THE DIARREA

Diarrhea, also called colitis in common parlance, is the emission of unformed stools, i.e., liquid or semi-liquid, often foul-smelling, expelled with violent discharges.

Such discharges, called diarrheal discharges, can follow one another even at short intervals, and in severe cases can go so far as to completely displace the patient, dehydrating him or her and making him or her unable to work and perform common daily chores.

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Read this page written by Dr. Luisella Troyer to find out the causes of diarrhea, and what can be done to treat it.

What is diarrhea?

Diarrhea is an alteration of alvus, perhaps the most common and well-known (along with constipation) of the bowel dysfunctions.

It presents as violent and, often, painful discharges of unformed, liquid or semi-liquid, foul-smelling stools, often accompanied by cramping, abdominal spasms, and aerophagia.

Diarrhea is not a disease per se, but is an extreme defense of our body, trying to get rid of a pathogen that has infected the intestines, a chemical attack, or, in general, any element that the body judges as foreign and dangerous.

This attempt to expel the germ or toxin from the colon causes an imbalance in the intestinal flora, that is, the bacteria that live symbiotically in our large intestine and help us complete digestion and fluid reabsorption.

What is diarrhea caused by?

More than 70% of diarrhea cases are caused by the infection of a bacterium, which releases toxins that are harmful to our intestines.

The list of bacteria that can cause diarrhea is very long, but among the many we can certainly mention Escherichia coli, Salmonella, Clostridium difficile, and Staphylococcus aureus.

Some viruses can also infect intestinal cells, thus causing diarrhea, such as rotavirus, norovirus, and enteric adenovirus.

Allergies, food intolerances (such as celiac disease) or even exposure to radiation or metals can also cause diarrhea, as they are capable of damaging both the intestinal mucosa and the benevolent flora residing therein.

Some autoimmune diseases, such as ulcerative rectocolitis and Crohn's disease, often give, as symptoms, violent episodes of diarrhea, which unfortunately tend to recur periodically, exacerbating and becoming chronic.

Among the chronic conditions that can lead to episodes of diarrhea unrelated to bacterial or viral infection, undoubtedly the best known and, statistically, relevant, is irritable bowel syndrome.

The different types of diarrhea

Diarrhea is, clinically, divided into two specific types: acute diarrhea and chronic diarrhea.

Acute diarrhea is defined as a violent and painful attack that leads to frequent daily discharges and is usually the body's response to infection by harmful bacteria or viruses, usually entered into the intestines through ingestion of infected liquids or foods.

This type of diarrhea usually resolves spontaneously within two weeks, but can still linger for longer, depending on the level of infection and immune response.

Chronic diarrhea, on the other hand, is defined as a perennial diarrheal situation, or at least recurring at more or less regular times, alternating brief moments of well-being with frequent diarrheal episodes, which last for more than four weeks and tend, over time, to increase in intensity and frequency.

What is the treatment for diarrhea?

Diarrhea is a natural defense of our body, and therefore it is a symptom and never a cause.

Therefore, to help the body rebalance itself, it is necessary to understand the origin of the diarrheal act, which may be chemical, bacterial, viral, or as a symptom of other diseases or chronic pathological conditions.

If the body is trying to rid itself of microbes or toxins produced by them, it is therefore necessary to facilitate and support it in the task, and not prevent it from doing so.

This is why the use (often, abuse) of antidiarrheals, especially if self-administered without the advice of a Physician, should always be avoided.

At best, these drugs that can essentially block peristalsis momentarily should be prescribed only as a palliative and momentary comfort remedy, to stall while the real cause of the diarrhea is investigated.

In the case of established intestinal bacterial infections, the use of antibiotic therapy should be systematically avoided: in fact, such drugs, in addition to killing the malevolent parasitic bacterium, unfortunately make no distinction, while also destroying the benevolent bacterial flora of the intestine, thus worsening the situation.

The use of broad-spectrum antibiotics is therefore almost always discouraged in cases of suspected bacterial diarrhea, while therapy with targeted antibiotics can be considered only when the exact strain of the bacterium that is causing the infection has been discovered.

In any case, the use of probiotics (milk enzymes) and constant hydration is the therapy of choice for most episodes of acute diarrhea.

Generally, regular hydration carried out through drinking is sufficient, but in severe cases of dehydration, intravenously administered hydration can also be used.

If the cause of diarrhea is celiac disease, it is necessary to wait until the body has expelled all gluten residue, in which case the only possible therapy is supportive care, again with appropriate hydration.

How dangerous is diarrhea?

Diarrhea, as mentioned earlier, is not a real disease but a symptom, which resolves only when the cause of it has been resolved.

Although in the past, given poor sanitation and the absence of sewerage and proper supportive medical treatment, diarrhea was a serious, often fatal problem, nowadays in a modern country like Italy it is rarely life-threatening.

More than 70% of diarrheal colitis is in fact accidental, and resolves spontaneously in a few days or weeks with the right supportive therapy.

Many of the autoimmune diseases that cause frequent diarrheal discharges can also be kept under control, if not cured at least stabilized by the right medical therapy.

The main danger of diarrhea is dehydration, and knowing this it is now possible to prepare the right supportive and rehydration therapies, which can be implemented in both home and hospital settings.

The important thing in the case of prolonged attacks of diarrhea over time is not to start do-it-yourself therapies, but always rely on the diagnosis and treatment decided by a Physician.

Is it true that chronic diarrhea can lead to the onset of pathological hemorrhoids?

Yes, unfortunately it is true.

Chronic diarrhea is in fact, along with constipation, one of the triggers of hemorrhoidal disease, and this fact has been established for many years now.

Liquid or otherwise semi-liquid stools typical of diarrheal discharges are acidified, thus capable of attacking and injuring the delicate anal mucosa and peri-anal skin.

This means that, in patients suffering from chronic diarrhea, the anal mucosa is perpetually stressed and injured by acidic stools, causing excess blood flow that, in the long run, leads to the onset of hemorrhoidal pathology.

That is why, among other things, it is important to diagnose and treat chronic diarrhea early to prevent hemorrhoid extrusion and safeguard the anal canal.

Which Physician should one turn to in case of diarrhea?

Any Physician worth his or her salt, even a general practitioner, can treat acute diarrhea with the right supportive integrative therapy.

However, chronic diarrhea may require advanced knowledge of Colonproctology and Gastroenenterology, so the family physician may not be enough.

In such cases, a visit to the Gastroenterologist or Proctology Physician may help to understand the original dysfunction that is causing the chronicity of diarrhea.

In Dubai, Dr. Luisella Troyer is your trusted proctologist against chronic diarrhea

Dr. Luisella Troyer is a Proctologic Vascular Surgeon who has specialized in bowel and bowel dysfunction for many years.

In her clinic in Dubai, Dr. Troyer can help you understand the origin of chronic diarrhea, rounding up the right diagnosis and treatment, including with the help of modern Electronic Endoscopic Videoproscopy.

A noninvasive and painless, totally digitized examination of the anorectal canal, which can help the Physician fully inspect the area and understand the origin of inflammation that could lead to chronic diarrhea.