Diarrhea
Updated: 2023-08-11
Definition
Everyone occasionally has diarrhea — loose, watery and more-frequent bowel movements. You might also have abdominal cramps and produce a greater volume of stool. The duration of diarrhea symptoms can provide a clue to the underlying cause.
Acute diarrhea lasts from 2 days to 2 weeks. Persistent diarrhea lasts 2 to 4 weeks. Acute and persistent diarrhea are typically caused by a bacterial, viral or parasitic infection of some sort.
Chronic diarrhea lasts longer than does acute or persistent diarrhea, generally more than four weeks. Chronic diarrhea can indicate a serious disorder, such as ulcerative colitis or Crohn's disease, or a less serious condition, such as irritable bowel syndrome.
Causes
Acute or persistent diarrhea causes may include:
- Antibiotic-associated diarrhea or other problems caused by medicines.
- Artificial sweeteners
- C. difficile infection
- Coronavirus disease 2019 (COVID-19)
- Cryptosporidium infection
- Cytomegalovirus (CMV) infection
- E. coli
- Food intolerances
- Food poisoning
- Fructose intolerance
- Giardia infection (giardiasis) or other infections caused by parasites.
- Lactose intolerance
- Norovirus infection
- Medicines, such as antacids containing magnesium and some cancer treatments
- Rotavirus or infections caused by other viruses.
- Salmonella infection or other infections that may be caused by bacteria.
- Shigella infection
- Stomach surgery
- Traveler's diarrhea
Chronic diarrhea causes may include:
- Celiac disease
- Colon cancer — cancer that starts in the part of the large intestine called the colon.
- Crohn's disease — which causes tissues in the digestive tract to become inflamed.
- Inflammatory bowel disease (IBD)
- Irritable bowel syndrome — a group of symptoms that affect the stomach and intestines.
- Medications used to treat heartburn, such as proton pump inhibitors and H-2 receptor antagonists
- Radiation therapy
- Small intestinal bacterial overgrowth (SIBO)
- Ulcerative colitis — a disease that causes ulcers and swelling called inflammation in the lining of the large intestine.
- Whipple's disease
Some infections, such as giardia or C. difficile infection, may lead to chronic diarrhea if not treated.
When to see a doctor
Most cases of acute diarrhea go away without treatment. However, severe diarrhea (greater than 10 bowel movements a day or diarrhea where fluid losses are significantly greater than oral intake) can cause dehydration, which can be life-threatening if untreated. Dehydration is particularly dangerous in children, older adults and those with weakened immune systems.
Seek medical attention for a child with these symptoms:
- Diarrhea that doesn't improve after 24 hours.
- No wet diaper in three or more hours.
- A fever of more than 102 F (39 C).
- Bloody or black stools.
- A dry mouth or tongue or cries without tears.
- Unusually sleepy, drowsy, unresponsive or irritable.
- A sunken appearance to the abdomen, eyes or cheeks.
- Skin that doesn't flatten if pinched and released.
Schedule a doctor's visit for an adult with these symptoms:
- Diarrhea lasts more than two days without improvement.
- Excessive thirst, dry mouth or skin, little or no urination, severe weakness, dizziness or lightheadedness, or dark-colored urine, which could indicate dehydration.
- Severe abdominal or rectal pain.
- Bloody or black stools.
- A fever of more than 102 F (39 C).