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Hilfe, ich habe Durchfall - was kann ich tun?

Help, I have diarrhea - what can I do?

Causes of the diarrhea

Diarrhea has various causes, which can be divided into several categories. Bacterial and viral infections are often responsible, with pathogens such as Vibrio cholerae being prevalent worldwide and causing gastroenteritis gastroenteritis. Exudative diarrhea often occurs in chronic inflammatory intestinal diseases such as Crohn's disease or ulcerative colitis, where mucosal defects result in the loss of osmotically active substances.

Drug influences are also significant; laxatives and antibiotics in particular can upset the balance of the intestinal mucosa. intestinal flora and lead to diarrhea for example due to the overgrowth of Clostridium difficile. Food intolerances, such as lactose or gluten intolerance, can also cause acute diarrhea. diarrhea especially in sensitive individuals.

In addition, there are also functional diarrheawhich is often caused by psychological factors or disorders of the intestinal motor function is triggered. In this case, there is an excess release of fluid without sufficient thickening of the stool. The causes are diverse and vary from person to person.

Bacterial infections

Bacterial infections caused by pathogens such as E. coli, salmonella, CampylobacterShigella and Staphylococcus, are frequent triggers for acute diarrhea. These pathogens often spread through the consumption of spoiled or contaminated food, which leads to gastrointestinal infections leads to gastrointestinal infections. In immunocompetent people, long-term shedding of these pathogens is rather rare. However, this phenomenon occurs more frequently in chronically ill and immunocompromised people. A worrying complication that particularly affects immunocompromised patients is salmonella sepsis, a serious illness. In addition, bacterial diarrheal pathogens such as Campylobacter and Salmonella in patients with gastroenteritis often trigger symptoms such as nausea and vomiting, which further aggravate the condition. It is important to follow hygiene practices and ensure careful food preparation to avoid infection.

Viral infections

Viral Diarrheal pathogenslike human rotaviruses and human norovirusesare widespread in Germany and often cause acute infections. gastroenteritis. Transmission is mainly from person to person, which is the case with gastrointestinal infections plays an important role. An infection caused by viruses gastroenteritis typically leads to watery stools that do not contain any blood or mucus.

Especially in infections with norovirus and rotavirus often cause additional symptoms such as nausea and vomiting. These diseases are not only widespread in Germany, but also in (sub)tropical countries and pose a considerable challenge for healthcare. Prevention, such as hygiene and vaccination, plays a crucial role in minimizing the spread of these viral infections and protecting the health of the population.

Food intolerances

Food intolerances are widespread and affect many people. One of the best-known forms is lactose intolerance, in which the enzyme lactase is missing. This means that unsplit lactose in the large intestine by bacteria in the colon, leading to gas formation and diarrhea as a result. Lactose intolerance often affects the majority of the adult population and can be diagnosed by a lactose breath test.

In addition to lactose intolerance, there are also other food intolerances, such as allergies to strawberries, milk, nuts, egg whites or fish. These can also cause symptoms such as diarrhea diarrhea.

In addition, external factors such as the use of antibiotics can lead to diarrhea as they inhibit the natural intestinal flora damage the natural intestinal flora. The misuse of laxatives, often in connection with weight loss, can also cause serious health complications, including electrolyte loss. It is important to listen to your body and consult a doctor if you suspect any intolerances.

Side effects of medication

The side effects of medication can vary greatly depending on the type of medication. For example, oral antibiotics can cause severe diarrhea may be limited in their effectiveness, so that a doctor must be consulted. 
In children, especially children under two years of age loperamide should be avoided as it can enter the nervous system and potentially cause respiratory depression or delirium. Similarly, the use of opioids can cause the intestinal motility suppress intestinal motility, which may provide short-term relief of diarrhea but may lead to complications.
It is crucial that symptoms such as diarrhea are reported to a doctor before treatment is started to avoid adverse effects and to ensure effective use of the medication.

Symptoms of diarrhea

Diarrhea is medically defined as more than three mushy or liquid bowel movements per day, often associated with a high water content in the stool. Common accompanying symptoms include nausea and vomiting, especially in viral infections. gastrointestinal infectionscaused by pathogens such as norovirus and rotavirus. In the case of bacterial diarrheasuch as salmonella, often only the diarrhea symptoms while vomiting is less common.

Chronic diarrhea can be a sign of serious illnesses such as irritable bowel syndrome or chronic inflammatory intestinal diseases (e.g. Crohn's disease, ulcerative colitis). Acute diarrhea is usually mild and subsides on its own within a few days. Especially with long-lasting diarrheaespecially in small children, medical advice should be sought urgently.

Acute vs. chronic diarrhea

Acute and chronic diarrhea differ in their duration and causes. Acute diarrhea lasts a maximum of two to three weeks and often has infectious or toxic causes, such as bacterial and viral infections (e.g. norovirusessalmonella). Symptoms include more than three unformed stools daily, but acute cases often resolve quickly and can usually be easily treated.

In contrast, chronic diarrhea lasts longer than two weeks and is often associated with food intolerances, chronic intestinal diseases or tumors. Pathophysiologically, it can be classified as osmotic, secretory, exudative or hypermotile, indicating differentiated underlying diseases. Chronic diarrhea can last for months and requires more intensive diagnosis and treatment, as it often signals more serious health problems.

Overall, the course of diarrheawhether acute or chronic, depends largely on the cause.

Diagnosis

The diagnosis of diarrhea (Diarrhea) is crucial to identify the underlying cause. In acute diarrheadefined as symptomometry of 14 days or less, it is important to differentiate between infectious and non-infectious causes. Diagnostic methods include stool examinations, blood tests, ultrasound and colonoscopy.

Chronic diarrheathat lasts longer than 14 days may indicate more serious conditions such as inflammatory intestinal diseases inflammatory bowel disease. The definition of diarrhea includes the discharge of liquid stool more than three times a day and a stool weight of more than 250 g per day.

An indication of an infectious diarrhea may be foul-smelling stool, which indicates a bacterial infection. These diagnostic approaches help determine the appropriate treatment and target the cause of the symptoms.

Assessment of medical history

The basic medical diagnosis of diarrheal diseases begins with a comprehensive medical history. It is important to record the frequency of bowel movements, the consistency of the stool and accompanying symptoms such as pain. Information about potential sources of infection, such as food or diarrheal diseases in the personal environment, are also crucial.

In addition, a targeted examination of the patient should be carried out, including stool and blood tests as well as imaging procedures such as ultrasound and colonoscopy can include. Early medical consultation is particularly recommended for vulnerable groups such as infants, young children or the elderly, especially if symptoms such as fever, severe abdominal pain or bloody stools occur.

A careful differential diagnosis is essential, as acute diarrhea indicate serious illnesses such as chronic inflammatory intestinal diseases which require rapid medical action.

Laboratory tests

Laboratory tests for gastrointestinal infectionsespecially for those causing acute diarrhea are crucial, but also difficult. Comprehensive stool testing for all potential pathogens is often neither medically nor economically justified, as many infections are self-limiting. The diagnostic yield of conventional stool cultures is relatively low at around 5-10%, especially if there is no prior clinical risk stratification.
To improve pathogen detection, stool samples should be transported in special containers as quickly as possible, ideally within 6 to 12 hours and no longer than 24 hours. This speed is of crucial importance as certain pathogens, such as Shigella and Campylobactercan spoil quickly without adequate preservation, underlining the need for immediate analysis. A sample size of two to three spoonfuls taken from different areas of the stool is usually sufficient for an effective diagnosis. 

Treatment options

The treatment of diarrhea begins primarily with fluid replacement to prevent dehydration, especially in young children. Antibiotics can be used for bacterial infections, but there is a risk that they themselves can cause diarrhea. Diarrhea themselves. Adults and adolescents need antibiotics for acute diarrhea often require no specific treatment, while chronic diarrhea diarrhea requires targeted treatment of the underlying disease.

Loperamide is a short-term antidiarrheal and can be used in severe cases. If loperamide is not sufficiently effective, tincture of opium can be prescribed as an alternative. Acute diarrhea is often caused by acute gastrointestinal infectionscaused by bacteria or viruses. In such cases, the diagnosis should be made quickly and medical intervention should be considered.

Electrolyte supplementation

In children, the elderly and in cases of severe diarrhea it is important to electrolyte loss to compensate for the loss of electrolytes. For this purpose, special electrolyte drink solutions are recommended, which are available in pharmacies or drugstores. These solutions are available as water-soluble powders and contain salts, minerals and glucose, which contribute to rehydration.

The general recommendation is around 40 milliliters Electrolyte drink solution per kilogram of body weight per day. For example, a child weighing 20 kilograms should drink around 800 millilitres of the solution to compensate for the loss.

In addition, it is important to diarrhea drink sufficient fluids. Non-carbonated drinks such as still water or medicinal herbal teas are particularly suitable for replenishing lost electrolytes lost electrolytes. Proper fluid intake can prevent dehydration and improve well-being.

Medication (e.g. loperamide)

loperamide is a synthetic opioid that is used for the treatment of diarrhea is used to treat diarrhea. It is important, loperamide for severe bacterial intestinal infectionsassociated with fever and bloody diarrhea as it inhibits the elimination of pathogens. Its use is contraindicated in children under two years of age, as it can reach the nervous system and could lead to respiratory inhibition or delirium.

For older children and adults loperamide is relatively safe, however, as the blood-brain barrier prevents it from entering the nervous system. Loperamide should not be used for longer than 48 hours and is used as a short-term solution for severe diarrheauntil medical attention can be sought.

An alternative treatment option is tincture of opium, which can be used if other antidiarrheal drugs are not effective enough.

Strategies for fluid intake

For acute diarrhea symptoms it is crucial to maintain the fluid and electrolyte loss to compensate for this. The World Health Organization (WHO) recommends taking a special oral rehydration solution containing sodium chloride, sodium citrate, potassium chloride and glucose. This mixture helps to effectively compensate for fluid loss.

It is important to increase fluid intake to at least two to three liters per day to compensate for the loss through diarrhea to compensate for the loss due to diarrhea. A solution of boiled water, salt and sugar can also be helpful to stabilize the fluid balance. Be sure to monitor symptoms and consult a doctor if necessary if symptoms persist.

Prevention strategies

Careful hygiene is essential to prevent infections caused by pathogens, especially during a diarrheal illnessduring a diarrheal illness. One of the most important measures is to wash your hands regularly and thoroughly after using the toilet. Travelers to (sub)tropical countries should take particular care, as 30 to 50 % of them suffer from traveler's diarrhea can fall ill.

It is recommended that during a diarrheal illness to use your own toilet and to clean and disinfect it thoroughly after each use. Protection from infectious diarrhea also depends on the consumption of clean water and food.

In summary, a combination of personal hygiene, careful food and water choices and attentive toilet use is the key to preventing diarrheal pathogens and protecting your own health and the health of others.

Nutritional considerations

With Diarrhea it is important to choose a light light diet in order to gastrointestinal tract to avoid putting additional strain on the gastrointestinal tract. Potatoes are an excellent source of nutrition as they are rich in potassium and help to retain free fluid in the intestines. intestines which can solidify the stool. Also a dietrich in pectin, such as that found in bananas or apple peel, can also be beneficial, as pectin reduces the likelihood of stool retention. diarrhea can reduce diarrhea.

Probiotic foods, such as yoghurt and raw sauerkraut, support the intestinal flora and can also help to prevent the occurrence of diarrhea reduce the occurrence of diarrhea. In addition, excessive consumption of alcohol, coffee, sugar and flatulent and fatty foods should be avoided in order to reduce the risk of diarrhea to minimize the risk of diarrhea. A balanced and careful diet is essential to promote the health of the digestive system and avoid unpleasant symptoms.

Hygiene practices

Good hygiene practices are crucial to prevent the transmission of pathogens, especially in the case of gastroenteritis. Frequent hand washing, especially after using the toilet or before preparing food, should become routine. If a housemate becomes ill, it is advisable to use a different toilet to minimize the risk of infection.

Clothes, towels and bed linen should be washed regularly at temperatures of at least 60 degrees Celsius to kill potential germs. In the kitchen, it is important to pay attention to cleanliness; dishes and cutting boards should also be cleaned with hot water of at least 60 degrees Celsius to be hygienically safe.

In addition, the toilet should be cleaned thoroughly and aired regularly. This will help to prevent the spread of infection in the home and maintain a healthy living environment. Overall, these simple measures are crucial to protecting the health of all household members.

When to see a doctor

There are several situations in which it is advisable to seek medical attention for diarrhea consult a doctor. After a stay in subtropical or tropical countries, if diarrhea occurs diarrhea medical assistance should be sought immediately, as diseases such as typhoid or cholera may be prevalent here. If you have bloody stools or suspect poisoning, you should see a doctor immediately.

Significant weight loss of more than 10 percent of body weight is also a warning sign. Special care should be taken with infants under six months of age who diarrhea diarrhea, or if children have more than eight watery diarrhea in 24 hours or vomited more than four times a day.

While adults and adolescents generally do not require special treatment for acute diarrhea, the diarrhea diarrhea, due to the higher risk of significant water and electrolyte loss young children and older people should always consult a doctor.

Source: istockphoto bymuratdeniz

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