Symptoms & Causes of Diarrhea

In this section:

• What are the symptoms of diarrhea?
• What are the symptoms of dehydration and malabsorption?
• When should I seek a doctor’s help?
• What causes diarrhea?

What are the symptoms of diarrhea?

Diarrhea causes similar symptoms for adults and children, such as⁴

• loose, watery stools three or more times a day, or more often than what is normal for you
• an urgent need to use the bathroom
• cramping or pain in the abdomen
• loss of control of bowel movements
• nausea
• weight loss, if you have chronic diarrhea

Symptoms of diarrhea caused by some infections may also include

• bloody stools
• fever and chills
• lightheadedness and dizziness
• vomiting

Diarrhea may also cause dehydration and malabsorption.

You may have cramping or an urgent need to use the bathroom when you have diarrhea.

What are the symptoms of dehydration and malabsorption?

Dehydration and malabsorption can be serious health problems related to diarrhea.

Dehydration

Symptoms of dehydration may include

• extreme thirst or dry mouth
• urinating less than usual
• feeling tired, dizzy, or lightheaded
• dark-colored urine
• skin that, when pinched and released, does not flatten back to normal right away
• sunken eyes or cheeks

In addition to the symptoms above, infants, toddlers, and young children with dehydration may also have⁴

• no wet diapers for 3 hours or more
• no tears when crying
• sunken soft spot in the skull
• drowsiness

Malabsorption

Symptoms of malabsorption may include

• bloating
• changes in appetite
• gas
• loose, greasy, foul-smelling bowel movements
• weight loss or poor weight gain in children

When should I seek a doctor’s help?

Diarrhea can become dangerous if it leads to severe dehydration. Diarrhea may also be a sign of a more serious problem.

Talk with a doctor right away if you or an adult or child in your care has symptoms such as

• change in mental state, such as irritability or lack of energy
• frequent vomiting
• severe pain in the abdomen or rectum
• stools that are black and tarry or contain red blood or pus
• symptoms of dehydration

Additional symptoms for adults

You should also talk with a doctor right away if you or an adult in your care has symptoms such as⁵

• diarrhea lasting more than 2 days
• high fever
• six or more loose stools per day

People who have diarrhea and are pregnant, are over age 65, are currently taking antibiotics, or have a weakened immune system are more likely to have health problems from diarrhea and should keep in touch with their doctor.⁵

Additional symptoms for infants and children

You should also talk with a doctor right away if an infant or child has symptoms such as

• diarrhea lasting more than a day
• any fever in infants or high fever in older children
• refusing to eat or drink anything for longer than a few hours in infants
• frequent loose stools

If an infant or child has diarrhea, don’t hesitate to call a doctor for advice. Diarrhea is especially dangerous in newborns and infants and can lead to severe dehydration in just a day or two. A child with symptoms of dehydration can die within a day if left untreated.

Seek a doctor’s help right away if the child has diarrhea and is younger than 12 months, was born prematurely, or has a history of other medical conditions. Also, seek a doctor’s help right away if the child can’t drink enough liquids or oral rehydration solutions to prevent dehydration.

What causes diarrhea?

Acute diarrhea often has different causes than persistent and chronic diarrhea.

Acute diarrhea

The most common causes of acute diarrhea are viral gastroenteritis, food poisoning, and medicine side effects.

Viral gastroenteritis

Viral gastroenteritis is an infection of your intestines and a common cause of acute diarrhea. Many different viruses can cause viral gastroenteritis. The most common viruses include

• norovirus
• rotavirus
• adenovirus
• astrovirus

Food poisoning

Diarrhea can be a symptom of food poisoning. Food poisoning is an infection or irritation of your digestive tract that spreads through foods or drinks. Microbes—viruses, bacteria, and parasites—cause most food poisoning. Food poisoning usually goes away within a week, but some infections can last longer.

The most common microbes that cause food poisoning include

• certain types of Salmonella
• Clostridium perfringens, also called C. perfringens
• certain types of Campylobacter
• Staphylococcus aureus, also called staph
• Escherichia coli, also called E. coli

Any food or drink can contain microbes that cause food poisoning. However, some foods are more likely to lead to food poisoning than others, including

• undercooked meats, poultry, and seafood
• fruits and vegetables
• raw or untreated milk, eggs, and cheeses

Travelers’ diarrhea

Consuming contaminated food and water or other drinks while traveling may also cause diarrhea, a condition known as travelers’ diarrhea. Travelers’ diarrhea can occur anywhere. However, it’s more likely to affect people traveling to areas where sanitation and access to clean water are limited.

Medicine side effects

Medicines, such as antibiotics, antacids containing magnesium, and medicines commonly used to treat cancer, may cause acute diarrhea. Some liquid medicines contain sugar alcohols—such as sorbitol, mannitol, and xylitol—which may also cause diarrhea in some people.

Persistent and chronic diarrhea

Some infections, food allergies and intolerances, digestive tract problems, abdominal surgery, and long-term use of medicines can cause persistent and chronic diarrhea.

Infections

Some infections may cause ongoing diarrhea. After the infection goes away, you may have problems digesting certain carbohydrates, which can make diarrhea last longer.

Food allergies and intolerances

Allergies to foods such as cow’s milk, soy, cereal grains, eggs, and seafood may cause chronic diarrhea.

Some people have problems digesting certain carbohydrates, which can also cause chronic diarrhea.

• Lactose intolerance is a condition in which you may have diarrhea after you consume foods or drinks that contain lactose. Lactose is a sugar naturally found in milk and milk products.
• Dietary fructose intolerance is a condition in which you may have diarrhea after you consume foods or drinks that contain fructose. Fructose is a sugar found in fruits, fruit juices, and honey. Fructose is also added to many foods and soft drinks.
• Sucrose intolerance is a condition in which you may have diarrhea after you consume foods or drinks that contain sucrose. Sucrose is also known as table sugar or white sugar.
• Sugar alcohols commonly found in sugar-free candies and gum may also cause diarrhea in some people.

Digestive tract problems

Digestive tract problems that may cause chronic diarrhea include

• celiac disease
• Crohn’s disease
• diabetes problems, such as autonomic neuropathy
• problems with the pancreas
• small intestinal bacterial overgrowth
• ulcerative colitis

Disorders of gut-brain interaction

Disorders of gut-brain interaction, which used to be called functional gastrointestinal (GI) disorders, are related to problems with how the brain and gut work together. Disorders of gut-brain interaction aren’t diseases. They are groups of symptoms that occur together.

Two disorders of gut-brain interaction that cause chronic diarrhea are

• irritable bowel syndrome, in which you have repeated pain in your abdomen and changes in your bowel movements
• functional diarrhea, in which you have chronic diarrhea that isn’t due to another cause

Abdominal surgery

You may develop chronic diarrhea if you had surgery on your appendix, gallbladder, large intestine, liver, pancreas, or small intestine.

If you had surgery on your stomach or esophagus, you may develop a condition called dumping syndrome. Chronic diarrhea is a possible symptom of dumping syndrome.

Long-term use of certain medicines

Certain medicines that must be taken for a long time may cause chronic diarrhea. For example, antibiotics can change your gut flora and increase your chances of developing a Clostridioides difficile (C. difficile) infection. A C. difficile infection can cause chronic diarrhea.

References