What is diarrhea?

Diarrhea refers to bowel movements that are watery to loose in consistency and occur greater than three times per day.


What causes diarrhea?

• Viruses
• Bacteria
• Parasites
• Food intolerance
• Inflammatory bowel disease
• Celiac disease
• Microscopic colitis
• Side effects to medications
• Irritable bowel syndrome

The cause of diarrhea is not always established in most cases, particularly if symptoms improve rapidly on their own.


Acute vs. Chronic Diarrhea

Acute episodes of diarrhea typically occur secondary to infections, recent changes in diet or the use of new medications. These tend to be self-limiting and generally improve with time, supportive care and/or removal of the causing agent. Diarrhea lasting for four weeks is termed chronic diarrhea. Chronic diarrhea can occur for many reasons including but not limited to underlying intestinal inflammation, irritable bowel syndrome, thyroid disease, diabetes, chronic infections and food sensitivities/allergies.


What can be done from home for acute episodes of diarrhea?

In the setting of mild to moderate acute diarrhea, symptoms can generally be treated from home. The following are important steps to take when suffering from diarrhea at home:



It is important to drink plenty of fluids, particularly those containing water, salt and sugars. Specific oral rehydration solutions can be used and are the most effective way to rehydrate in the setting of watery diarrhea. Other solutions such as flavored sports drinks (i.e. gatorade), broths and soups are good alternatives. If you become unable to take fluids by mouth, it is important to contact your doctor for further instructions as you may require intravenous fluids for more support.



In terms of diet, no specific diet has been clearly established for the treatment of acute diarrhea. A bland diet is generally recommended which includes boiled starches, cereals, rice, bananas, soup, crackers and boiled vegetables.



Medications to reduce diarrhea are available and generally safe. They are used as a method of reducing frequency of bowel movements but are not considered curative. These medications should be avoided in the setting of diarrhea with fevers or bloody stools. Medications to improve diarrhea include loperamide (Immodium®), bismuth subsalicylate (Pepto-Bismol®, Kaopectate®) and diphenoxylate-atropine (Lomotil®). It is important to discuss your symptoms with your doctor prior to the use of any anti-diarrheals.



Antibiotics are generally not required for the treatment of most cases of acute diarrhea. They can be of benefit in certain situations including greater than eight bowel movements per day, severe dehydration, prolonged symptoms for greater than one week and in those with weakened immune systems. The use of antibiotics should be discussed with your doctor to ensure that there is more benefit than risk.


Preventing infection spread:

It is important to prevent the spread of diarrhea-causing infections to your family, friends and co-workers. These infections are spread from hand to mouth and you are considered infectious as long as the diarrhea persists. Effective hand washing is the best method to prevent the spread of infection. It is important to wash hands for at least twenty seconds, particularly before and after preparing meals, before eating, after using the restroom and after changing a diaper. Staying out of work or school may be required to prevent spread while still having symptoms.


When to seek help?

It is important to contact your doctor or seek the help of a medical professional in certain instances of diarrhea. These include the following:

• Severe dehydration (i.e. lightheadedness, fatigue, dark-colored urine, confusion, chest pain or shortness of breath)
• Blood within stools
• Black colored stools
• Fevers
• Persistent symptoms for greater than 48 hours
• Less than 6 episodes per day
• Severe abdominal pain


What testing should be performed?

For acute mild cases of diarrhea, testing is generally not necessary and symptoms tend to improve on their own. At times, your physician may order stool testing to rule out an bacterial or parasitic infection, particularly if you recently travelled to an endemic area where these infections are more common. In the setting of chronic diarrhea, testing is typically required to establish the cause of the loose or watery stools. Lab and stool tests are generally performed to assess for any signs of infection, thyroid disorder, gluten sensitivity or inflammation. Specialized breath testing can be performed to evaluate for any specific food intolerance of the presence of bacterial overgrowth in the small intestine. In certain instances, an endoscopy or colonoscopy may be required for evaluation of the mucosal lining of the small intestine and colon.


The information provided above is meant to be used as an informative guide for patients. For precise and individualized recommendations, please consult with one of our board certified gastroenterologists to discuss your symptoms.

For additional information or to book an appointment at the Gastroenterology Center of New York, please feel free to reach out to our dedicated team by calling us at 718-210-2960. You can also schedule online or reach out to us via the Contact Us form.

Questions? Our staff is always happy to assist.
Email us at info@gastrocenterofny.com or call us at 718.210.2960