UNDERSTANDING AND MANAGING DIARRHOEA

Everybody has experienced diarrhoea at some point in their lives, unfortunately. It sneaks up, it disappears and it leaves you feeling terrible. Diarrhoea is caused by various elements and to combat this symptom you need to understand what you are dealing with. A comprehensive overview will be given to the different types of diarrhoea and how to manage each one.

Diarrhoea is defined by the World Health Organization (WHO) as three or more watery or loose bowel movements in a 24 hour period.

DIARRHOEA CAN BE CLASSIFIED INTO 2 CATEGORIES

1. Acute diarrhoea

Acute diarrhoea usually lasts for less than 2 weeks. This is commonly found with food poisoning, bacterial or viral infections, travellers’ diarrhoea or the start of a new medication.

2. Chronic diarrhoea

Diarrhoea lasting for longer than 2 weeks is classified as chronic diarrhoea. It can be the result of disease processes, medication or genetic abnormalities. This is usually associated with inflammatory bowel diseases and chronic diseases.

DIFFERENT TYPES OF DIARRHOEA

1. Secretory

Secretory diarrhoea arises when there is an increase in the amount of fluid being drawn into the lumen (the centre hollow part) of the bowel such that the ability of the intestines to reabsorb is overwhelmed. Infective agents are the culprits for this unnatural inability to take up fluid correctly.

2. Osmotic

Osmotic diarrhoea occurs when there is a dysfunction in the ability of the intestine to reabsorb fluid as it flows through the lumen. This faecal matter creates a negative osmotic gradient causing leakage of more fluid into the gut increasing the stool volume. Causes of osmotic diarrhoea include:

  • Decreased enzymatic availability e.g. lactose intolerance.
  • Genetic abnormalities.
  • Sugars that are poorly absorbed (athletes when competing and taking in high sugar supplements while not drinking enough water).

3. Motility-related

Your gut moves with peristaltic movements and for your “food” to move from the beginning to the end can take up to 24 hours. If this movement is too fast or too slow it can lead to diarrhoea.Increased motility can be caused by:

  • Inflammatory bowel disease
  • Irritable bowel syndrome
  • Infectious agents

Decreased motility leads to faecal impaction (constipation) which will lead to faecal leakage that can present as diarrhoea. This is when the stools behind the bulk impacted stool leaks through as a liquid.

TREATMENT

There are various ways to treat diarrhoea; usually diarrhoea is the symptom of a different problem. We will discuss how to manage this symptom.

  • Stay hydrated: fluids are essential when you are losing them more than normal. You can make use of commercially available oral rehydration solutions (ORS) or make your own.Recipe: 1 litre of clean water, 8 teaspoons of sugar and ½ teaspoon of salt.Drink the ORS slowly.
  • Keep your energy levels up: eat small amounts of food that are energy dense. Soft fruits or dry salty biscuits will be tolerated well.
  • ABC – apple, banana, carrot. Grate the apple and carrot and combine banana. Leave to brown and eat slowly. The pectin in the fruit is a water-soluble fibre that helps to absorb the overload of fluid in the intestines. It is also high in potassium and electrolytes that will help with the rehydration and your body functions.
  • Drink tea: rooibos or chamomile tea is known for its calming effect on the gut. It has anti-spasmodic properties that will reduce the peristaltic movements of the intestines slightly.
  • Yoghurt (those brands that specify on pack “with live cultures/probiotics”) contains natural probiotics that will replace the lost “good” organisms in your gut, especially if you have antibiotic-related diarrhoea. You can also mix a sachet of HOWARU® Premium Probiotics from your box of FUTURELIFE® Smart Fibre™ 2in1 in a glass of clean water and drink it.
  • If your diarrhoea worsens at any stage or does not clear up visit a doctor.
  • Remember that you cannot always just treat the symptom to solve the problem.

References

  1. http://www.freece.com/Files/Classroom/ProgramSlides/74e8eb83-3951-476c-87c9-ce00afb7e3b6/Diarrhea%20Homestudy.pdf
  2. http://patients.gi.org/topics/diarrhea-acute-and-chronic/
  3. http://www.medicinenet.com/diarrhea/page4.htm
  4. http://www.healthline.com/symptom/diarrhea
  5. http://www.top10homeremedies.com/how-to/how-to-get-rid-of-diarrhea.html