Diarrhea: Triggers and Treatments

Education

You get cramps, followed by a strong urge to have a bowel movement, then loose stools. If it happens once or twice a year, it’s a passing bother. But when diarrhea lasts for weeks, you’ve got something that impacts your life.

Your doctor can help find the things that start your chronic diarrhea. He can also give you treatment options.

Dairy products may be a trigger. “One of the most common food intolerances that causes chronic diarrhea is lactose intolerance,” says Sandra Quezada, MD, assistant professor at the University of Maryland. She suggests that if you’re having chronic diarrhea, cutting out dairy may solve your problem.

Gluten may also bring it on. People with celiac disease, who must avoid gluten, may not have diarrhea. Some have bloating. Even if you don’t have celiac disease, you may feel better without gluten.

“[It could be] gluten or some other ingredient that tends to coexist with gluten,” Quezada says. “I tell these patients, ‘You don’t have celiac, but you’ve figured out a way to feel better.’ You don’t need gluten in your diet, so you can continue to avoid it.”

Greasy, fatty foods are possible foes. “[They] can slow down gastric emptying, which makes people feel bloated,” says Douglas A. Drossman, MD, professor emeritus of the University of North Carolina at Chapel Hill. It can also tighten the muscles in your GI tract. That can cause diarrhea.

Don’t rule out alcohol or caffeine. Both can cause loose stools. If you have frequent diarrhea, quitting your morning coffee or evening beer may help, particularly if you have more than one of either each day.

It could even be your medicine. A number of drugs have diarrhea as an unwanted side effect. These include:

  • Laxatives
  • Antacids
  • Drugs that contain magnesium
  • NSAIDs (like aspirin and ibuprofen)

So if you have chronic pain, you may have chronic diarrhea, as well.

Another problem could be leading to it. Other illnesses can cause diarrhea, for example:

  • Irritable bowel syndrome (IBS)
  • Crohn’s disease
  • Ulcerative colitis
  • Diabetes

If you have IBS, stress from it can make diarrhea worse. Medicine and lifestyle changes can help reduce flare-ups.

Diabetes as a trigger often surprises people.

“It can affect the nerves to the gut,” Quezada says. “Chronic diabetes in some people can cause chronic diarrhea. The best recommendation [to help the situation] is get better control of the diabetes.”

Cancer treatments may cause diarrhea, particularly chemotherapy and radiation.

“Chemo — that’s often either a side effect of the medication, or it can cause damage to the lining of the digestive tract,” Quezada says.

Radiation can inflame the GI tract, too.

How Do I Get Relief?

If you’ve had diarrhea for 2 weeks or longer, see your doctor. If you have blood in the stool, fever, or unplanned weight loss, go sooner.

Your doctor will use your medical history to figure out the cause. He also may test your blood or stool.

You may be prescribed medicine used for things like IBS.

Some people are simply prone to chronic diarrhea. In that case, over-the-counter drugs may be helpful.

“People find their way,” Drossman says. They may carry some [medicine] with them. They may eat smaller meals and less fat.”

As long as you’re not having a flare of Crohn’s disease or ulcerative colitis, you may be able to reduce your diarrhea by adding fiber to your diet.

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