poor countries bear the biggest brunt but developed countries are not spared.

Diarrhea means loose, watery stools and abdominal cramps. Frequency of bowel movements may vary in each case. It may be acute in nature. That means it may last only a few days. It is unpleasant and from time to time almost everyone experiences it.

Most common causes of acute diarrhea are due to infections. Viruses like rotavirus and adenovirus are common examples in young children. Direct contact easily spreads viral diarrhea.
Parasites such as giardia and cryptosporidium can cause diarrhea. Certain bacteria like campylobacter, salmonella, shigella and E. coli can cause diarrhea. The source of infection is contaminated food or water.

Acute diarrhea can also be side effect of many medications, particularly antibiotics. Antibiotics related colitis has been discussed in these columns before. Traveller’s diarrhea can occur in 20 to 50 percent of travellers to tropical countries. Eighty percent of traveller’s diarrhea is due to bacterial infection.

Chronic diarrhea lasts much longer than acute diarrhea. Diarrhea lasting four weeks would probably be considered chronic but six to eight weeks would provide a better distinction.

The prevalence of chronic diarrhea in developed countries seems to be approximately five percent. It can be a sign of a serious disorder like chronic infection, inflammatory bowel disease or poor absorption of nutrients (malabsorption). It may be due to a less serious condition such as irritable bowel syndrome.

Other causes of diarrhea are lactose intolerance (a sugar found in milk and milk products), artificial sweeteners (sorbitol and mannitol), found in chewing gum and other sugar-free products can cause diarrhea.

There are many more causes of chronic diarrhea. They cannot all be mentioned here. To name a few: dumping syndrome, celiac disease, chronic pancreatitis, antacids, alcohol use and diabetes.

In one study, 30 percent of the patients a definite cause of diarrhea was found. In 20 percent of the patients the cause was found to be in laxative and diuretic abuse. In 50 percent of the patients no specific diagnoses was made. They were given the diagnoses of “functional” or “idiopathic” diarrhea.

Most significant complication of diarrhea is dehydration – as suggested by excessive thirst, dry mouth, little or no urination, severe weakness, dizziness or lightheadedness. This can be dangerous especially in children and the elderly. Bloody diarrhea with fever can be dangerous too. One should seek immediate medical help.

Sometimes diarrhea is only an inconvenience. Sometimes it can be life threatening. Sometimes it can be prevented by good preventive measures like washing hands and avoiding potentially contaminated food and water. Sometimes there is not much you can do to avoid it – especially in cases like ulcerative colitis, Crohn’s disease and other medical conditions.

If there is a change in your bowel habit then seek medical attention. It may save your body and your butt lot of grief.

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