When you have diarrhea, you have loose, liquid stools, an urgent need to use the bathroom, and increased frequency of bowel movements Table 01. You may experience abdominal cramps or pain, rectal pain, bloating, gas, nausea, or vomiting. You may have leakage of stool between bowel movements. You may develop a fever or have blood or flecks of mucus in the stool. If diarrhea persists for more than a few days, as in cases of chronic diarrhea, you may lose your appetite and lose weight. Symptoms appear within 4 to 48 hours after exposure to contaminated food or water, and are most severe during the first 24 hours.
Table 1. Symptom Checklist
Loose, liquid stools Increased frequency of defecation Urgent need to defecate Bloating, gas Abdominal pain or cramps Nausea, vomiting Fever Blood or mucus in the stool Loss of appetite, weight loss
If you lose too much liquid from your body because of diarrhea and vomiting, you may become dehydrated. Signs of dehydration include dry mouth, excessive thirst, dry eyes, and infrequent urination. Dehydration is the most serious consequence of diarrhea. Addressing dehydration is the most important aspect of treatment.
The symptoms of acute diarrhea in infants include loose stools that occur more than once after each feeding.
Older children may have watery, loose stools; fever; abdominal cramps; nausea and vomiting; loss of appetite; weight loss; and dehydration.
Infants and children can become dehydrated quickly, often within a matter of several hours. Look for such symptoms as lack of tears when your baby cries, sunken eyes, wrinkled skin, and fewer than six wet diapers per day. In older children, you may notice dry mouth, increased thirst, sunken eyes, crying without tears, infrequent urination, pale or dry skin, and irritability. Older children and adults who are dehydrated may feel weak or dizzy with a racing pulse. Feeling dizzy when going from lying down to sitting up or standing is a strong clue that a person has become dehydrated.
Although diarrhea is usually thought to be a minor problem, some of the bacteria that can cause it may spread into the bloodstream and cause symptoms in organs other than the intestines. Salmonella species is of particular concern. Salmonella bacteria can cause infections in the bones, joints, brain, membranes covering the brain, and other sites.
The symptoms of traveler's diarrhea are the same as those of diarrhea contracted at home: frequent, loose bowel movements; abdominal cramps; nausea; bloating; fever; and listlessness. Although traveler's diarrhea usually occurs the first week you are away from home, it may occur at any time while you are abroad or after you return. The condition lasts an average of three or four days. You may experience more than one attack during a lengthy trip.
The signs of chronic diarrhea are usually similar to those of acute diarrhea; the distinction lies in the duration of the condition. Chronic diarrhea is usually described as lasting at least two to four weeks, while acute diarrhea normally clears up in a few days. However, in some cases, the course of chronic diarrhea may vary. Diarrhea associated with irritable bowel syndrome usually occurs only during the day, and may alternate with constipation. In addition, stress or anxiety may aggravate the symptoms.
Eating contaminated food or drinking contaminated water is a primary risk factor for diarrhea caused by infectious agents. This risk is higher in nonindustrialized countries, although contamination can occur anywhere. You may develop an infection while camping or backpacking if you drink impure water from a stream or lake. You can also pick up an infection from improperly cooked food or food that has become contaminated after cooking. Such contamination can occur no matter where the food is prepared.
Traveler's diarrhea occurs mainly in areas with contaminated water supplies, poor sewage systems, and inadequate techniques or supplies for food preparation. High-risk destinations include most of the developing countries of Central America, Africa, the Middle East, and Asia. Intermediate-risk locales include most of the southern European countries and a few Caribbean islands. The U.S., Canada, Northern Europe, Australia, New Zealand, and several Caribbean islands are considered low-risk destinations.
Children are at higher risk due to their poor personal hygiene and close contact with others in such settings as day-care centers; families are also at risk because of infections that children may bring home.
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