What is diarrhea?

Diarrhea can refer to the urgent passage of stool or high stool frequency or a change in the composition of stool (for instance, becoming loose and watery). Patients can refer to diarrhea with many different terms and definitions; as your gastroenterologist, it is important to have an in depth conversation and define your stool pattern, frequency and consistency.

When should I see a doctor for diarrhea?

There are many reasons to see a doctor for diarrhea. In general, if your stool pattern or stool consistency or stool frequency is bothering you, then it is best to bring it to the attention of a physician.

What is the difference irritable bowel syndrome and diarrhea?

While the terms “Irritable bowel syndrome” and “diarrhea” are often used in place of one another, there is actually an important distinction between the two. Not all diarrhea is irritable bowel syndrome, and not all irritable bowel syndrome deals with irritable. The key difference between the two is that irritable bowel syndrome is centered around abdominal pain that is relieved by defecation, whereas functional diarrhea is mostly without pain. Irritable bowel syndrome is defined by a set of criteria (Rome criteria)1:
Recurrent abdominal pain or discomfort at least 3 days per month, in the past 3 months associated with two or more of the following:

  • Improvement with defecation
  • Onset (of pain) associated with a change in the frequency of stool
  • Onset (of pain) associated with a change in the form (appearance) of stool

Causes of diarrhea

There are hundreds of different causes of diarrhea, including functional diarrhea, medication side effects, malabsorption of carbohydrates (and artificial sugars), pancreatic insufficiency, celiac disease, Crohn’s disease, Ulcerative Colitis, lymphoma, colon cancer, fat malabsorption, parasites, sprue, infections (viruses, protozoa, Strongyloides, atypical infections), dietary components, radiation injury, history of abdominal surgery, microscopic colitis, small intestine bacterial overgrowth, bile acid malabsorption, laxative abuse, etc.

How does a gastroenterologist evaluate diarrhea?

As you can see, there are hundreds of different causes of diarrhea. A diarrhea evaluation starts with an office visit where we have an in depth conversation about your stool consistency, stool frequency, and any associated abdominal symptoms. In addition to obtaining a careful history, it is also important to review and discuss other medical conditions, previous surgeries, and current medications. After a careful history and physical exam, we will decide on the best next steps, which can include analysis of stool (a stool sample), imaging (CT scans) and even procedures (upper gastrointestinal endoscopy, colonoscopy).

What are treatments for diarrhea?

There are multiple different medications and treatments for diarrhea. Prescribing the right medication is imperative for treating your diarrhea! The best way to determine the best medication for you starts with an office visit and in depth discussion.