Diarrhea

Everyone gets diarrhea from time to time and we all know that it is generally not serious.  Some people always have loose or diarrheal stools, so for them it is relatively normal.  Those with irritable bowel syndrome, for example,  know too well that they will have inexplicable intermittent bouts of diarrhea while feeling otherwise fine. Everyone has to consider how their body normally functions when assessing a symptom.  In this case we are talking about an increased number of loose stools, looser than usual, possibly accompanied by a feeling of urgency that is not normally present.

Any illness, even a common cold, can result in bowel upset and diarrhea.  The key is to be able to identify when it is more than just a transient upset and could represent something more serious.  Certainly, diarrhea that lasts more than 5 days need to be assessed.  Diarrhea that causes the patient to wake up at night in order to relieve themselves is almost never normal.  Diarrhea accompanied by blood or slime or pus or accompanied by abdominal pain or fever needs to be assessed by a specialist.  In some cases, there may be an infection in the colon, such as a parasite or toxigenic bacteria.  In other cases there may be no infection, but the colon or rectum may be inflamed (colitis or proctitis).  Some elderly patients can develop what is called ‘spurious diarrhea’ – this is a condition in which they are actually so severely constipated that the only thing that can pass by their impacted stool is fluid.  So the treatment of this type of diarrhea is actually laxatives!  Colorectal cancer can, very rarely, present as diarrhea if the cancer is obstructing the colon.

© Pezim Clinic, Vancouver, British Columbia, Canada