How much do you know about diarrhea?

Diarrhea is a very common clinical symptom, and it has two characteristics: first, more than three bowel movements per day, or significantly more than the usual number of bowel movements; second, the daily fecal volume exceeds 200 grams, the feces are thin, and the water content is greater than 85%. Only when these two characteristics are present can diarrhea be diagnosed.

Three symptoms that are easily misdiagnosed as diarrhea

First, fecal incontinence. It is manifested by an increase in the frequency of bowel movements, and there may also be unformed stools, but the daily fecal volume does not increase and does not exceed 200 grams. This cannot be diagnosed as diarrhea.

Second, poor bowel movements. This is manifested by a significant increase in the number of bowel movements per day, even up to 10 to 20 times, and the stool is not formed, but the total amount of stool per day has not increased. Instead, there is abdominal distension and pain, and a feeling that there is stool in the stomach. This cannot be diagnosed as diarrhea.

Third, the stool is not formed. For many years, the patient usually has a bowel movement once a day, but every morning he always has watery diarrhea, which is not much, without mucus, pus, blood, or abdominal pain. Instead, the patient feels comfortable after defecation.

Although these three symptoms are very similar to diarrhea, the first two cases do not have the characteristics of increased stool volume and high water content in the stool, and the latter case does not have the characteristic of increased bowel movement frequency, so they cannot be diagnosed as diarrhea. This is what we should pay attention to in clinical differentiation.

Where does the water in diarrhea come from?

When you have diarrhea, a lot of water is excreted from your stool, but normally, there is no noticeable amount of water in your stool. So where does the large amount of water in your intestines come from when you have diarrhea?

In a normal person, 9 to 10 liters of fluid enter the gastrointestinal tract within 24 hours. These fluids include fluids ingested through diet and digestive fluids secreted by the gastrointestinal tract. Under normal circumstances, most of these fluids will be absorbed by the intestines, and only a small amount of water will be excreted with feces. In the case of diarrhea, the human intestine will be in a state of high osmotic pressure, and the water in the body will penetrate into the intestinal system through the intestinal wall. In severe cases, water in the blood will also penetrate into the intestinal system; at the same time, the absorption function of the intestine will be affected, and it will not be able to absorb the water in the food, causing the water in the food to be excreted intact. Therefore, there will be more water in the stool during diarrhea.

Possible complications of persistent diarrhea

First, diarrhea causes a large amount of water loss, which can lead to dehydration. Severe dehydration can lead to shock and even be life-threatening. It also causes a lot of electrolyte loss, especially magnesium, sodium, and potassium ions. Diarrhea is often accompanied by dehydration and electrolyte imbalance.

Secondly, the gastrointestinal tract is an important place for the human body to absorb nutrients. When diarrhea occurs, the intestinal nutrients are lost first, and the nutrients taken in cannot be fully digested and absorbed by the body. If diarrhea cannot be controlled in time, the human body will lack nutrients such as sugar, fat, protein, and vitamins, which will lead to malnutrition, weight loss, anemia, hypoproteinemia, etc.

Third, if the diarrhea lasts for a long time, a large amount of nutrients will be lost, which will lead to a decrease in the body's immune function and make it easy for pathogens to invade.

Because of this, diarrhea should be taken seriously by us. If it is not treated in time and is not cured, it will cause serious harm to the human body and may even endanger life.

Classification and causes of diarrhea

Generally speaking, depending on the length of the disease course, diarrhea is clinically divided into two categories: acute diarrhea and chronic diarrhea.

Acute diarrhea refers to a disease course of less than 3 weeks, with more than 10 bowel movements per day, and a large amount of loose stools. The following diseases may cause acute diarrhea: (1) intestinal infection, including intestinal infection caused by viruses, bacteria or parasites; (2) poisoning, mainly food poisoning, heavy metal poisoning and pesticide poisoning; (3) gastrointestinal side effects of drugs, including oral laxatives (polyethylene glycol, lactulose), digitalis drugs, non-steroidal anti-inflammatory drugs, proton pump inhibitors and hypoglycemic drugs such as metformin, all of which may cause adverse reactions such as irritation of the gastrointestinal tract and diarrhea; (4) other intestinal diseases, including acute exacerbation of ulcerative colitis, acute necrotizing enterocolitis and food allergies.

Chronic diarrhea refers to diarrhea lasting more than 4 weeks. The following diseases may cause chronic diarrhea: (1) intestinal infectious diseases, such as chronic amoebic dysentery, chronic bacillary dysentery, intestinal tuberculosis, intestinal candidiasis, and giardiasis; (2) non-infectious intestinal inflammation, such as inflammatory bowel disease, radiation colitis, ischemic colitis, and diverticulitis; (3) intestinal tumors, such as colorectal cancer, colon adenomatosis, small intestinal malignant lymphoma, carcinoid, and intestinal vipoma; (4) small intestinal malabsorption, mainly primary and secondary small intestinal malabsorption; (5) intestinal motility diseases, mainly irritable bowel syndrome; (6) gastric and hepatobiliary and pancreatic diseases, such as post-subtotal gastrectomy-gastrojejunostomy, chronic atrophic gastritis, chronic hepatitis, cirrhosis, chronic pancreatitis, chronic cholecystitis, and alcoholic diarrhea.

Classification and causes of diarrhea 2

Exudative diarrhea is diarrhea caused by inflammation of the intestinal mucosa. It is characterized by diarrhea with mucus, pus and blood in the stool. Common diseases include infectious diseases (such as bacillary dysentery, amoebic dysentery, viral enteritis, typhoid fever, salmonella infection sepsis, schistosomiasis), non-infectious inflammation (nonspecific ulcerative colitis, Crohn's disease, allergic eosinophilic gastroenteritis, colon diverticulitis, colon cancer, rectal cancer).

Osmotic diarrhea is diarrhea caused by a significant increase in intestinal osmotic pressure. The characteristic is that the stool contains a large amount of food components that are not completely digested or decomposed. Once fasting, the diarrhea stops. Causes of this type of diarrhea include oral hyperosmotic drugs, such as magnesium sulfate; congenital enzyme deficiency, such as congenital lactose intolerance; chronic pancreatitis and liver disease and biliary obstructive diseases causing insufficient pancreatic secretion, reduced bile secretion or obstructed excretion.

Secretory diarrhea refers to diarrhea caused by excessive secretion of water and electrolytes and inhibition of absorption due to irritation of the intestinal mucosa. The clinical characteristics of secretory diarrhea are the discharge of large amounts of watery stool (up to several liters per day), the stool does not contain pus or blood, the diarrhea does not stop after fasting, and there is generally no abdominal pain. Diseases that cause secretory diarrhea include cholera, vipoma, short-term syndrome and fat malabsorption caused by pancreatic and small intestinal lesions, extensive small intestinal lymphoma, collagenous colitis, etc.

Dynamic diarrhea refers to diarrhea caused by excessive intestinal peristalsis, which shortens the time in which intestinal contents stay in the intestine and is not fully absorbed. Its clinical characteristics are paroxysmal abdominal pain, which is relieved after diarrhea and is often accompanied by abdominal borborygmi. It is common in diseases such as enteritis and gastrointestinal dysfunction, and the representative disease is irritable bowel syndrome.

Diarrhea can also occur with extra-gastrointestinal illnesses

In addition to digestive system diseases that can cause diarrhea, systemic diseases can also cause diarrhea by affecting the intestines. Common diseases include hyperthyroidism, hypoparathyroidism, diabetes, uremia, chronic adrenocortical insufficiency, systemic lupus erythematosus, niacin deficiency, food and drug allergies.

In addition, the occurrence of diarrhea may be related to lifestyle. For example, if you like to wear belly-revealing clothes or fail to add clothes in time when the temperature changes, it may cause the abdomen to catch cold and cause diarrhea symptoms. Unclean diet, overeating, a preference for raw, cold, spicy, and indigestible foods, as well as foods and beverages with artificial sweeteners, caffeine or alcohol may also cause diarrhea and should be avoided.

In summary, diarrhea may seem simple, but its causes are complex and each has its own corresponding clinical manifestations. If not treated in time, it may be life-threatening. Therefore, once you encounter this situation, you should go to the gastroenterology department of a regular hospital in time to complete the diagnosis and treatment under the guidance of a doctor.