Diarrhea, Age 12 and Older
Diarrhea, Age 12 and OlderSkip to the navigationTopic OverviewDiarrhea occurs when there is
an increase in the number of bowel movements or bowel movements are more watery
and loose than normal. When the intestines push stools through the bowel before
the water in the stool can be reabsorbed, diarrhea occurs. It can also occur
when inflammation of the bowel lining causes excess fluid to leak into the
stool. Abdominal cramps, nausea, vomiting, or a fever may occur along with the
diarrhea. Diarrhea is one of the most commonly occurring health
problems affecting all ages. Most adults will have 4 episodes of diarrhea each
year. Diarrhea that comes on suddenly may last up to 14 days. Diarrhea has many causes. - Diarrhea is often caused by stomach flu (gastroenteritis) or
food poisoning. Diarrhea is your body's way of quickly
clearing viruses, bacteria, or toxins from the digestive tract. Since most
cases of diarrhea are viral, they will clear up in a few days with good home
treatment.
E. coli is a common bacteria that causes diarrhea.
E. coli infection is related to improper food
preparation.
- Drinking
untreated water or unpasteurized dairy products can
cause viral, bacterial, or parasitic infections, such as
Giardia lamblia. Giardia lamblia parasite can cause diarrhea that develops 1 to 4 weeks later.
These infections can also occur when you use untreated water to brush your
teeth, wash your dishes or vegetables, or make ice for drinks.
- Diarrhea can also occur from infections passed on by animals.
- Many
prescription and nonprescription
medicines can cause diarrhea.
- Antibiotics may cause mild diarrhea that
usually clears up without treatment. A more serious type of diarrhea caused by
the bacteria Clostridium difficile (sometimes called
C-diff) may occur while taking an antibiotic or shortly after finishing the
antibiotic.
- Laxatives, such as Correctol, Dulcolax, Ex-Lax, or
Feen-a-Mint, may cause diarrhea.
- Using too much of products that contain sorbitol
(such as chewing gum) or fructose can cause diarrhea.
- Some people
get infections that cause diarrhea while they are traveling (traveler's diarrhea).
- For
some people, emotional stress,
irritable bowel syndrome, anxiety, or food digestion
problems (such as
lactose intolerance) cause
diarrhea.
- Repeated episodes of diarrhea may be caused by
inflammatory bowel disease.
- Diarrhea may
also be caused by
malabsorption problems and certain types of
cancer.
- Diarrhea may develop after stomach, bowel, or gallbladder
surgery, or after bariatric surgery for
obesity.
Many times the exact cause of diarrhea is hard to
determine. Almost everyone has an occasional bout of diarrhea. Although
diarrhea is annoying, most cases are not serious and will clear up with home
treatment. Check your symptoms to decide if and
when you should see a doctor. Check Your SymptomsHow old are you? 11 years or younger 11 years or younger 12 to 55 years 12 to 55 years 56 years or older 56 years or older Are you pregnant? Yes, you know that you're pregnant. Pregnancy No, you're not pregnant, or you're not sure if you're pregnant. Pregnancy Do you have moderate or severe belly pain? This is not the cramping type of pain you have with diarrhea. Moderate Moderate dehydration Are you having trouble drinking enough to replace the fluids you've lost? Little sips of fluid usually are not enough. You need to be able to take in and keep down plenty of fluids. Yes Unable to maintain fluid intake No Able to maintain fluid intake Yes Symptoms of serious illness No Symptoms of serious illness Have you had: At least 1 stool that is mostly black or bloody? At least 1 stool mostly black or bloody At least 1 stool that is partly black or bloody? At least 1 stool partly black or bloody Streaks of blood in your stool? Streaks of blood in stool Do you think you may have a fever? Did you take your temperature? How high is the fever? The answer may depend on how you took the temperature. High: 104°F (40°C) or higher, oral High fever: 104°F (40°C) or higher, oral Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral Mild: 100.3°F (37.9°C) or lower, oral Mild fever: 100.3°F (37.9°C) or lower, oral How high do you think the fever is? Moderate Feels fever is moderate Mild or low Feels fever is mild How long have you had a fever? Less than 2 days (48 hours) Fever for less than 2 days At least 2 days but less than 1 week Fever for at least 2 days but less than 1 week 1 week or more Fever for 1 week or more Do you have a health problem or take medicine that weakens your immune system? Yes Disease or medicine that causes immune system problems No Disease or medicine that causes immune system problems Do you have shaking chills or very heavy sweating? Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off you or soaking through your clothes. Yes Shaking chills or heavy sweating No Shaking chills or heavy sweating Does the fever come and go? Have you traveled to another country in the past 6 weeks? Is your diabetes getting out of control because you are sick? Yes Diabetes is affected by illness No Diabetes is affected by illness Is the plan helping get your blood sugar under control? Yes Diabetes illness plan working No Diabetes illness plan not working How fast is it getting out of control? Quickly (over several hours) Blood sugar quickly worsening Slowly (over days) Blood sugar slowly worsening Moderate Moderate diarrhea Have you had diarrhea for more than 1 week? Yes Diarrhea for more than 1 week No Diarrhea for 1 week or less Do you think that a medicine could be causing the diarrhea? Think about whether the diarrhea started after you began taking a new medicine or a higher dose of a medicine. Yes Medicine may be causing diarrhea No Medicine may be causing diarrhea Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
If you're not sure if a fever is high, moderate, or mild,
think about these issues: With a high fever: - You feel very hot.
- It is likely one of
the highest fevers you've ever had. High fevers are not that common, especially
in adults.
With a moderate fever: - You feel warm or hot.
- You know you have
a fever.
With a mild fever: - You may feel a little warm.
- You think
you might have a fever, but you're not sure.
Temperature varies a little depending on how you measure it.
For adults and children age 12 and older, these are the ranges for high,
moderate, and mild, according to how you took the temperature. Oral (by mouth) temperature - High:
104°F (40°C) and
higher
- Moderate:
100.4°F (38°C) to
103.9°F (39.9°C)
- Mild:
100.3°F (37.9°C) and
lower
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature. Ear or rectal temperature - High:
105°F (40.6°C) and
higher
- Moderate:
101.4°F (38.6°C) to
104.9°F (40.5°C)
- Mild:
101.3°F (38.5°C) and
lower
Armpit (axillary) temperature - High: 103°F (39.5°C) and higher
- Moderate:
99.4°F (37.4°C) to
102.9°F (39.4°C)
- Mild: 99.3°F (37.3°C) and lower
Symptoms of serious illness may
include: - A severe headache.
- A stiff
neck.
- Mental changes, such as feeling confused or much less
alert.
- Extreme fatigue (to the point where it's hard for you to
function).
- Shaking chills.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are: - Diseases such as diabetes, cancer, heart disease,
and HIV/AIDS.
- Long-term alcohol and drug
problems.
- Steroid medicines, which may be used to treat a variety
of conditions.
- Chemotherapy and radiation therapy for
cancer.
- Other medicines used to treat autoimmune
disease.
- Medicines taken after organ transplant.
- Not
having a spleen.
- Severe diarrhea means having
more than 10 loose, watery stools in a single day (24 hours).
- Moderate diarrhea means having more than a few but not more
than 10 diarrhea stools in a day.
- Mild diarrhea means having a few diarrhea stools in a day.
You can get dehydrated when
you lose a lot of fluids because of problems like vomiting or fever. Symptoms of dehydration can range from mild to severe. For
example: - You may feel tired and edgy (mild dehydration), or
you may feel weak, not alert, and not able to think clearly (severe
dehydration).
- You may pass less urine than usual (mild
dehydration), or you may not be passing urine at all (severe
dehydration).
Severe dehydration means: - Your mouth and eyes may be extremely
dry.
- You may pass little or no urine for 12 or more
hours.
- You may not feel alert or be able to think
clearly.
- You may be too weak or dizzy to stand.
- You may
pass out.
Moderate dehydration means: - You may be a lot more thirsty than
usual.
- Your mouth and eyes may be drier than usual.
- You may
pass little or no urine for 8 or more hours.
- You may feel dizzy
when you stand or sit up.
Mild dehydration means: - You may be more thirsty than usual.
- You may pass less urine than usual.
Many prescription and nonprescription medicines can cause
diarrhea. A few examples are: - Antibiotics.
- Antidepressants.
- Antacids.
- Proton
pump inhibitors, such as omeprazole (Prilosec) and lansoprazole (Prevacid).
- Medicines used to treat cancer (chemotherapy).
It is easy for your diabetes to become out of control when
you are sick. Because of an illness: - Your blood sugar may be too high or too
low.
- You may not be able take your diabetes medicine (if you are
vomiting or having trouble keeping food or fluids down).
- You may
not know how to adjust the timing or dose of your diabetes
medicine.
- You may not be eating enough or drinking enough
fluids.
An illness plan for people with diabetes usually covers things like: - How often to test blood sugar and what the target
range is.
- Whether and how to adjust the dose and timing of insulin
or other diabetes medicines.
- What to do if you have trouble keeping
food or fluids down.
- When to call your doctor.
The plan is designed to help keep your diabetes in control even
though you are sick. When you have diabetes, even a minor illness can cause
problems. Blood in the stool can come from
anywhere in the digestive tract, such as the stomach or intestines. Depending
on where the blood is coming from and how fast it is moving, it may be bright
red, reddish brown, or black like tar. A little bit of bright red
blood on the stool or on the toilet paper is often caused by mild irritation of
the rectum. For example, this can happen if you have to strain hard to pass a
stool or if you have a hemorrhoid. Certain medicines and foods can affect the color of stool. Diarrhea
medicines (such as Pepto-Bismol) and iron tablets can make the stool black.
Eating lots of beets may turn the stool red. Eating foods with black or dark
blue food coloring can turn the stool black. If you take aspirin or some other medicine (called a blood thinner) that prevents blood clots, it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms. Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Abdominal Pain, Age 12 and Older Pregnancy-Related Problems Diarrhea, Age 11 and Younger Home TreatmentHome treatment can help you treat
your diarrhea and avoid other related problems, such as
dehydration. - Take frequent, small sips of water or a
rehydration drink and small bites of salty crackers.
- Try to increase your fluid intake to at least
1 qt (1 L) per hour for 1 to 2
hours, or longer if you keep having large amounts of diarrhea. Note: If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
- Begin eating mild foods the next day or sooner,
depending on how you feel.
- Avoid spicy foods, fruits, alcohol, and
caffeine until 48 hours after all symptoms have disappeared.
- Avoid
chewing gum that contains sorbitol.
- Avoid
milk for 3 days after symptoms disappear.
You can eat cheese or yogurt with probiotics.
Nonprescription medicines for diarrheaIf you are
pregnant, talk with your doctor before taking any medicines for
diarrhea. Nonprescription medicines may be helpful in treating your
diarrhea. Follow these tips when taking a nonprescription medicine for
diarrhea: - Use nonprescription antidiarrheal medicine if
you have diarrhea for longer than 6 hours. Do not use nonprescription
antidiarrheal medicines if you have bloody diarrhea, a high fever, or other
signs of serious illness.
- Read and follow
all label directions on the nonprescription medicine bottle or box. Be sure to
take the recommended dose.
- Long-term use of nonprescription
antidiarrheal medicine is not recommended. To avoid constipation, stop taking
antidiarrheal medicines as soon as stools thicken.
- If your child or
teen gets
chickenpox or
flu, do not treat the symptoms with over-the-counter
medicines that contain bismuth subsalicylate (such as Pepto-Bismol and
Kaopectate). Subsalicylate has been linked to
Reye syndrome, a rare but serious illness. If your
child has taken this kind of medicine and he or she has changes in behavior
with nausea and vomiting, call your doctor. These symptoms could be an early
sign of Reye syndrome.
There are several types of antidiarrheal medicines: those
that absorb water and thicken the stool, and those that slow intestinal
spasms. - Thickening mixtures (such as psyllium) absorb water. This helps bulk up the stool and make it more firm.
- Antispasmodic antidiarrheals, such as Imodium A-D and Pepto
Diarrhea Control, slow intestinal spasms. Some products contain both thickening
and antispasmodic ingredients.
- Probiotics, such as Lactobacillus, are available in either pills or powder. This
bacteria occurs naturally in the intestine and may help with digestion. When
diarrhea is present, the number of these bacteria is reduced.
General tipsLearn how to clean up diarrhea safely. Protect your hands with gloves while cleaning up. Wash your hands after you are done cleaning up. Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home
treatment: - Signs of dehydration
develop.
- Severe diarrhea (10 or more loose watery stools in 24 hours) develops.
- Black or bloody stools develop.
- A fever
develops.
- Your symptoms become
more severe or more frequent.
PreventionFood poisoning
is a common cause of diarrhea in children and adults. Most cases of food
poisoning may be prevented by taking a few precautions when preparing and
storing food at home. Perishable foods, such as eggs, meats, poultry, fish,
shellfish, milk, and milk products, should be treated with extra care. Also,
precautions should be taken if you are pregnant, have an
impaired immune system or a chronic illness, or are preparing foods for other high-risk groups, such as young children or older
adults. The U.S. Department of
Agriculture (USDA) recommends the following steps to prevent food poisoning:
Many counties in the United States have extension services
listed in the phone book. These services can answer your question about safe
home canning and food preparation.
When you travel in wilderness areas or to other countries of the world, it is common to get traveler's diarrhea from food or water because the methods of food preparation are different. Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions: - How long have you had diarrhea?
- How
many times per day are you having diarrhea?
- What does your diarrhea
look like? Describe the color, consistency (watery, mushy), and other
characteristics (contains blood or mucus).
- When was your last
episode of diarrhea?
- Have you recently increased the amount of
fiber in your diet (more fresh fruit, vegetables, or other high-fiber
foods)?
- What prescription and nonprescription medicines do you
take?
- Are you taking any new
medicines?
- Did you recently increase the dose of a
medicine?
- Have you taken any antibiotics recently?
- Did
you recently receive an antibiotic while in the hospital?
- Do you routinely use laxatives or stool
softeners?
- Have you been under an unusual amount of stress at home,
work, or both?
- Does anyone you live with or work with have
diarrhea?
- Did your diarrhea start after eating at a restaurant? Has
anyone who ate there with you become ill?
- Did you drink lake or
stream water or untreated well water?
- Have you recently visited a
foreign country or taken a ship cruise?
- Do you have any risk
factors that make you more susceptible to diarrhea, such as irritable bowel
syndrome?
- What home treatment measures have you tried? Be sure to
include any nonprescription medicines you have taken.
- Do you have
other symptoms, such as vomiting, fever, or dehydration?
- Do you
have any
health risks?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Adam Husney, MD - Family Medicine Specialist Medical ReviewerKathleen Romito, MD - Family Medicine Current as of:
May 3, 2017 Last modified on: 8 September 2017
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