Diarrhea: how it happens and what to do

Acute diarrhea usually comes completely unexpected and is not only extremely uncomfortable, but often also painful. We’ll tell you more about the different types of diarrhea and what you can do to find relief in an acute case.

What is diarrhea and is diarrhea dangerous?

How often we go to the toilet and the amount and consistency of our stool differs not only from person to person , but also depends heavily on what we eat and what life situation we are in.

Frequencies of three times a day to three times a week are considered normal, but upcoming exams, stress in everyday life and work can hit the digestive tract in such a way that the changed frequency or stool consistency seems completely unusual to us. If, on the other hand, we eat a lot of fiber, we often have more and more firmly formed stools.

In the case of diarrhea, the frequency, amount or consistency of the stool are changed, although in the medical sense diarrhea is only spoken of if:

  • occur more than three thin stools a day or
  • the stool weighs more than 200 grams per day, or
  • the water content of the stool is more than 80 percent.

Diarrhea can become extremely uncomfortable and can also be accompanied by pain, fever, and vomiting . In this case, it can also be dangerous, especially for small children and the elderly.

However, severe diarrhea can lead to a high loss of fluid and the associated loss of electrolytes , especially sodium, potassium, magnesium and chloride. These substances play an important role in the functioning of the heart, muscles and nerves and cannot be produced by the body itself .

Particularly in children and the elderly and weakened people, you should therefore watch out for signs of dehydration , such as a dry tongue or increasingly dark urine. If in doubt, you should consult a doctor.

When is medical help necessary for diarrhea?

Even if diarrhea is not generally dangerous, a doctor should be consulted if:

  • Infants or young children (under 5 years of age) are affected
  • A diarrhea lasts longer than three days
  • You feel dehydrated
  • The stool is bloody, slimy, or greasy
  • The diarrhea occurs during or after a long-haul trip
  • High fever above 39 ° C occurs

How does diarrhea occur: is the bowel always the cause?

If the food pulp passes through the intestine too quickly during digestion, if insufficient water is withdrawn from it during the intestinal passage, or if too much water released from the intestine is added, the stool becomes too liquid and diarrhea can occur .

If you only guess on food, infections or intestinal diseases when it comes to causes of diarrhea, you are not always correct: Since the autonomic nervous system has a strong influence on the unconscious intestinal function, excitement, depression, fear and stress can also be the cause of diarrhea. Diarrhea can also be a side effect of medications , such as: B. antibiotics or antihypertensive drugs.

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Types of Diarrhea and What They Mean

What all types of diarrhea have in common is that it is a symptom that is an expression of a functional disorder. The actual causes of diarrhea can be very different and range from (mild) bacterial or viral infections, food intolerance , side effects of drugs to severe inflammation of the intestinal mucosa . Although many of these causes lie directly in the intestine, factors remote from the intestine (such as stress) can also promote the development of diarrhea. Even too much sun and heat can  lead to diarrhea in summer .

The duration of the diarrhea can often allow conclusions to be drawn about the exact cause. A distinction should therefore be made between acute and chronic diarrhea .

Of acute diarrhea is when these last 14 days no longer, often subside after a few days.

Typical causes of acute diarrhea are:

This type of diarrhea is usually the result of an infection of the intestines with bacteria, as is the case with travelers’ diarrhea.

The most common bacterial pathogens causing traveler’s diarrhea include E. coli, Salmonella, Campylobacter and Shigella. Viruses, including noroviruses and rotaviruses, or parasites can also cause infections that cause diarrhea. As a rule, these diarrhea are mild in their course and subside after a few days . On the other hand, a high fever, blood in the stool, a high level of fluid loss and an increasing feeling of illness indicate more severe forms of the disease, for which a doctor should be consulted .

Excitement, nervousness and stress can also lead to acute diarrhea, as can physical exertion and mechanical strain on the intestines, for example during intense endurance exercise such as marathons.

Incidentally, the term stool comes from a time when people still used a so-called toilet chair to empty their bowels.

Chronic diarrhea , on the other hand, is characterized by diarrhea lasting longer than two weeks , whereby the causes in these cases can be very diverse.

Possible endogenous, i.e. endogenous, causes include  food intolerance such as lactose intolerance (lactose intolerance) or fructose malabsorption and autoimmune diseases such as celiac disease (gluten intolerance). But a irritable bowel syndrome or inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease are among the most frequent endogenous causes.

The exogenous, i.e. externally acting, causes include bacterial overgrowth or chronically invasive infections of the intestine by bacteria, viruses or parasites. In general, it is always advisable to consult a doctor for clarification , especially in the case of long-term complaints .

Diarrhea can occur through a number of different mechanisms :

OSMOTIC Diarrhoea

Through a physical process called osmosis , undigested components draw water from the surrounding tissue into the interior of the intestine, which in turn can lead to diarrhea or aggravate the diarrhea ( osmotic diarrhea ).

In watery diarrhea, certain substances are either not absorbed from the food pulp into the intestine or actively released from the intestine into the stool , so that excessive amounts of water remain in the stool, which in turn leads to diarrhea: Lactose (milk sugar) and fructose (fruit sugar) are typical substances that, in the event of excessive consumption or existing intolerance, cannot be sufficiently absorbed by the intestine and instead retain water in the food pulp …

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The excessive consumption of unusable substances such as certain sweeteners, including sorbitol or mannitol, can also be the cause of watery diarrhea. If so, and you limit your consumption of these foods, it will usually relieve symptoms of diarrhea as well.


Some pathogens, such as cholera bacteria, trigger an increased excretion of water (secretion) into the interior of the intestine in the mucous membrane cells of the intestine. The food pulp located there becomes very fluid (secretory diarrhea).

In the case of chronic infections , however, electrolytes such as sodium or potassium are often increasingly released into the intestine, which in turn means that more water remains in the stool and makes it liquid to watery.


Other gastrointestinal flu pathogens cause severe inflammation of the mucous membrane , which subsequently secretes more mucus and occasionally even blood (exudative diarrhea).

The often severe diarrhea in an acute gastrointestinal infection, on the other hand, results from the impairment of the mucous membrane cells in the small and large intestines. Basically, the different pathogens lead to diarrhea in different ways. There are three different mechanisms . Often it is the combination of these mechanisms that causes the diarrhea in gastrointestinal flu.

Diarrhea can be very different – sometimes mushy, sometimes liquid and then slimy again. It can also be very different in color. In any case, the exact observation of the consistency and the point in time, e.g. after consuming certain foods or after taking medication, helps to investigate the cause. In case of doubt: Always consult a doctor.

Mucous diarrhea is often caused by chronic inflammation of the intestinal lining, which secretes mucus and blood. Allergic reactions also often lead to secretions of mucus in the stool.

If this mucus leaves behind greasy or oily residues in the toilet, which do not easily come off when you rinse, there may also be a disturbance in the digestion of fat , which in turn can have very different causes. For example, a change in the formation of bile acids, which is necessary for the utilization of fats, can lead to a reduced absorption of fatty acids in the intestine and thus to diarrhea.

Bloody diarrhea can have a number of causes, many of which are harmless, such as: B. with mild hamotthoid disease such as injuries and fissures of the anus .

Since blood residues in the stool are often indistinguishable from harmless food-borne stool discoloration, a doctor’s assessment of the stool is always recommended if you think you may have blood in your stool.

What helps against diarrhea?

In the case of diarrhea, the main thing is to replace the loss of fluids and electrolytes and not to further strain or irritate the intestine. With consistent hygiene, including frequent hand washing and regular disinfection of the toilet, you can also reduce the risk of infection for others.

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What you can eat and drink

Unsweetened herbal teas such as chamomile, peppermint or fennel, bouillon, diluted juices or low-carbon mineral water are suitable to restore fluid and minerals such as magnesium, sodium and potassium to your body .

If you have diarrhea, you should avoid spicy, spicy and fatty foods as well as alcohol, cigarettes and coffee , so as not to irritate and strain your intestines. This includes dairy products as they can be high in fat and lactose. Rusks, white bread, gently cooked carrots and potatoes, in addition to rice and oat flakes, are suitable light foods for diarrhea .

Even if cola is generally considered to be helpful for diarrhea, it contains too much sugar , which in the worst case, like the caffeine it contains , can also have a laxative effect. Cola, like undiluted fruit juices, which can contain a lot of fructose, should therefore be avoided in the case of diarrhea.

Home remedies and medicines for diarrhea

If the diarrhea is accompanied by cramping abdominal pain, hot water bottles, cherry stone pillows, etc. can help you relax the abdominal muscles and relieve pain.

Although psyllium husks from the health food store are unable to fight the bacteria and viruses in acute diarrhea, they can help to bind fluid in the intestine and thus make the stool firmer again. Also, grated apple is considered as a useful home remedy for liquid diarrhea because it contains pectin, which swell in the gut and so fluid bind. This helps regulate the consistency of the stool. But be careful: apples may contain a lot of sugar and fruit acids, which can irritate the stomach and intestines. If in doubt, wait until your stomach has calmed down a bit.

In acute cases, the flow of fluid into the intestine can be normalized again with the active ingredient Racecadotril from the pharmacy. Another active ingredient, loperamide, causes decreased bowel movement (motility) . However, since pathogens may also be excreted more slowly with the latter, it is important to carefully weigh up the use of the various active ingredients.

Probiotics can help to positively regulate a messed up colonization of the intestine. In the case of more severe infection-related forms, antibiotics are often used, whereby in these cases attention should also be paid to what influence these in turn can have on the sensitive intestinal flora.

Medicinal plants such as fingerweed can also  support the stomach in the case of mild diarrhea symptoms .

Diarrhea: how it happens and what you can do about it

Even if diarrhea is not generally dangerous, it can have very different causes. While acute diarrhea is often viral and usually subsides after a few days, chronic diarrhea can be due to inflammatory bowel diseases, metabolic diseases, food intolerances or other causes that should be clarified medically.

The nature of the stool and its timing, e.g. in connection with certain foods, medication or situations, can also provide information on possible causes and should therefore be observed. In acute cases, home remedies can provide support or medicinal substances can provide relief.

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