Acute Diarrhea – Overview, Causes, Prevention & Treatment

Diarrhea Overview

Diarrhea is a common medical health condition that is characterized by the passage of loose and watery stools and an increased frequency of stools.

Diarrhea usually occurs as a symptom of underlying medical conditions such as intestinal infections, side-effects of drugs, changes in diet, and typhoid fever also.

Diarrhea is usually experienced by most people at some stage of their life. Usually, diarrhea is temporary and can resolve within 2 to 3 days if the underlying cause is diagnosed and treated in time.

Diarrhea in adults is a mild condition that does not require hospital admission in the majority of cases, but it can be life-threatening in infants and children if not managed in time.

One of the most common causes of diarrhea is a gastrointestinal infection, which is often caused by bacteria, viruses, or parasites. These infections are usually caused by contaminated food and water, and poor sanitation and hygiene of the individual and surroundings.

Rotavirus causes diarrhea in children, some other pathogenic organisms are E.Coli, Salmonella, and Norovirus.

Another cause of Diarrhea is changes in dietary patterns such as consuming excessive caffeine, alcohol, spicy food, etc.  Lactose intolerance and Celiac disease are two health conditions that can also lead to diarrhea which is not acute but chronic in nature.

Certain drug overuse can also lead to diarrhea. Antibiotics cause diarrhea as their side effect because antibiotics disrupt the balance between good and bad bacteria. Medication used to treat constipation such as laxatives and antacids also caused diarrhea when not taken as prescribed by health care experts.

Inflammatory bowel disease (IBD) which includes Crohn’s disease and ulcerative colitis causes the inflammation of the bowel which can lead to a variety of symptoms such as diarrhea, abdominal pain, cramps, etc.

Irritable bowel syndrome causes irritation of bowel loops which presents as multiple episodes of diarrhea, changes in bowel habits, and abdominal pain.

When an individual experiences diarrhea, the most important method to prevent dehydration caused by diarrhea is to stay hydrated by increasing fluid intake such as ORS (oral rehydration solution), coconut water, lemon soda, water, etc.

If diarrhea has associated symptoms such as high-grade fever, blood in stools, and continuous abdominal pain and vomiting then seek immediate medical attention.

Various studies have shown that food hygiene practices such as washing hands before and after using the washroom and eating food can prevent diarrhea to a great extent.

Sanitation and safety of drinking water should be properly ensured to prevent contamination of water and food from diarrhea-causing bacteria.

Vaccines are also available for certain diarrhea-causing organisms such as the Rotavirus vaccine for infants.

What is Acute Diarrhea?

Acute diarrhea is a type of diarrhea in which there is a sudden onset of loose and watery stool for a short duration of time. Acute diarrhea usually lasts for less than two weeks in duration.

The most common causes of acute diarrhea are gastrointestinal infections which are caused by bacteria, parasites, and viruses. Acute diarrhea can occur in all age groups but is usually more common in children.

Gastrointestinal infection transmits through ingestion of contaminated food and water, poor sanitation and hygiene, or close contact with infected individuals.

Some of the common pathogens for acute diarrhea are E.Coli, Salmonella, Shigella, Campylobacter, Rotavirus, and Norovirus. These pathogens act by irritating the epithelial lining of the intestine which leads to decreased absorption of water and increase fluid secretion which results in the passage of loose and watery stool.

Acute diarrhea itself is the symptom of an underlying health condition but it can be associated with various symptoms such as: –

1. Frequent bowel movements – Individuals who are suffering from acute diarrhea may experience an increase in the frequency of bowel movements and urgency to pass stool.
2. Abdominal Cramps – Some individuals with acute diarrhea also experience abdominal pain or cramps which is caused by irritation of the intestinal lining.
3. Nausea and Vomiting – Nausea and Vomiting are usually seen as associated symptoms of acute diarrhea in most individuals.
4. Fever – Acute Diarrhea can also lead to elevated body temperature which resolves once the diarrhea subsides.
5. Dehydration – Severe acute diarrhea can cause dehydration if the fluid replacement is not done adequately. Dehydration occurs in individuals with acute diarrhea where vomiting is associated with diarrhea.

Signs of dehydration are increased thirst, dryness of mouth, decreased urine output, loss of skin turgor, fatigue, and light-headedness.

Treatment of acute diarrhea is usually supportive and consists of managing to underline health conditions and dehydration. To manage dehydration oral fluid intake should be increased to replace water and electrolytes which are lost due to diarrhea.

Intake of Oral Rehydration Solution (ORS) is advisable as they contain the right balance of salt and sugars in them. Products such as caffeine, alcohol, junk food, and spicy food should be avoided to prevent and manage acute diarrhea

Acute diarrhea will resolve on its own if dehydration is prevented by increasing fluid intake. However, if the underlying cause of acute diarrhea is diagnosed then it should be managed properly.

If diarrhea symptoms don’t resolve or worsen or diarrhea persists for more than one week or is associated with blood in stool, high-grade fever, and abdominal pain then consult your health care provider.

Acute diarrhea prevention includes regular hand washing especially before and after using restrooms and eating food. Acute diarrhea can be prevented by avoiding eating outside i.e. street food, fast food, and junk food. Freshly prepared, home-cooked food can prevent episodes of acute diarrhea.

Who can get infected with Acute Diarrhea?

Acute Diarrhea can affect any individual from infants to old age groups, men or women, and individuals with all backgrounds. The risk of getting infected with acute diarrhea depends upon several factors which are:-

1. Age – Children are most vulnerable to acute diarrhea, especially below 5 years of age. The immune system of children is still in the development phase, and they do not have immunity against certain pathogens, also they have fewer hygiene practices and are more likely to touch contaminated surfaces and put their hands in their mouths. That’s why children get affected by acute diarrhea very easily.
2. Weak Immune System – Individuals who have weak immune systems due to other diseases such as HIV AIDS, cancer, and undergoing chemotherapy or taking other immunosuppressive medications have higher chances to get infected with acute diarrhea. Their body becomes weak against pathogens and is not able to fight due to a weak immune system leading to a higher risk of infection and other diseases.
3. Living Conditions – People who do not follow the proper hygiene practices and live in poor sanitation are at increased risk of getting infected with acute diarrhea.
   People living in areas where there is a lack of clean water and proper sanitation facilities and have limited hygiene education get infected with acute diarrhea.Also, people who are drinking and using water that is contaminated and has improper food handling practices, and not following adequate methods to clean their hands properly are easily infected with acute diarrhea.
4. Travelers – People who are traveling to areas that have inadequate sanitation and poor hygiene practices are at increased risk of getting infected with acute diarrhea. This is also known as “Travelers Diarrhea” which is caused by consuming contaminated food or water in unfamiliar places.
5. Personal Habits and Hygiene Practices – People who do not follow the proper hygiene practices such as not washing hands after using the toilet or washing inadequately, not washing hands before preparing food increase the risk of getting acute diarrhea to them and their family members.
6. Occupation – People who are working in hospitals, food handling, and childcare settings have an increased risk of getting exposed to diarrhea pathogens and can get infected with acute diarrhea.

It is important to follow good hygiene practices such as regular hand washing with soap and water, eating fresh and safe food, drink clean water helps in reducing the risk of getting infected with acute diarrhea.

Can Acute Diarrhea harm your Health?

In most cases, acute diarrhea is a temporary condition and is not life-threatening. However, in some cases, when acute diarrhea is not managed properly or other risk factors are involved, then acute diarrhea can lead to complications. Below are the risks associated with acute diarrhea

Potential Health Risk with Acute Diarrhea

1. Dehydration – Individuals who are infected with acute diarrhea lose fluid from their body at an increased rate if they are not replaced it leads to dehydration. Dehydration can be dangerous for infants, children, old age groups, and people with weak immune systems. If dehydration is not managed properly and its severity increases it leads to electrolyte imbalances in the body, kidney problems, and can be life-threatening complications.
2. Nutritional Deficiencies – Due to prolonged suffering from acute diarrhea, it can lead to malabsorption of essential nutrients, vitamins, proteins, and minerals. Due to loss of nutrients and dietary restrictions nutritional deficiencies occur. Nutritional Deficiencies hamper the growth and development of children and infants.
3. Weakened Immune System – Acute diarrhea itself does not impact the body’s immune system but certain pathogens that are responsible for causing acute diarrhea can weaken the immune system of the body. A weakened immune system makes an individual more susceptible to other infections and complications.
4. Spread of Infection – Infectious agents which are responsible for causing acute diarrhea is highly contagious and can spread easily to others if proper hygiene practices are not followed.
5. Underlying Medical Conditions – Individuals who are suffering from other medical conditions such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), or gastrointestinal disorders, acute diarrhea can worsen the situation by triggering flare-ups in these conditions and can increase the complications and severity of the disease.Now we know acute diarrhea has potential risks we can minimize the same by following several practices.

Minimizing Potential Health Risks from Acute Diarrhea

1. Stay Hydrated – Staying hydrated is very important in acute diarrhea because of lost fluids. An infected person should be given oral rehydration solutions (ORS) to replenish lost fluids and electrolytes.
   Drink plenty of water and other resources such as coconut water, clean juices, etc. to stay hydrated.
    
2. Nutrition Support – Take a nutritional diet consisting of proteins, vitamins, and healthy fats to overcome nutritional deficiencies during and after acute diarrhea. Your meal should include green vegetables, eggs, fruits, salads, etc., and avoid food that can exacerbate diarrhea such as fast food, spicy food, caffeine, alcohol, etc.
3. Follow Good Hygiene Practices – Following good hygiene practices such as washing hands after using the toilet, before preparing food, and before consuming food can help in preventing getting infected from acute diarrhea and other infections. These hygiene practices also help to stop the spread of acute diarrhea infections to others.
    
4. Seeking medical attention when necessary – If the acute diarrhea is prolonged or symptoms get worsen like high fever, blood in stool, or dehydration seek medical attention immediately for proper treatment.

What are the causes of Acute Diarrhea?

There are several factors that can lead to acute diarrhea such as dietary factors, medication side effects, infections, and other underlying medical conditions.  Below are the common causes of acute diarrhea: –

1. Gastrointestinal infections – Gastrointestinal infection is the most common cause of acute diarrhea and can be due to bacteria, viruses, or parasites. Individuals can get infected with acute diarrhea by eating contaminated food and drinking poor water, following poor hygiene practices, or coming in close contact with an infected person.The most common pathogens responsible for gastrointestinal infections are Escherichia coli (E. coli), Salmonella, Shigella, Campylobacter, Rotavirus, and Norovirus.
2. Food Poisoning – Eating food that is contaminated by bacteria, and toxins or prepared by following unhygienic practices can lead to acute diarrhea. Staphylococcus aureus or Bacillus cereus (Bacterial pathogens) can multiply inside improperly stored food causing illness to individuals. Toxins such as Clostridium perfringens which are produced from certain bacteria also cause food poisoning and acute diarrhea.
3. Viral Infections – Infants and children under 5 years are most vulnerable to acute diarrhea due to virus infections like rotavirus, norovirus, and enteroviruses. These viruses are highly contagious and can easily spread from one person to another by coming into direct contact, with contaminated surfaces and food.
4. Parasitic Infections – Few parasites such as Giardia lamblia, Cryptosporidium, or Entamoeba histolytica can cause infection in the gastrointestinal tract and cause acute diarrhea in individuals. These parasites are transmitted to humans by drinking contaminated water or by eating contaminated food and can lead to prolonged diarrhea if not managed properly.
5. Dietary Factors – Food that is difficult to digest and difficult to tolerate by individuals such as lactose or gluten can lead to acute diarrhea with lactose intolerance or celiac disease.
6. Medications – Few medicines can have adverse side effects which can lead to acute diarrhea in individuals. Antibiotics, laxatives, few chemotherapy drugs can cause acute diarrhea in individuals as medication side effects.
7. Underlying Medical Conditions – Individuals who are already suffering from underlying medical conditions such as Crohn’s disease or ulcerative colitis can lead to recurrent episodes of diarrhea.

What are the signs & symptoms of acute diarrhea?

Signs and symptoms of acute diarrhea are different in individuals depending upon their age, the severity of diseases, and other factors.

Common Signs & Symptoms of Acute Diarrhea are 

1. Loose, Watery Stools – Loose and watery stools are the first symptoms of acute diarrhea that appear in an individual. The frequency of bowel movement also increases in acute diarrhea in comparison to normal frequency.
2. Urgency – In acute diarrhea frequency, urgency, and loss of control over bowel movement also occurs.
3. Abdominal cramps and pain – Spasmodic pain and cramps in the abdomen also occurs in some individuals who are infected with acute diarrhea. Pain is sometimes also associated with distention of the abdomen/bloating.
4. Nausea and vomiting – Nausea and vomiting are also very common symptoms of acute diarrhea. Viral infection causes more nausea in comparison to other infections.
5. Fever – Acute diarrhea which is caused by underlying bacterial or viral infections can also present with fever. Fever indicates the active immune response to the underlying infection which is causing acute diarrhea.
6. Dehydration – If the acute diarrhea becomes severe or stays for a longer time then it can lead to dehydration. Various signs of dehydration are increased thrust, mouth dryness, decrease in urine output, and dark-colored urine. Patients suffering from dehydration will also experience fatigue, dizziness, or fainting.
7. Loss of appetite – Acute diarrhea can lead to decrease appetite due to spasmodic pain, bloating, and discomfort in abdomen.
8. Malaise – Acute diarrhea patients may feel weakness, generalized fatigue, or malaise. This can be due to a lack of energy, which is lost due to multiple episodes of acute diarrhea.

How to Prevent Acute Diarrhea?

Acute diarrhea is a disease that is preventable if various measures are implemented to reduce the risk of infections.

Some of the important preventive methods of acute diarrhea are-

a. Hand Hygiene – Hand washing prevents the spread of bacterial, and viral infections to a great extent that causes acute diarrhea and other diseases. Hand washing should be performed for at least 20 seconds with soap and water before and after using the toilet, before preparing and consuming food. If in case water and soap are not available, use alcohol-based sanitizers.
b. Safe Food and Water – Every time you have your meal, ensure that it is safe. The food and water should be clean which you consume and use for cooking.

• Always drink water from clean and reliable sources. If you are traveling or unsure about the quality of tap water, use bottled water or purify water by boiling it or using filter paper.
• Wash Fruit and vegetables in clean water thoroughly before cooking and consumption.
• Try avoiding eating raw meat, undercooked meat, or seafood.
• Handle the food properly and store it safely. Always cook the food at the right temperature and maintain the proper temperature for cold and hot foods.

c. Food Hygiene – Always follow good hygiene practices to minimize and reduce the risk of getting food contaminated. This includes-

• Person who is responsible for cooking and preparing food should follow proper hand hygiene.
• Store and refrigerate the food properly.
• Try to eat food from the hygienic street only. Avoid eating unhygienic food.

d. Personal Hygiene – Practice and maintain good personal hygiene to reduce the risk of getting infected with acute diarrhea.

• Take a regular bath or shower.
• Keep your surroundings and living place neat and clean.
• Try to avoid coming in close contact with persons who have acute diarrhea or other illness.

e. Vaccination – Get yourself vaccinated against the pathogens that cause acute diarrhea. For example, rotavirus vaccines are recommended for infants and children to protect them against rotavirus, which is the common cause of acute diarrhea.

f. Taking Precautions while Traveling – If you need to travel to an area that has poor sanitation infrastructure, you need to take extra precautions to prevent yourself from the traveller’s diarrhea. This includes –

• Always drink bottled water or purified water.
•  Do not take raw ice cubes or uncooked food.
• Wash your hands and use sanitizers after using the restroom or while traveling to public places.
• Consume food from reputed restaurants that follow safety standards.

How to diagnose Acute Diarrhea?

To diagnose acute diarrhea your healthcare expert needs to do your medical history evaluation, physical examination and in a few cases laboratory tests are required. Below are the common methods and steps used to diagnose acute diarrhea:-

a. Patient Medical History – Your healthcare expert will start by obtaining and examining a detailed medical history, information about infection, duration, and frequency of diarrhea, other associated symptoms, recent travel history, food habits, and any other potential source of infection.

b. Physical Examination – A physical examination may be required to assess the vital signs, check hydration status and check other signs of complications. Your healthcare expert may also touch or palpate your abdomen to check for abnormalities.

c. Stool Analysis – To diagnose acute diarrhea, stool analysis is the most common diagnostic stool. An infected person’s stool sample is collected and sent to the laboratory for testing. The tests which are performed in the laboratory are: –

d. Microscopic Examination of Stool – A stool sample is examined to identify the presence of parasites, and ova under a microscope.

e. Culture – To identify the bacterial pathogens stool sample is cultured. It helps in determining the presence of any specific bacteria which is causing acute diarrhea and the requirement of antibiotic treatment.

f. Polymerase Chain Reaction (PCR) – PCR testing is used to detect the presence of viral or bacterial DNA or RNA in the stool.

g. Toxin Testing – In case of food poisoning or suspected bacterial infection, toxin testing is done to identify certain toxins produced by bacteria in the stool.

h. Blood Tests – To check electrolyte balances in the body, or to identify other signs of infections blood tests are done.

i. Imaging Studies – During severe complications abdominal X-rays and ultrasounds are ordered.

j. Endoscopic examination – In cases of IBD (Inflammatory Bowel Disease), colonoscopy or sigmoidoscopy is recommended by the health care experts if the underlying condition is suspected.

How to treat Acute Diarrhea?

Acute diarrhea treatment involves focusing on relieving symptoms, preventing dehydration, and addressing the underlying causes. Below are methods to treat acute diarrhea-

Acute Diarrhea Treatment 

a. Fluid Replacement – Prevention of dehydration is one of the most important parameters of acute diarrhea. In dehydration, body fluids are lost which need to be replenished with the help of oral rehydration solution (ORS). ORS contains the correct amount of salt and sugar which are needed to replace the lost fluids. In case of severe acute diarrhea, intravenous fluid replacement is needed to cure dehydration.

b. Diet Modifications – Changes in diet can also be beneficial in the management of acute diarrhea. Foods that can be digested easily such as banana, rice, apple sauce, and toast (BRAT diet) relives the symptoms of acute diarrhea. Avoiding certain foods such as spicy, junk food, caffeine, and alcoholic beverages also reduces the severity & risk of acute diarrhea.

c. Medication – Certain medicines such as loperamide relieves acute diarrhea by reducing bowel movements. Medications for acute diarrhea should be taken under the supervision of a medical professional because certain diarrhea is not treated with over-the-counter medications.

d. Antibiotics and antiparasitic medications – If acute diarrhea is caused by bacterial or parasitic infection then specific antibiotics and antiparasitic drugs can be used to treat the same.  If antibiotics are taken to treat acute diarrhea, then the course should be completed as advised by a health care expert.

e. Symptom management – Symptoms of acute diarrhea such as abdominal pain and cramps, nausea, and vomiting can be managed with the help of over-the-counter medications however medication should be used judiciously.

f. Rest and Self-care – Rest is the most important parameter to treat or manage acute diarrhea because rest allows the body to heal, regain strength, and recover from acute diarrhea.

Q1. What is considered acute diarrhea?

 Ans. Acute diarrhea is a type of diarrhea when there is a sudden onset of loose watery stools for a brief period of time, usually less than two weeks.

Q2. What are the common causes of acute diarrhea?

Ans. Some of the most common causes of acute diarrhea are bacterial, viral, parasitic infection, food poisoning, dietary changes, and side effect of a few medicines or drugs.

Q3. How is acute diarrhea different from chronic diarrhea?

Ans. Acute and chronic diarrhea are differentiated based on their duration. Acute diarrhea is short-lived whereas chronic diarrhea persist for a longer duration usually more than 2 weeks.

Q4. When should I seek medical attention for acute diarrhea?

Ans. You should seek immediate medical attention if you are experiencing or have severe symptoms of acute diarrhea such as multiple episodes of diarrhea within a short duration, diarrhea along with vomiting, abdominal pain, and if signs of dehydration persist.

Q5. How can I prevent acute diarrhea?

Ans. Prevention is the key to reducing cases of acute diarrhea. Various preventive measures are good hand hygiene and sanitisation, consuming hygienic food, and drinking clean water.

Q6. What should I eat during acute diarrhea?

Ans. You should always consume light and easily digestible food when you are infected with acute diarrhea. Foods like bananas, rice, applesauce, and toast (BRAT diet) are easy to digest. Do not take any junk, or spicy, high-fat foods. Avoid caffeine and alcohol-based drinks.

Q7. Can antibiotics treat acute diarrhea?

Ans. Antibiotics are recommended when a bacterial infection is confirmed. For routine acute diarrhea cases which are caused due to viruses, antibiotics are not recommended as they resolve on their own.

Q8. Is acute diarrhea contagious?

Ans. Yes, Acute diarrhea is contagious and it is highly recommended to follow good hygiene practices and avoid close contact with the infected persons to limit the spread of bacteria and infection.

Q9. Can I take over-the-counter anti-diarrheal medications for acute diarrhea?

Ans. Over-the-counter medicines (anti- diarrheal medicines) such as loperamide or bismuth subsalicylate can provide temporary relief from the diarrhea but they should be taken as per the prescription of health care advisor because these drugs are not suitable for everyone or certain types of diarrhea.

Q10. How long does it take to recover from acute diarrhea?

Ans. The recovery period from acute diarrhea depends upon a few factors like age, severity of diarrhea, underlying causes, and treatment. In most cases, acute diarrhea resolves within a few days to a week if proper care and hydration measures are used.

Q11. Is it normal to have blood in the stool during acute diarrhea?

Ans. No, it is not normal to have blood in stool during acute diarrhea. Blood in stool indicated the serious underlying condition of the patient and immediate medical attention should be sought if these symptoms follow.

Q12. Can I continue breastfeeding my baby if they have acute diarrhea?

Ans. Yes, in most cases it is safe to continue breastfeeding to the babies even if they are diagnosed with acute diarrhea. Breast milk provides important nutrients and helps in replacing the nutrients lost during acute diarrhea infection.
Seek medical advice for guidance on managing breastfeeding during diarrhea