Diarrhoea in Adults
Diarrhoea can be acute (sudden onset and lasts less than 2 weeks) or chronic (persistent). This leaflet deals with acute diarrhoea which is common.
What causes acute diarrhoea?
• Infection of the gut is the common cause. This is called acute infectious diarrhoea. Many bacteria, viruses, and other 'bugs' can cause diarrhoea. Sometimes the bugs come from infected food (food poisoning). Infected water is a cause in some countries. Sometimes it is just 'one of those bugs going about'. Viruses are easily spread from one person to another by close contact, or when an infected person prepares food for others.
• Other causes are uncommon and include: drinking lots of beer, side-effects from some medicines, and anxiety.
• Gut disorders which cause chronic (persistent) diarrhoea, such as colitis, may be mistaken for acute diarrhoea when they first begin.
The rest of this leaflet deals only with infectious causes of acute diarrhoea.
What are the symptoms of acute infectious diarrhoea?
Symptoms can range from a mild stomach upset for a day or two with slight diarrhoea, to severe watery diarrhoea for several days or longer. Crampy pains in the abdomen (tummy) are common. Pains may ease each time some diarrhoea is passed. Vomiting, high temperature (fever), and headache may also develop.
Can diarrhoea be prevented?
Good hygiene helps to prevent infectious diarrhoea. Always wash your hands:
After you go to the toilet.
Before you touch food.
After gardening.
After playing with pets (healthy animals can carry certain harmful bacteria).
Between handling raw meat and food ready to be eaten. (There may be some bacteria on raw meat.)
If you have infectious diarrhoea, the following are also recommended until symptoms go.
• Regularly clean the toilets that you use. Wipe the flush handle and toilet seat with disinfectant (such as household bleach) after each time you use the toilet.
• Wash your hands thoroughly after going to the toilet. Don't share towels and flannels.
• Do not prepare food for others.
• Stay off work until symptoms go. If you work with food ('food handlers') or work as a health carer you should stay off work until you have had no diarrhoea or vomiting for 48 hours.
What is the treatment for acute infectious diarrhoea?
Symptoms often settle within a week or so as the immune system usually clears the infection. The following are commonly advised until symptoms ease.
• Have lots to drink. The aim is to avoid dehydration (low body fluid). Dehydration is more likely to develop if you vomit a lot as well as have diarrhoea. Even if you vomit, or don't feel like drinking, you should try to take frequent sips as you will still absorb some fluid. Have water as your main drink. But, you should aalso try to drink some fruit juice as this contains some sugar. However, any drink is better than none.
• Rehydration drinks may be advised by a doctor or nurse if they are concerned that you are at risk of
dehydration. You can drink these instead of, or in addition to, normal drinks. Rehydration drinks are made from sachets which you can buy from pharmacies. You add the contents of the sachet to water. Rehydration drinks provide a perfect balance of water, salt, and sugar. They are better than just drinking water alone. The small amount of sugar and salt helps the water to be absorbed better from the gut into the body. They do not stop or reduce diarrhoea, but are the best drinks to prevent or treat dehydration. (Do not use home made salt drinks as the quantity of salt has to be exact.)
• Eat as normally as possible. It used to be advised to 'starve' for a while, but this is now known to be wrong. However, you may not feel like food and most adults can do without food for a few days (but don't stop drinking). Eat as soon as you are able. Soups and foods high in carbohydrate such as bread, pasta, rice, or potatoes are best to start with.
• Anti-diarrhoea medicines are not usually necessary. However, you may wish to reduce the number of trips to the toilet. You can buy anti-diarrhoea medicines from pharmacies. Possibly the safest and most effective is loperamide. The dose of this is two capsules at first. This is followed by one capsule after each time you pass some diarrhoea up to a maximum of eight capsules in 24 hours. It works by slowing down the gut's activity. (Note: do not give anti-diarrhoea medicines to children. Also, do not use anti-diarrhoea medicines if you pass blood with the diarrhoea.)
• Paracetamol or ibuprofen are useful to ease a high temperature or headache.
If symptoms are severe, or persist, a doctor may ask for a sample of the diarrhoea. This is sent to the lab to look for infecting bugs (bacteria, parasites, etc). Sometimes an antibiotic or other treatments are needed.
Are there any complications from acute infectious diarrhoea?
Complications are uncommon. See a doctor if any of the following develop, or if any other symptoms occur which you are concerned about.
Dehydration. Symptoms include: passing little urine, a dry mouth and tongue, drowsiness.
Blood in the diarrhoea.
Vomiting for more than 1-2 days, or diarrhoea which does not start to settle after 3-4 days.
Pains which are getting worse.
Drowsiness or confusion.
Infections caught abroad.
Some people are admitted to hospital if symptoms are severe, or if complications develop develop.
