Caregiver Guide: Diarrhea

Understanding the Problem

Diarrhea is the passing of three or more loose or watery stools per day, or a definite decrease in consistency and increase in frequency of bowel movements based upon what is usual for the individual. (Simply put, diarrhea is when a person goes to the bathroom more often than usual for that person and the stool is not as firm as usual.) It is a common problem that usually lasts a day or two and goes away on its own without any special treatment. Diarrhea that lasts more than three weeks can be a sign of a serious problem, or may be due to a less serious condition such as irritable bowel syndrome.

Diarrhea can cause dehydration, which means the body doesn’t have enough fluid to function properly. Dehydration is particularly dangerous in older people, and it must be treated promptly to avoid serious health problems.
People of all ages can get diarrhea. The average adult has an episode of diarrhea about four times a year.

Symptoms of diarrhea

Diarrhea may be accompanied by cramping abdominal pain, bloating, nausea, and an urgent need to use the bathroom. Depending on the cause of the diarrhea, a person might have a fever or bloody stools.

Diarrhea can be either acute or chronic. The acute form, which lasts less than three weeks, is usually related to a bacterial, viral, or parasitic infection.

Chronic diarrhea lasts more than three weeks and is usually related to other problems like irritable bowel syndrome (characterized by recurring abdominal pain associated with a change in consistency and frequency of stools) or diseases like celiac disease (characterized by malabsorption and intolerance to gluten, the protein in wheat) or inflammatory bowel disease (characterized by bloody diarrhea and abdominal pain).

Causes of diarrhea

A few of the more common causes of diarrhea include the following:

Bacterial and viral infections

Certain types of infections can impact our gut, causing us to pass watery stool.

Food intolerance

Some people are unable to digest a component of food, such as lactose (the sugar found in milk) or gluten (the protein found in wheat), which results in celiac disease. In addition, the artificial sweeteners sorbitol and mannitol found in chewing gum and other sugar-free products can cause diarrhea.


Diarrhea can be a side effect of many medicines, particularly antibiotics. Antibiotics can disturb the natural balance of bacteria in the intestines.

Other causes

  • Intestinal diseases such as inflammatory bowel disease or celiac disease.
  • Functional and other bowel disorders such as irritable bowel syndrome, or the result of stomach surgery, or removal of the gallbladder.
  • People who visit foreign countries are at risk for traveler's diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or parasites.
  • In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes away on its own, an extensive search for the cause is not usually necessary.

Your goals are to:

  • Call for professional help when needed
  • Replace lost fluids and nutrients
  • Consider diarrhea medicines
  • Avoid offering certain foods while there is diarrhea
  • Do what you can to increase the older person’s comfort

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