Diarrhea is a type of digestive problem that is characterized by watery or loose stools. Diarrhea is experienced by many individuals and these episodes are usually acute, which get better in a few days without any complications. However, some people have diarrhea, which persists for greater than 2-4 weeks and this is referred to as chronic diarrhea. Acute diarrhea is not a serious issue, but, chronic diarrhea if not treated can result in problems. Hence, it’s imperative to diagnose the underlying cause and treat it.
What Causes Chronic Loose Stools?
Excessive consumption – Quite frequently the cause of diarrhea is excessive intake of something in diet. Usually this is excessive intake of some chemical substance or sugar. Examples include caffeine and alcohol. Excessive consumption of alcohol particularly wine and beer may result in loose stools next morning. To see if alcohol is causing diarrhea, stop total consumption of alcohol and check if you still have loose stools. If your diarrhea stops, then you may resume drinking cautiously at a modest level.
Drinks – Drinks containing caffeine have laxative properties. Drinking greater than 2 or 3 cups of tea or coffee per day can result in diarrhea. Stop gradually instead of stopping at once to prevent headache and then try stopping completely for some time. Certain chemicals may still be present in decaffeinated drinks that may loosen your stools. Smaller amounts are tolerated by most people well.
Sugar – Diarrhea can result from some sugars. For instance, artificial sweetener sorbitol possesses no calories, but it works as a laxative if consumed in sufficient quantity. Fructose is the natural sugar present in fruits. It is also present in candies, honey, preservatives and soft drinks. In sufficient quantity it can lead to diarrhea. Many people suffer from loose and frequent bowel movements in summer when fresh vegetables and fruits are available freely. You should keep your intake of fruits to moderate.
Lactose intolerance – Lactose intolerance can cause chronic loose stools in some individuals. Lactose is a type of sugar present in milk of cow. For its digestion, the enzyme lactase should be present in adequate amounts in the small intestine. To treat lactose intolerance, in the beginning all products that contain lactose are eliminated from your diet. Then moderate quantities of dairy products or dairy products that are modified are reintroduced gradually into your diet as per your tolerance.
Herbs – Herbal medicines frequently contain laxatives. A common example is senna tea. Herbs that have laxative effect may be present in multiple other popular medicines. Moreover, all the contents present in an herbal medicine may not be printed on the label. To make sure that an herbal medicine is the cause of diarrhea you have to stop the medicine for some time and then see whether the diarrhea stops or not.
Medicines – Many medicines that are taken regularly can cause diarrhea as a side effect. Some of these medicines are:
- Antacids that contain magnesium hydroxide
- Stool softeners
- Caffeine and
- Drugs taken for ‘regularity’
You should be cautious if you are taking any medicine regularly or taking any natural or herbal medicine.
Allergies – True allergies to food can rarely cause chronic loose stools. If you are trying an elimination diet, you should take care to not end up consuming a diet that is nutritionally deficient. It is important to do it under the supervision of your physician.
Infections – Chronic diarrhea may occur due to infections with gut parasites, which are common in certain parts of world. They are detected either in stool tests or by biopsy of small bowel.
Surgeries – Chronic diarrhea may sometime occur as a complication of previous surgeries of intestines. You should inform your physician of any history of abdominal surgery and its precise nature, since diarrhea of this type can be treated.
Malabsorption – Certain medical conditions, which interfere with the digestion and absorption of nutrients, can cause loose stools. This occurs because due to malabsorption excess of some substances such as fats are left undigested in your stool. Two common malabsorption disorders are Celiac disease and Crohn’s disease. Furthermore, radiation therapy to abdominal area may temporarily result in malabsorption leading to chronic loose stools.
Irritable Bowel Syndrome – IBS may cause diarrhea or loose stools all through the day or in morning. IBS presents itself in many forms and in the form where diarrhea is the predominant symptom; the intestinal contractions are very strong and remains for longer than usual. This leads to the passage of water and food very fast causing diarrhea.
Food Poisoning – Food borne diseases often result in loose stools and they can be viral, bacterial or parasitic. This is due to gastroenteritis, which is an inflammation of stomach and bowel. The water is not reabsorbed properly by colon resulting in loose stools. Diarrhea may be accompanied by stomach cramps and in bacterial food poisoning the stools may be foul smelling. Food poisoning usually gets resolved within a week or so.
Dumping Syndrome – This occurs when food reaches small intestine quite fast. People who suffer from dumping syndrome pass stool within ½ an hour of eating a meal. This is one of the causes of chronic loose stools just after eating. Dumping syndrome is a common complication of gastric bypass surgery.
Hyperthyroidism – Hyperthyroidism is characterized by excessive secretion of thyroxine hormone which results in high metabolic rate. This leads to diarrhea as your body processes food faster than normal. Other symptoms are unexpected loss of weight, rapid heartbeat, irritability and anxiety, tremors of finger and hand, brittle hair, sleep disruptions and thinning of skin.
When to Visit a Physician
Consult a physician if diarrhea is associated with the following symptoms:
- Blood in stools
- Tar like black stools (loose or not)
- Fever greater than 101 degrees F for more than one day
- Severe pain in rectum or abdomen
- Diarrhea for 2 days or greater than that
- Vomiting or nausea due to which you cannot drink fluids
- Stool problems start after you return from overseas
How to Deal with Chronic Loose Stools
Treatment depends on underlying cause. The following are some of the treatment options:
Manage the Related Condition
Diarrhea caused due to a medical illness such as irritable bowel syndrome will resolve once the illness is treated. It is imperative to consult your physician and develop a management plan to treat loose stools and the underlying condition.
Anti-diarrheal medicines should be used for short term to relieve symptoms.
Other medicines that may help are:
- Antibiotics to treat infections
- Medicines that contain codeine can decrease loose and watery stools
- OTC medicines such as Pepto-Bismol (bismuth) and Imodium (loperamide) may slow down stool passage through digestive tract.
People who are on medicines that have chronic diarrhea as side effect should consult their physician about alternative medicines, which do not have this adverse effect.
It is imperative to remain hydrated. Drink plenty of clear fluids including water, low-sodium broth and non-caffeinated teas all through the day.
If a particular drink or food is causing loose stools, remove them from your diet and see if your stools improve.
You can maintain a food diary to help spot your trigger foods or drinks.
Other changes in diet that you can make are:
- Limit or avoid caffeine
- Limit or avoid alcohol
- Follow portion control
Chronic diarrhea may be relieved by certain natural products. Probiotics may help in restoring a balance of good bacteria in the gut. Certain fiber supplements including psyllium may help in relieving chronic diarrhea particularly in individuals suffering from IBS. However, you should avoid psyllium supplements that also have laxatives.