Diarrhea means passing loose and watery stools. The severity of the condition may vary between slightly watery faeces along with an upset stomach that stays for a day or two or extremely watery faeces along with severe abdominal pains.
Symptoms of diarrhea
Common symptoms associated with diarrhea include:-
- Loose watery stools with three or more frequency a day
- Change in consistency of stools from usual (stools may become loose or less formed)
- Nausea and vomiting may be seen
- High temperature or fever over 38ºC (100.4ºF)
- Moderate to severe abdominal cramps
- Loss of appetite. Babies and infants may refuse to feed
- There may be a metallic or bitter taste in the mouth
With severe episodes of diarrhea there may be dehydration as well. This is particularly dangerous especially for young children and the elderly.
Babies having six or more episodes of Diarrhea in the past 24 hours are at risk of dehydration. Children with over six episodes of watery Diarrhea in the past 24 hours along with vomiting, bloody diarrhea and diarrhea that lasts for longer than two weeks are at risk of dehydration and need urgent attention.
Adults who have been recently treated in a hospital, or who have been treated with antibiotics, bloody diarrhea, persistent diarrhea and vomiting, abnormal weight loss and large volumes of watery diarrhea are at risk of dehydration and complications.
Symptoms of dehydration
Symptoms of dehydration include:-
- In children:-
- Increased thirst
- Cold, pale and clammy skin
- Irritable or drowsy
- Passing urine infrequently and passing dark coloured urine
- Cold hands and feet
- Dry tongue
- Sunken eyes and no tears
- There are sunken cheeks and sunken soft spot over the skull
- Skin stays pinched up and takes time to return to normal.
- In adults:-
- Increased thirst
- Fatigue, dizziness and light headedness
- Loss of appetite
- Dry tongue
- Sunken eyes
- Muscle cramps
- Rapid heart rate
Diagnosis of diarrhea and dehydration
Diarrhea and dehydration is most commonly diagnosed clinically by symptoms.
Most cases resolve on their own within 2 days or less. In these cases diagnostic tests are usually not necessary.
If diarrhea lasts longer or is accompanied by symptoms such as fever or bloody stools diagnostic tests may be used to determine the cause of diarrhea.
Investigations and diagnosis involves:-
- History of exposure to contaminated food or water or travel
- Physical examination for dehydration symptoms
- Stool is examined for bacteria, virus or parasites. Stool culture is also advised if the causative organism is not detected on examination
- Blood tests are used to detect causes that may lead to chronic diarrhea. Routine blood tests may detect anemia in cases of parasitic or other infections. Infections also show up as raised white blood cell count.
- Food allergy and intolerance tests may also be advised
- Sigmoidoscopy or colonoscopy is advised if inflammatory bowel disease or bowel cancers are suspected. Sigmoidoscopy and colonoscopy involves introducing a thin, flexible, lighted tube with a camera on its tip into the large intestines.