Diarrhea (Loose stools)

What is diarrhea?

Diarrhea is passing loose, watery stools (bowel movements) three or more times a day. Acute diarrhea lasts for a short time. It is a common problem. It usually lasts about one or two days, but it may last longer. Then it goes away on its own.

Diarrhea lasting more than a few days may be a sign of a more serious problem. Chronic diarrhea lasts at least four weeks. It can be a symptom of chronic disease.

How bad is my diarrhea?

Mild: Increase of less than 4 stools per day over baseline (your usual number of stools every day); or mild increase in ostomy output compared to baseline.

Moderate: Increase of 4 – 6 stools per day over baseline; or moderate increase in ostomy output compared to baseline. Diarrhea that limits instrumental activities of daily living (preparing meals, managing money, shopping, doing housework, and using a telephone). It can sometimes be safely managed at home but may require the attention of your medical team.

Severe: Increase of >=7 stools per day over baseline, or a severe increase in ostomy output compared to baseline. Diarrhea that limits self-care activities of daily life (eating, dressing, getting into or out of a bed or chair, taking a bath or shower, and using the toilet). Hospitalization is typically indicated.

How to manage mild diarrhea?
  • Use only bottled or purified water for drinking, making ice cubes, and brushing your teeth.
  • If you do use tap water, boil it or use iodine tablets.
  • Consume fully cooked food and serve it hot
  • Avoid unwashed or unpeeled raw fruits and vegetables
How to manage moderate and severe diarrhea?

Although it is usually not harmful, diarrhea can become dangerous or signal a more serious problem. Contact your health care provider if you have:

  • Signs of dehydration
  • If lasts for more than 2 days, if you are an adult
  • Severe pain in your abdomen or rectum (for adults)
  • A fever of 102 degrees or higher
  • Stools containing blood or pus
  • Stools that are black and tarry
What causes diarrhea?
  • Certain cancer treatments like chemotherapies (like cisplatin, 5-FU etc); immunotherapies (like Keytruda or Opdivo), or radiation
  • Antibiotics and antacids that contain magnesium
  • Food intolerances and sensitivities, which are problems digesting certain ingredients or foods. An example is lactose intolerance.
  • Bacteria from contaminated food or water
  • Viruses such as the flunorovirus, or rotavirus
  • Parasites or tiny organisms found in contaminated food or water
  • Diseases that affect the stomach, small intestine, or colon, such as Crohn’s disease
  • Problems with how the colon functions, such as irritable bowel syndrome
  • Stomach surgery

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