Chronic diarrhea: Causes, Risk and Treatment

Picture of chronic diarrhea

What is Chronic diarrhea?

Diarrhea that lasts for more than 2-4 weeks is considered persistent or chronic. In an otherwise healthy person, chronic diarrhea can be a nuisance at best or become a serious health issue. For someone who has a weakened immune system, chronic diarrhea may represent a life-threatening illness.

Causes of Chronic diarrhea

A wide range of problems can cause chronic diarrhea; some of the most common causes include irritable bowel syndrome (IBS), inflammatory bowel disease (Crohn disease and ulcerative colitis), malabsorption syndromes in which food cannot be digested and absorbed, and chronic infections. There are also many other less common causes of chronic diarrhea.

Irritable bowel syndrome: Irritable bowel syndrome is one of the most common causes of chronic diarrhea. IBS can cause crampy abdominal pain and changes in bowel habits (diarrhea, constipation, or both). IBS can develop after having an infection.

Inflammatory bowel disease: There are several types of inflammatory bowel disease, two of the most common of which are Crohn disease and ulcerative colitis. These conditions may develop when the body’s immune system attacks parts of the digestive tract.

Infections: Intestinal infections are a cause of chronic diarrhea. Infections that cause chronic diarrhea can be seen in people who travel or live in tropical or developing countries. Intestinal infections can also develop after eating contaminated food or drinking contaminated water or unpasteurized (“raw”) milk.

Endocrine disorders: An overactive thyroid (hyperthyroidism) can cause chronic diarrhea and weight loss. Diabetes can cause chronic diarrhea if the nerves that supply the digestive tract are injured.

Food allergy or sensitivity: Food allergies and hypersensitivity can cause chronic diarrhea. People with celiac disease are sensitive to gluten, a major component of wheat flour which can cause diarrhea and weight loss. Patients with lactose intolerance develop diarrhea and gas when they ingest milk.

Medicines: Medicines (prescription and nonprescription), herbs, and dietary supplements can cause diarrhea as a side effect. To determine if a medicine could be the cause of your diarrhea, review your list of medicines with your doctor, nurse, or pharmacist. This information may also be available on the medicine bottle or paperwork that comes with most prescriptions.

Risk for Chronic diarrhea

The risk of serious complications from chronic diarrhea depends on the cause of the diarrhea and the age and general health of the patient. Chronic diarrhea from some causes can result in serious nutritional disorders and malnutrition. Severely immunocompromised persons, including those with HIV/AIDS and those receiving chemotherapy for cancer or organ transplantation can be at risk for serious chronic diarrhea. Determining the correct cause of chronic diarrhea is necessary in order to select proper treatment and reduce the risk of serious complications.

How is Chronic diarrhea Treated?

The treatment of chronic diarrhea is determined by its cause. Follow the advice of your health care provider.

  • Diarrhea caused by an infection sometimes can be treated with antibiotics or other drugs. However, the correct diagnosis must be made so that the proper medication can be prescribed.
  • Diarrhea not caused by an infection can be more difficult to diagnose and therefore treat. Long term medical treatment and nutritional support may be necessary. Surgery may be required to treat some causes of chronic diarrhea.

For diarrhea whose cause has not been determined, the following guidelines may help relieve symptoms. Follow the advice of your health care provider.

  • Remain well hydrated and avoid dehydration. Serious health problems can occur if the body does not maintain proper fluid levels. Diarrhea may become worse and hospitalization may be required if dehydration occurs.
  • Maintain a well-balanced diet. Doing so may help speed recovery.
  • Avoid beverages that contain caffeine, such as tea, coffee, and many soft drinks.
  • Avoid alcohol; it can lead to dehydration

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