Acute Diarrhoea in Adults

Diarrhoea can be acute (sudden onset and lasting less than 2 weeks) or chronic (ongoing).

What causes acute diarrhoea?

Infection - of the guts is the common cause. This is called acute infectious diarrhoea. Many bacteria, viruses and other 'bugs' can cause it. Sometimes the bugs come from infected food (food poisoning). Infected water is a cause in some countries. Sometimes it is just 'one of those bugs going about'. Viruses are easily spread from one person to another by close contact or when an infected person prepares food for others.

Other causes - are uncommon. Drinking lots of beer, side effects from some medicines and anxiety are some examples.

Bowel conditions - that cause chronic diarrhoea, such as colitis, may be mistaken for acute diarrhoea when they first begin.

What are the symptoms of acute infectious diarrhoea?

Symptoms range from a mild stomach upset for a day or two with slight diarrhoea to severe watery diarrhoea for several days or longer. Crampy pains in the abdomen (tummy) are common. Pains may ease each time some diarrhoea is passed. Vomiting, high temperatures (fever) and headaches may also develop.

Can diarrhoea be prevented?

Good hygiene helps to prevent infectious diarrhoea. Always wash your hands:

• after going to the toilet
• before touching food
• after gardening
• after playing with pets (healthy animals can carry certain harmful bacteria)
• between handling raw meat and food ready to be eaten. (There may be some bacteria on raw meat.)

If you have infectious diarrhoea, the following are also recommended until symptoms go:

• Clean the toilets that you use frequently
• Wipe the flush handle and toilet seat with disinfectant (such as household bleach) after each time you use the toilet
• Wash your hands thoroughly after going to the toilet. Don't share towels and flannels
• Do not prepare food for others

What is the treatment for acute infectious diarrhoea?

Acute infectious diarrhoea normally clears within a week or so. The immune system usually fights off the infection. The following are commonly advised until symptoms ease.

Drinks - have lots to drink. The aim is to avoid dehydration (low body fluid) which is the main possible complication of severe diarrhoea. Even if you vomit or don't feel like it, it is important to take frequent sips as some fluid will still be absorbed. Ideally, fruit juice should be included as this contains some sugar. However, any drink is better than none.

Rehydration drinks - may be advised by a doctor or nurse. They are used if there is a concern about dehydration. They can be taken instead of, or in addition to, normal drinks. They are made from sachets that can be bought from pharmacies. The contents of the sachet are added to water. Rehydration drinks provide a perfect balance of water, salt and sugar. They are better than just drinking water alone. The small amount of sugar and salt helps the water to be absorbed better from the gut into the body. They do not stop or reduce diarrhoea but are the best drinks to prevent or treat dehydration. (Do not use home made salt drinks as the quantity of salt has to be exact.)

Eat as normally as possible. It used to be advised to 'starve' for a while but this is now known to be wrong. However, you may not feel like food and most adults can do without food for a few days (but don't stop drinking). Eat as soon as you are able. Soups and foods high in carbohydrate such as bread or pasta are best to start with.

Anti-diarrhoea medicines - are not usually advised. Plenty to drink and a 'let it out' approach is often all that is required. However, limiting the number of toilet trips may be desirable. Anti-diarrhoea medicines can be bought from pharmacies. (These medicines should not be given to children). Possibly the safest and most effective is loperamide. The dose of this is 2 capsules at first followed by 1 capsule after each motion. The maximum is 8 in 24hrs. It works by slowing down the gut's activity.

Paracetamol - is useful to ease fever or headaches.

Antibiotics - are rarely needed. They may be prescribed if symptoms are severe.

Are there any complications from acute diarrhoea?

Complications are uncommon. See a doctor if any of the following develop or if any other symptoms occur that you are concerned about.

• Dehydration. This may be developing if you drink little, pass little urine, have a dry mouth and tongue or become drowsy
• Blood in diarrhoea
• Vomiting for more than 1-2 days or diarrhoea not starting to settle after 3-4 days
• Pains that are getting worse
• Drowsiness or confusion
• Infections caught abroad

Extract from Mentor Plus copyright OUP, EMIS and Authors 1999

Acute Diarrhoea in Children

Diarrhoea can be acute (sudden onset and lasting less than 2 weeks) or chronic (ongoing). This leaflet just deals with acute diarrhoea which is very common in children.

What causes acute diarrhoea?

Infection of the guts is the common cause. This is called acute infectious diarrhoea. Many bacteria, viruses and other 'bugs' can cause it. Sometimes the bugs come from infected food (food poisoning). Infected water is a cause in some countries. Sometimes it is just 'one of those bugs going about'. Viruses are easily spread from one person to another by close contact or when an infected person prepares food for others. Non-infectious causes of acute diarrhoea are uncommon in children.

What are the symptoms of acute infectious diarrhoea?

Symptoms can range from a mild stomach upset for a day or two with slight diarrhoea to severe watery diarrhoea for several days or longer. Crampy pains in the abdomen (tummy) are common. Pains may ease each time some diarrhoea is passed. Vomiting, high temperature (fever) and headache may also develop.

Can diarrhoea be prevented?

Good hygiene helps to prevent infectious diarrhoea. Always wash your hands and teach children to wash theirs:

• after going to the toilet (and after changing dirty nappies).
• before touching food.
• after gardening.
• after playing with pets (healthy animals can carry certain harmful bacteria).
• between handling raw meat and food ready to be eaten. (There may be some bacteria on raw meat.)

If a child has infectious diarrhoea, the following are also recommended until symptoms go.

• Clean the toilets that they use frequently.
• Wipe the flush handle and toilet seat with disinfectant (such as household bleach) after each time they use the toilet.
• Make sure they wash their hands after going to the toilet. Don't share towels and flannels.
• Do not let them help prepare food for others.

What is the treatment for acute infective diarrhoea in children?

Acute diarrhoea normally clears within a week or so. The immune system usually fights off the infection. The following are commonly advised until symptoms ease.

Drinks - give lots to drink. The aim is to avoid dehydration (low body fluid) which is the main possible complication of severe diarrhoea. Even if the child vomits or feels sick it is important to give frequent sips as some fluid will still be absorbed. Ideally, fruit juice should be included as this contains some sugar. However, any drink is better than none. If the child will only drink their favourite drink then that is fine. (Ice cubes and ice lollies are useful extra sources of fluid.)

Rehydration drinks - may be advised by a doctor or nurse. They are used if there is a concern about dehydration. They can be taken instead of, or in addition to, normal drinks. They are made from sachets available from pharmacies. The contents of the sachet are added to water. Rehydration drinks provide a perfect balance of water, salt and sugar. They are better than just drinking water alone. The small amount of sugar and salt helps the water to be absorbed better from the gut into the body. They do not stop or reduce diarrhoea but are the best drinks to prevent or treat dehydration. (Do not use home made salt drinks as the quantity of salt has to be exact.)

Food - do not starve a child with diarrhoea. This used to be advised but is now known to be wrong. The child should eat as normally as possible. However, if he or she does not want to eat, then that is fine. Drinks are the most important and food can wait until their appetite returns. Offer some food every now and then. Soups and food high in carbohydrate such as bread, crackers and pasta are best to start with.

Breast fed babies - should continue to breast feed if they will take it. This is in addition to extra rehydration drinks if advised.

Bottle fed babies - should be fed with their normal full strength feeds if they will take it. Again, this is in addition to extra rehydration drinks if advised.

Medicines - to stop diarrhoea should never be given to children. They sound attractive remedies but are unsafe to give to children due to possible complications.

Paracetamol - (Calpol, Disprol, etc) is useful to ease fever, headache or stomach pains.

Are there any complications from acute diarrhoea?

Complications are uncommon. See a doctor if any of the following develop or if any other symptoms occur that you are concerned about.

Dehydration. This may be developing if the child drinks little, passes little urine, has a dry mouth and tongue or becomes drowsy.

Blood in diarrhoea.

Vomiting for more than 1 day or diarrhoea not starting to settle after 3-4 days.
 
Pains that are getting worse.

Drowsiness or confusion.

Infections caught abroad.

Extract from Mentor Plus copyright OUP, EMIS and Authors 1999