Acute Diarrhea

Acute diarrhea is defined as three or more loose or watery stools within 24 hours or more than one stool with mucus and/or blood. These symptoms can occur suddenly and last no longer than two weeks. However, the patient must not have had a history of diarrhea that regularly comes and goes.

Diarrhea can be categorized according to symptoms as follows:
  • Diarrhea as the main symptom means that the patient started with diarrhea, which is more severe or more apparent than any other symptoms that might follow, such as vomiting, abdominal pain, and/or fever. Diarrhea can be divided into two sub-groups:
    • Loose or watery stools; large amount of watery stools; stools that are a cloudy white color.
    • Stool mixed with blood and mucus.
  • Vomiting as the main symptom means that the patient started with vomiting, which can be severe. This symptom is followed by diarrhea, which can be mild or infrequent.
Diarrhea may be caused by bacteria, virus, or parasite from eating or drinking contaminated food and water.
When the patient comes to see the doctor, the doctor will ask them about their history, including symptoms, the food and water recently consumed, when the symptoms started and how long they have lasted, the number of bowel movements, the color and smell of stool, and any other symptoms, such as fever, abdominal pain, nausea, vomiting, etc.

Furthermore, the doctor will carry out a physical examination, including checking pulse rate, examining the abdomen, and assessing loss of fluids and electrolytes (dehydration). Signs of dehydration include dry mouth and throat, thirst, dry skin (if skin is pulled up it doesn’t return to normal position right away) or if the nail is pressed, it takes more than two seconds to return to a pink color (normally this takes two seconds).

If the doctor suspects other problems, additional tests might be ordered.
  1. Prevention and treatment of dehydration by replacing loss fluids because the body must maintain the level of electrolytes, especially sodium and potassium. These are important to maintain the rhythm of the heart. If there is an electrolyte balance and fluids is not replaced by drinking electrolytes, this imbalance can result in dangerous complications, such as seizure and loss of consciousness.
  2. Antibiotics and anti-diarrheal may be prescribed if the doctor thinks it is necessary.
Acute diarrhea found in patients over 65 may lead to death and more complications than in younger patients. Older patients tend to have other medical conditions, such as heart disease, diabetes, hypertension, and diseases of the lungs or kidneys, at the same time. This group of patients is at higher risk of electrolyte imbalance when compared to younger patients.
The World Health Organization has issued 10 golden rules for prevention of diarrhea as follows:
  1. Eat foods that have been prepared safely. For example, drink only pasteurized milk and wash fruit and vegetables thoroughly with plenty of water.
  2. Cook food well before eating.
  3. Eat only food that has been recently cooked.
  4. If you need to store cooked food for more than four to five hours, do so in the refrigerator.
  5. Before eating food, heat it up thoroughly until it is hot.
  6. Do not mix cooked food with raw food as this can contaminate the cooked food.
  7. Wash your hands before preparing food, before eating, and especially after using the toilet.
  8. Maintain cleanliness of the food preparation area and clean it well after cooking.
  9. Store food away from insects, rats, and other animals.
  10. Use clean water to prepare food and be especially careful when using water to prepare food for infants.

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