Diarrhoea - Symptoms, Types, Causes & Diagnosis

Diarrhoea - Symptoms, Types, Causes & Diagnosis

Diarrhoea is a common digestive condition that is characterized by loose, watery stools, often accompanied by abdominal cramps, bloating, and nausea. It occurs when the digestive system is not functioning properly, leading to...

Stay hydrated, stay healthy: and fight diarrhoea.


Diarrhoea is a common digestive condition that is characterized by loose, watery stools, often accompanied by abdominal cramps, bloating, and nausea. It occurs when the digestive system is not functioning properly, leading to the inability to absorb fluids and nutrients properly from food and drink. There are many potential causes of diarrhoea, including bacterial or viral infections, food intolerances or allergies, inflammatory bowel disease, certain medications, and other underlying medical conditions.

What is Diarrhea?

Diarrhoea is not only a disease but it is a symptom of different gastrointestinal disorders. In the past, the definition of diarrhoea was based on the amount, regularity, and/or consistency of stools. Patients frequently mistakenly interpret increased stool fluidity as diarrhoea.

Diarrhoea is characterised by an increase in faecal bulk brought on by a rise in the amount of water or solids present. This is sometimes accompanied by an increase in the volume, fluidity, or frequency of faeces. Serious deviations in fluid, electrolyte, and nutrient balance can result from diarrhoea. It can cause the patient's condition to worsen if not treated properly.

How Common is Diarrhea?

According to the WHO, even though persistent diarrhoea only makes up 10% of diarrheal episodes, it is responsible for up to 35% of diarrhoea-related mortality in children under the age of five. According to community research, seven cases of persistent diarrhoea occur annually for every 100 children under the age of four [2] and account for one-third to half of all diarrhoea-related deaths. In malnourished children, 20% of acute diarrheal episodes last longer than two weeks. 90% of PD cases happen before the age of one year and 60% before the age of six months.

Ways Through Which Diarrhoea is Transmitted:

Faecal-oral transmission, also known as stool-to-mouth transmission, is the process by which infectious agents, including viruses, bacteria, protozoa, and helminths, spread from one person's stool into another's mouth and produce diarrhoea.

A significant number of these agents are probably still to be identified. Some are well-known, and others are recent discoveries or emerging new agents. They differ in the number of organisms required to spread infection and disease as well as the path taken by the stool to reach the mouth.

A key factor in determining the quantity of the inoculum needed to produce sickness among bacteria is their capacity to survive stomach acid. Shigella bacteria, for instance, are resistant to low pH and only need a small number of organisms to cause illness. These bacteria are easily spread through direct human contact.

How Can you Get Encountered this Disease?

An infection in the digestive tract is the cause of diarrhoea in many cases. The bacteria that caused this infection include the following:

  • Viruses,
  •  Parasitic creatures,
  •  Bacteria

The bacteria Salmonella, Campylobacter, Shigella, and Escherichia coli are the most often found causes of acute diarrhoea in the United States.

Although all of the digestive organs seem to be operating normally, some forms of chronic diarrhoea are referred to as "functional" cases because of this. Irritable bowel syndrome (IBS) is the most prevalent cause of functional diarrhoea in the developed world.

Constipation, diarrhoea, or both may be among the changed bowel habits that IBS patients experience, in addition to cramping and abdominal pain.

The condition known as IBD is another reason why people experience chronic diarrhoea. IBD refers to Crohn's disease or ulcerative colitis.

What to Know about Traveller's Diarrhoea?

Diarrhoea is frequently brought on by bacterial, viral, or parasitic infections, particularly when travelling. The "stomach flu" is another name for viral diarrhoea, even though the flu virus is not the underlying cause. Norwalk virus and rotavirus are two typical diarrhoea-inducing viruses. Salmonella, campylobacter, and E. coli are among the bacteria that frequently cause diarrhoea.

You can catch an infection by eating or drinking contaminated food, touching contaminated objects, or coming into close contact with an infected person. Wash your hands after using the lavatory and before touching your face to prevent infection.

What are the Possible causes of Diarrhoea in Children?

It is very commonly seen in children.

The body uses diarrhoea to get rid of pathogens, and most bouts range from a few days to a week. Fevernauseass, vomiting, cramping, dehydration, and even rashes can accompany diarrhoea. Among the most typical causes of diarrhoea in children are:

  1. Infection from bacteria like salmonella, viruses like rotavirus, and, in rare cases, parasites like giardia. The most frequent cause of diarrhoea in children is viruses. Symptoms of a viral gastroenteritis infection frequently include vomiting, stomachache, headache, and fever in addition to loose or watery faeces.
  2. Food poisoning- Kids who have food poisoning may also experience diarrhoea. Vomiting may be a symptom, and they typically appear suddenly and disappear within 24 hours.
  3. Irritable bowel syndrome, Crohn's disease, ulcerative colitis, food allergies, and celiac disease are additional causes of diarrhoea.

Pathophysiology of Diarrhoea

Diarrhoea is characterised by an increase in bowel movements or frequency. Although it can indicate primary diseases outside of the digestive system, it is one of the most prevalent clinical indications of gastrointestinal disease. Indeed, diseases of the small or large bowel can cause diarrhoea.

Although diarrhoea is sometimes considered a minor inconvenience or annoyance, at least 2 million people worldwide, primarily children, die from its effects every year.

Although there are many other reasons why people get diarrhoea, this condition is generally always a symptom of one of the four fundamental mechanisms listed below. More than one of the four processes frequently contributes to pathogenesis.

What is Osmotic Diarrhoea?

Insufficient solute absorption prevents water from being properly absorbed in the intestines. Water won't be absorbed and diarrhoea will happen if too many solutes are held in the intestinal lumen. One of two circumstances is usually the cause of osmotic diarrhoea:

  • Consumption of a poorly absorbed substrate: Often, a carbohydrate or a divalent ion is the problematic component. Mannitol orEpsomomol, Epsom salt (MgSO4), and several antacids are typical examples (MgOH2)
  • Malabsorption:
    • The most deficiency in this category of diarrhoea is the inability to digest specific carbohydrates, but it can result in almost any sort of malabsorption.
    • Lactose intolerance, which is brought on by a lack of the brush border enzyme lactase, is a typical case of malabsorption that affects many adult humans and animals.

Diarrhoea with Secretion

The small intestinal lumen ordinarily secretes enormous amounts of water, but most of this water is effectively absorbed before entering the large intestine. When water is secreted into the intestinal lumen at a higher rate than it is absorbed, diarrhoea results.

Many millions of individuals have perished from cholera-related secretory diarrhoea. VVibrio cholera the causative bacteria creates cholera toxin, which powerfully stimulates adenylyl cyclase and results in a sustained rise in the intracellular content of cyclic AMP in crypt enterocytes.

This alteration leads to a protracted opening of the chloride channels, which are essential for the unregulated secretion of water from the crypts. In addition, cholera toxin has an impact on the enteric nervous system, causing a separate stimulation for secretion.

How is Diarrhoea Classified?

In addition to other factors, diarrhoea can be categorised according to its length, pathophysiological mechanisms, and aetiology. Diarrhoea can be acute, persistent, or chronic depending on how long it lasts.

Acute diarrhoea has a fast start, often lasts under 14 days, and may be accompanied by vomiting and fever. Acute diarrhoea frequently precedes persistent diarrhoea, which typically lasts for 14 days but no longer than 28 days.

Chronic Diarrhoea usually develops slowly over more than 28 days and may be recurrent or continuous. In developing nations, infectious agents are most frequently to blame for acute watery diarrhoea in children, while non-infectious factors including genetic metabolic abnormalities, gluten sensitivity, or neoplasms are to blame for chronic diarrhoea. Rotavirus, enterotoxigenic Escherichia coli, Shigella spp., and Campylobacter jejuni are some of the implicated etiologic agents.

What are the Outcomes of Diarrhoea?

Passing loose, watery faeces three or more times per day is the main sign of diarrhoea.

The following signs may also be present in those who have diarrhoea:

  • Cramping desire to go to the toilet immediately
  • Inability to regulate bowel motions
  • Nausea
  • Abdominal discomfort

Certain infections can produce diarrhoea, which may also come with one or more of the symptoms listed below:

  • Fever
  • Chills
  • Lightheadedness
  • Nausea and vomiting with blood in the stools

Dehydration and malabsorption can result from diarrhoea.

What signs of Malnutrition and Dehydration is Present?

Diarrhoea can have major side effects such as dehydration and malabsorption. The followings are their signs and symptoms in adults, newborns, toddlers, and young children.


Dehydrated adults may have these signs:

  • Decreased skin turgor, which means that when your skin is pinched and released, the skin does not immediately flatten back to normal, 
  • Thirst
  • Feeling fatigued
  • Dark-coloured urine,
  • Dry mouth.
  • Sagging cheeks or eyes, dizziness, or fainting

Infants, toddlers, and young children may exhibit the following symptoms of dehydration-

  • Lack of energy
  • Lack of wet diapers for three hours or
  • Long lack of tears when sobbing,
  • Decreased skin turgor,
  • Sunken eyes, cheeks, or a soft place in the skull


Malabsorption symptoms in adults may include:

  • Changes in appetite,
  • Bloating, gas, and loose, greasy, pungent bowel movements
  • Slim down

Infants, toddlers, and young children that have malabsorption symptoms include-

  • bloating modifications to appetite loose, oily, and odorous bowel motions
  • lack of weight gain or decrease of weight.

Action Strategies for Diarrhea

Recently, the World Health Organization (WHO 2004) conducted a reevaluation of these interventions to ascertain their effectiveness and impact.

  • Anti-rotavirus vaccination: Rotavirus causes at least one-third of severe and potentially fatal watery diarrhoea episodes, mostly in developing nations, where an estimated 440,000 vaccine-preventable rotavirus deaths occur annually (Parashar and others 2003), compared to only a handful in a developed nation like France. Almost all infants contract rotavirus diarrhoea early in life (Fourquet and others 2003). The death rate from diarrhoea in developing nations would significantly decrease if rotavirus vaccines were effective.
  • Better water and sanitation infrastructure: The main source of diarrheal pathogens is human excrement.

An estimated 90% of childhood diarrhoea is caused by poor sanitation, a lack of clean water, and poor personal hygiene (WHO 1997).

According to Huttly, Morris, and Pisani (1997), encouraging hand washing reduces the incidence of diarrhoea by an average of 33%; it functions best when combined with other behaviour change strategies. No evidence of effects on mortality has been found. Unfortunately, the necessary behaviour change is complicated, necessitating substantial resources.

Costlier than regular hand soap antiseptic soap washing your hands after using the lavatory or handling child excrement.

  • Influenza vaccination: Due to the immunosuppression caused by measles, diarrheal illness is known to predispose to measles. According to Feachem and Koblinsky (1983), vaccinating 45–90% of babies against measles would prevent 44–64% of cases, 0.6 -- 3.8% of diarrheal episodes, and 6–26% of diarrhoea-related fatalities in children under the age of five.

Management of Diarrhea

When combined with the promotion of exclusive general nutritional support, and the selective and appropriate use of antibiotics, two recent developments in the management of diarrheal disease—(a) newly formulated ORS with lower concentrations of glucose and salts and (b) zinc supplementation—can further reduce the number of diarrheal deaths in children.

The majority of acute diarrhoea cases resolve on their own in a few days without medical intervention. Your doctor could suggest taking drugs or receiving other treatments if you've tried lifestyle modifications and home cures for diarrhoea without results.

Antibiotics or parasiticides: Diarrhoea brought on by bacteria or parasites may be treated with antibiotics or anti-parasitic drugs. Antibiotics will not relieve diarrhoea if a virus is the main reason for the disease. Antibiotics lie Metrogyl, ofloxacin, or other higher antibiotics.

Therapy to replenish lost fluids: Most likely, your doctor will urge you to replenish the salts and fluids. For the majority of adults, this involves consuming juice, broth, or water with electrolytes. Your doctor might advise receiving IV fluids if consuming liquids bothers your stomach or makes you throw up.

Water can be used to replenish lost fluids, but it is devoid of salts and electrolytes.

Administration of Bloody Diarrhoea: Antimicrobials are the main treatment for shigellosis, the most prevalent and serious cause of bloody diarrhoea. However with the rise of antimicrobial drug resistance, finding affordable, efficient, and safe oral medications for use in developing nations has become difficult. Formerly utilised as first-line treatments, tetracycline, ampicillin, and the fixed-ratio formulation of trimethoprim and sulfamethoxazole no longer consistently work.

The treatment of diarrhoea depends on its underlying cause. In many cases, the condition can be resolved on its own with home remedies such as staying hydrated, following a bland diet, and getting plenty of rest. However, severe or persistent diarrhoea may require medical attention, including the use of antibiotics, anti-parasitic medication, or other prescription medications.

Preventing diarrhoea involves taking measures to avoid the spread of infections, practising good hygiene, and avoiding food and water that may be contaminated. It's also important to stay well-hydrated and maintain a healthy diet.

If you're experiencing diarrhoea, it's important to seek medical attention if the symptoms are severe or persist for more than a few days, or if you have additional symptoms such as fever, blood in your stool, or abdominal pain. Your healthcare provider can help determine the underlying cause and recommend the appropriate treatment.

Don't ignore Diarrhea! Treat it.

Stay Hydrated and Stay Healthy!!