Acute diarrhea in adults

Acute diarrhea usually occurs quite suddenly. It is a loose, watery stool that occurs several times a day. The color and odor generally differ from your normal stool and sometimes the diarrhea is accompanied by abdominal cramps, vomiting and fever. The cause is often an infection with viruses or bacteria, but certain (new) medicines can also lead to acute diarrhea. In most cases, the diarrhea disappears on its own after a few days. Our food is transported to the stomach via the esophagus. Here – with the help of the gastric juice, the food is broken down in such a way that it can later be absorbed through the intestinal wall. After about three hours, the food leaves the stomach and goes to the small intestine. The most important part of digestion takes place there. Nutrients such as proteins, fats, minerals and vitamins are released into the blood through the intestinal wall. Afterwards, our food is nothing more than a thin paste of indigestible food remains. In the large intestine, fluid, salts and (the remaining) minerals are then extracted from the mash and released into the blood. What remains is thickened stool, which leaves our body via the rectum and anus.

An intestinal infection is the main cause

In acute diarrhea, the intestinal wall is unable to absorb sufficient fluid from the food mucus due to inflammation or irritation. This causes the stool to become thinner and a lot of fluid is lost. The main cause of acute diarrhea is an intestinal infection. Viruses or bacteria, for example found on spoiled food or in contaminated water, enter the intestines through your mouth. However, contamination can also occur through contact with other (infected) people or surfaces. The pathogens can be transmitted through feces and saliva. Hands, the toilet seat, doorknobs and kitchen utensils are common sources of contamination.
Acute diarrhea can sometimes also be a side effect of some medications, such as antibiotics, certain painkillers and antacids. Diarrhea can occur especially during or shortly after a course of antibiotics. Antibiotics affect the intestinal flora and can temporarily disrupt the natural bacterial balance in the intestines. The bacteria that cause diarrhea can then easily multiply. Using medicines with an intestinal stimulating (laxative) effect can also lead to acute diarrhea. An example of this is the drug Bisacodyl, which irritates the intestinal mucosa and stimulates intestinal movements.
Excessive alcohol use, anxiety and stress (hormones) can also lead to rapid emptying of the intestines.

Acute diarrhea, abdominal cramps and fever

A viral infection, for example caused by Rotavirus, Norovirus or Adenovirus, is the most common cause of acute diarrhea. The viral infection leads to gastroenteritis, of which (sometimes severe) diarrhea is the main symptom. However, a bacterial infection is also common. Infection with Campylobacter bacteria and Salmonella species is regularly seen in people on holiday, especially in warm countries, and after barbecuing. The bacteria are usually found on spoiled or undercooked food (meat) or in contaminated water. A viral or bacterial intestinal infection causes the intestines to suddenly contract considerably. This leads to abdominal cramps and a sudden urge to go to the toilet. This makes stool difficult to hold. Because you lose many important nutrients and fluids, you may feel tired, weak and suffer from headaches. Fever, nausea and vomiting are also quite common with an intestinal infection. In that case you lose extra fluid. This can lead to (dangerous) dehydration, especially in the elderly. It is therefore important to pay close attention to the signs that may indicate dehydration: no or little urination (dark urine), thirst, lethargy, fainting, confusion, drowsiness, rapid breathing, rapid heart rate, dry mouth, sunken eyes and cold arms and legs.
Diarrhea not only reduces the body’s ability to absorb nutrients and fluid from the intestines, but also medicines. Medications you take may therefore have a reduced effect. A well-known example of this is the contraceptive pill. But water tablets, anti-epileptic drugs, digoxin, lithium or diabetes medication may also work less well. It is wise to consult your doctor if you are taking such medications.

A visit to the doctor is sometimes necessary

Acute diarrhea usually goes away on its own after a few days. Until then, it is important to drink plenty of fluids (2 to 3 liters per day) to prevent dehydration. Your stomach and intestines are more sensitive than normal due to the infection or irritation. Food can irritate your intestines and cause them to contract (violently). This is a normal gastrointestinal reflex, but can sometimes lead to another wave of diarrhea. However, as soon as you feel hungry again, it is wise to try to eat small portions. This usually makes you feel a lot better. Fasting or a special diet is not necessary. In case of severe diarrhea you can use an ORS solution (oral rehydration solution). ORS contains sugars and salts that the body needs to absorb and retain fluid. ORS is available as a ready-made drink or dissolving powder at pharmacies and drugstores. Medicines are available to reduce diarrhea and associated complaints (for example loperamide). However, they do not cure the infection. In any case, do not use these medications for longer than two days, otherwise they can lead to constipation. It is also not wise to use sedatives if you have a fever.
Good hygiene is very important to prevent other people around you from getting diarrhea or from re-infecting yourself. Wash your hands regularly with soap and water and handle (preparing) food safely.
It is normal and not immediately necessary to go to the doctor with complaints of acute diarrhea. However, if there are signs of dehydration, haste is required and medical attention should be sought immediately. Even if the diarrhea is very severe (8 or more times a day) or lasts too long (longer than 3 days), you have blood or mucus in the stool, you have constant abdominal pain or you have a fever for more than 3 days, it is wise to to go to the doctor. In people aged 70 or over, it is advisable to seek medical advice if diarrhea persists for more than 1 day. Especially if there is also a fever.

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