What causes diarrhea and what helps against it

Adults suffer from diarrhea on average once a year, children more often. Why diarrhea often hits us when travelling, which home remedies help and when a doctor’s visit is necessary.

If you go to the toilet three or more times a day and have mushy to liquid-watery stools, you have diarrhea. Depending on the cause, it is accompanied by abdominal cramps and flatulence, and sometimes by fever in the case of infection.

At best, diarrhea is just annoying. On the other hand, if it is severe, it weakens the body within a few hours due to the high loss of water and electrolytes. It is therefore important in the event of diarrhea to compensate for this loss.

Diarrhea is not an independent disease, but a symptom. The liquid stool indicates that something is wrong somewhere in the body. This usually refers to the gastrointestinal tract.

The causes of diarrhea are extremely varied. Anyone who regularly suffers from diarrhea may have chronic intestinal inflammation or a food intolerance. Diarrhea after eating can indicate high-fat food or spoiled food. Acute diarrhea lasts a few days to a week and is usually the result of an infection. In the case of acute diarrhea, hygiene is important in order not to pass on possible pathogens.

Diarrhea: These symptoms are typical

A strange feeling in the stomach area, a gurgling in the stomach and a very strong urge to defecate – diarrhea is announced. Typical symptoms include:

liquid stool (mushy to watery)
stomach pain
in some cases colicky cramps
gas
nausea
sometimes also vomiting
mucus in the stool
blood in the stool
dizziness
circulatory problems
The latter two symptoms occur mainly when the body has already lost a large amount of water and electrolytes through diarrhea.

Causes of diarrhea

The most common cause of diarrhea is a gastrointestinal infection, popularly known as the gastrointestinal flu. It can be triggered by various pathogens, especially viruses and bacteria. In many cases, those affected have become infected through food contaminated with pathogens. The most well-known pathogens include:

salmonella
rotaviruses
Pathogens Escherichia coli (E. coli)
campylobacter
Yersinia
Norovirus and rotavirus are extremely contagious. Already 10 to 100 viruses are enough to trigger an infection.

The rare pathogens that are more likely to cause diarrheal diseases on long-distance travel include:

Shigella (trigger of bacterial dysentery)
Vibrio cholerae (causes cholera)
enterohemorrhagic E. coli (trigger of EHEC)
various parasites such as giardia, worms, amoebas or trichinae
Some infections with such pathogens are notifiable. These include diseases with Salmonella, Campylobacter, Yersinia, pathogens Escherichia coli, EHEC pathogens and Shigella.

In addition to pathogens, diarrhea can have many other causes. Irritable bowel syndrome, for example, often occurs in conjunction with diarrhea. Food intolerances can also cause pulpy stools. These include lactose intolerance and gluten intolerance (celiac disease).

Another non-infectious cause of diarrhea is inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis. In this case, the diarrhea tends to occur intermittently. Rare causes of diarrhea include poisoning, for example with chemicals, and tumor diseases.

Diarrhea can also occur as a side effect of medicines – especially with broad-spectrum antibiotics. Up to 25 percent of all patients who take antibiotics temporarily suffer from watery stools. The drugs not only attack pathogenic bacteria, but also the healthy intestinal flora, which gets mixed up. Food components can then no longer be properly digested, which promotes diarrhea.

Risk groups for diarrhea

Diarrhea is more dangerous for some people than for others. They belong to the risk groups. These include babies and small children, pregnant women, people with weakened immune systems and older people with previous illnesses. Pregnant women and those with a weakened immune system are generally more susceptible to infections, so they become infected more quickly with diarrheal pathogens. The disease is often more severe for them.

Children get diarrhea more often anyway. It can be enough for them to eat a larger amount of fruit. Some diseases, such as an otitis media, can be associated with diarrhea in children, unlike in adults.

Young children and the elderly are at risk of rapid dehydration. With additional vomiting and a high fever, this risk increases further because the body loses a lot of fluid.

Detect dehydration

Typical symptoms that indicate dehydration are a dry mouth, sallow skin without tension, breathing through the mouth and fatigue. Urine excretion can also be reduced in small children and the elderly. Caution: The latter is not the case with infants!

In the risk groups mentioned, it is therefore important to compensate for the loss of water and electrolytes as quickly as possible. Herbal teas are best suited for this, to which some glucose or salt is added. Alternatively, ready-made electrolyte solutions can be bought in pharmacies.

Why do we often get diarrhea when we travel?

About every third traveler suffers from diarrhea while on vacation. Hygiene standards for food preparation are difficult to maintain, especially in warm, tropical countries. Germs that cause diarrhea, such as salmonella or campylobacter, multiply rapidly under these climatic conditions. Infections with noroviruses (common on cruise ships) or coliform bacteria are particularly common.

Infections with cholera bacteria can lead to diarrhea, especially in countries with poor drinking water supplies. The disease is particularly common in Central America, northern South America, parts of Africa, and North and Southeast Asia. If you plan to stay in these regions for a longer period of time, you should consider getting a cholera vaccination. The oral vaccination provides 85 percent protection against infection.

Parasitic infections or mushroom poisoning can also cause travelers’ diarrhea. In some cases, however, it is only the unfamiliar foods that upset the intestines for a few days.

There is a phrase in English: “Peel it, boil it, cook it or forget it.”. Translated, the sentence means: peel it, heat it up, cook it or forget it. Anything that is undercooked, has been disinfected by heating, or has been protected from eating by a bowl is better not to be eaten when travelling.

home remedies for diarrhea

Mild or short-lived diarrhea in otherwise healthy people can be self-treated at first. Many people use home remedies for this. For diarrhea, sweetened herbal teas and savory snacks can help compensate for the loss of fluids and electrolytes.

In the case of severe diarrhea, however, a special electrolyte solution from the pharmacy is recommended. As an alternative, for example when travelling, you can also create such a solution yourself. To do this, mix four tablespoons of sugar, ¾ teaspoon of table salt and a glass of packaged orange juice in a liter of water.

Rice and rusks are considered gentle on the stomach and are also recommended for diarrhea. Although they do not work directly against the problem, they do prevent the intestine from being further irritated and the symptoms from getting worse.

Many sufferers of diarrhea suffer from a loss of appetite. If you do get hungry, it is best to focus on foods that bind fluid and thus help to strengthen the stool. This includes:

potatoes
oatmeal
zwieback
gruel
rice gruel
Foods containing pectin also bind liquid. In addition, they should be able to bind the toxins of some diarrhea pathogens. Apples contain a particularly large amount of pectin. You should grate these so that the pectin can be easily utilized during digestion. Carrots – best boiled – and bananas are also high in pectin and are considered a proven home remedy for diarrhea.

A myth among home remedies is cola. However, this one persists. The caffeinated fizzy drink is often given to children in combination with salty biscuits. However, cola does not work at all against diarrhea. On the contrary: the caffeine it contains stimulates intestinal activity, which is particularly dangerous for children.

anti-diarrheal medication

Depending on the severity of the diarrhea, home remedies may not be enough. Over-the-counter medication from the pharmacy may help. The two standard active ingredients are loperamide and racecadotril. Medicinal charcoal and medicinal yeast are also used more frequently.

Important NOTE

In certain cases, anti-diarrheal medications are unsuitable. To be on the safe side, ask the doctor’s office or the pharmacy whether you can take medication and if so, which ones.

Loperamide stops diarrhea by inhibiting bowel movement. It helps quickly, but should only be taken for a short time and with caution. Loperamide is not suitable for some diseases. Because if the intestinal movement slows down, possible toxins from bacteria remain in the intestine longer. Loperamide can also be dangerous if there is a risk of intestinal obstruction. In such cases, as well as in the case of infectious diarrhea, racecadotril can be an alternative. Unlike loperamide, it does not affect intestinal movement, but prevents the intestinal wall from releasing too much water and electrolytes into the intestine and excreting them.

Both active ingredients fight the diarrhea, but not its cause. It is advisable not to take tablets with the active ingredients mentioned for longer than two days in self-treatment – or better yet, to ask the doctor directly. Loperamide requires a prescription for children under the age of twelve and children under the age of two must not take it. When traveling or with severe watery diarrhea, they are a quick and immediate help. In the latter case, they help stop water loss.

Medicinal charcoal or activated charcoal has a completely different mode of action. It belongs to the adsorbents. This means that it binds substances – especially toxins that are produced by diarrhea pathogens. But: Charcoal does not distinguish between good and bad substances. It also adsorbs medicinal substances, for example. Therefore, between other medicines and medicinal charcoal, an interval of about two hours should be observed. For the same reason, activated charcoal is not suitable for preventing diarrhea, for example when travelling. Long-term intake can lead to vitamins and minerals being less easily absorbed by the body.

Probiotics, which include medicinal yeast, are considered a gentle alternative for mild diarrhea. These are microorganisms that belong to the healthy intestinal flora (intestinal microbiome) and have a positive effect on the composition of the bacteria in the intestine, which is often disturbed in diarrhea. Medicinal yeast includes the yeast Saccharomyces cerevisiae and related subspecies such as Saccharomyces boulardii. Both are generally well tolerated and have few side effects. In studies, medicinal yeast was able to shorten diarrhea by one day. They showed a positive effect, especially in diarrhea caused by antibiotics. In addition, they do not prevent the excretion of the pathogens in infectious diarrhea.

Diarrhea: when to see a doctor?

In some cases, it is necessary to see a doctor with diarrhea. This applies to the risk groups mentioned with severe diarrhea and to everyone else if there is no improvement after 48 hours – despite home remedies or over-the-counter medication. To be on the safe side, it is also advisable to see a doctor if you have a high fever, blood or mucus in your stool or if you have severe pain.