What is it about ?
Diarrhea is when you have a bowel movement more than 3 times a day and / or your stools are very watery (watery). During diarrhea, the amount of stool exceeds 200 grams per 24 hours. Diarrhea is said to be chronic (persistent) when it persists for more than 3 weeks.
The leading cause of variable diarrhea is a functional bowel disorder (irritable bowel syndrome).
Persistent (chronic) diarrhea can be caused by a condition, such as overactive thyroid (hyperthyroidism), a chronic inflammatory bowel disease (ulcerative colitis or Crohn’s disease), a disorder of the gallbladder, a disorder of the pancreas, a diabetes or a gastrointestinal tumor.
Chronic diarrhea caused by intolerance to certain foods is common: intolerance to wheat, rye or barley (gluten intolerance or celiac disease), dairy products (Lactose intolerance) or certain food additives such as aspartame or sorbitol.
Chronic diarrhea can also occur after radiation therapy, bowel surgery, the use of medications (antibiotics, laxatives, iron tablets, etc.) or excessive consumption of alcohol.
In the elderly, we sometimes observe the phenomenon of diarrhea of overflow: in reality, these people suffer from constipation, which only allows liquid stools to pass.
Chronic diarrhea is rarely caused by infection unless the immune system is weakened (immunosuppression).
Diarrhea due to parasitic infection mainly occurs after a stay in the tropics.
What is its frequency?
Chronic diarrhea is less common than acute diarrhea. Out of 1,000 people who see their GP, about 5 present with symptoms of chronic diarrhea.
How is the diagnosis made?
The doctor will ask you questions about your symptoms (fever, stomach ache, frequency and appearance of stools), your eating habits, your alcohol consumption, your family history, etc. He will examine you, ask for a blood test and a stool test. Your doctor may do a digital rectal exam to check for possible constipation or other abnormalities in the last part of the colon.
If he suspects a ulcerative colitis, Crohn’s disease or tumor, your doctor will prescribe a colonoscopy (endoscopy of the intestine) and a biopsy (taking a small piece of tissue).
If he suspects a constipation, a simple x-ray of the abdomen will provide more information.
If you suspect a food intolerance, your doctor may suggest an elimination diet, which involves avoiding foods that may trigger the symptoms.
What can you do ?
Chronic diarrhea is associated with a risk of dehydration. You must therefore ensure that you drink enough: a glass of water each time you have a bowel movement. If your symptoms are severe, such as repeated presence of blood in stool, weightloss, fever, deterioration of general condition, and if diarrhea persists for more than 3 weeks, consult a doctor.
What can your doctor do?
If you show signs of dehydration, your doctor will correct your salt and water imbalance by giving you fluids by mouth or intravenously.
If chronic diarrhea is due to an intolerance to certain foods or medications, the symptoms will go away as soon as they stop.
Loperamide should be avoided whenever possible.
If the stool culture is positive, the bacteria or parasite can be treated with antibiotics.
If the chronic diarrhea is due to a condition such as thyroid disorder, a tumor or chronic inflammatory disease, the doctor will treat this condition or refer you to a gastroenterologist.
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