Digestive Problems
Common Symptoms: Diarrhea
Diarrhea refers to the passage of loose, liquid or frequent bowel movements. Diarrhea can be acute or chronic, infectious or non-infectious.
Most cases of acute diarrhea are caused by infection with a bacterial or viral organism and tend to clear up within 24 hours. These illnesses are commonly referred to as stomach-flu, stomach bug, food poisoning or gastroenteritis and frequently occur while vacationing in a foreign country (Traveler's diarrhea). All that is generally required during an episode of infective diarrhea is dietary restriction and fluids to prevent dehydration. However, a physician should be consulted during more severe or prolonged episodes, or when dehydration, rectal bleeding or a high temperature is present.
Chronic diarrhea may be a symptom of a number of potentially serious diseases including Crohn's disease, ulcerative colitis, colon cancer and certain other cancers, chronic pancreatitis, celiac sprue and parasitic, bacterial or viral infections. In many cases of inflammation or cancer, additional features such as bleeding or weight loss will also be present. The treatment for chronic diarrhea will depend primarily on the cause, and patients should attend their physician who may perform tests such as stool cultures, endoscopic and radiological tests as appropriate. Other causes of diarrhea include irritable bowel syndrome, immune deficiency, enzyme deficiencies (lactose intolerance), overuse of laxatives, antibiotic use, following abdominal surgery and as a side effect of drugs.
Diarrhea is the most common health problem suffered by travelers to foreign countries. Depending on country of origin, destination, eating and drinking habits, between 25 and 60 percent of tourists will be affected by diarrhea. The cause of traveler's diarrhea is usually infection of the small intestine with a microorganism such as a bacterium (often E. Coli, Samonella or Shigella) or virus. In addition to diarrhea, other symptoms such as vomiting, stomach cramps and dehydration may be troublesome, and diarrhea can be blood stained during a severe infection.
Traveler's diarrhea is usually a self-limiting illness lasting less than 36 hours, but can be more severe, especially in children, elderly persons and those with additional diseases such as heart disease. Drinking bottled water, eating processed foods and avoiding raw fruits and vegetables may help prevent traveler's diarrhea, but the main treatment is fluid replacement to prevent dehydration. Replacement fluids should also contain salts and sugars. Medicines have also been used to combat this disease, and some antibiotics have proved effective in shortening the episodes of diarrhea. However, there are worries in the medical profession that the wide-scale use of antibiotics may result in the emergence of new organisms that are resistant to currently available antibiotics. There are also worries about using anti-diarrheal medicines. These should be avoided by adults if the episode of diarrhea is infective, and should not be used in severe cases when blood loss or a high temperature is present. Anti-diarrheals should not be given to children during episodes since diarrhea is the most effective way for the gut to remove the offending food or bacteria. When food is reintroduced to the diet it should initially consist of bland foods such as rice, eggs and soups.
Remember also that excess alcohol, hot, spicy foods and large amounts of fruit can cause symptoms similar to infective diarrhea. Many cases of traveler's diarrhea result from overindulgence at the dinner table or poolside bar!