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Diarrhoea: Chronic Diarrhoea

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What Is Chronic Diarrhoea?

Chronic diarrhoea means having loose and watery stools that last for at least four weeks. You will also experience going to the toilet three or more times per day.

Causes of Chronic Diarrhoea:​

  1. Digestive disorders that occur in the digestive tract (e.g. irritable bowel syndrome, inflammatory bowel disease, chronic pancreatitis and coeliac disease).
  2. Endocrine disorders that cause hormone imbalance in your body (e.g. hyperthyroidism and diabetes).
  3. Infections can cause chronic diarrhoea in people who travel or live in tropical or developing countries. Intestinal infections can develop after your consume contaminated food or water.
  4. Lactose intolerant patients develop diarrhoea and gas when they consume lactose, which is mainly found in milk and dairy products.
  5. Medicines, herbs, and dietary supplements can cause diarrhoea as a side effect.

Potential Complications of Chronic Diarrhoea:

  • Severe dehydration can occur and cause decreased urine volume, dark urine, fatigue/tiredness, lightheadedness and low blood pressure. If you become dehydrated, you may be given fluids via your vein (intravenous or IV) to replace the fluids and electrolytes (salts) lost during diarrhoea.
  • Malnutrition can occur during chronic diarrhoea due to a lack of absorption of important nutrients such as vitamins, minerals, proteins and fats.

How Is Chronic Diarrhoea Diagnosed?

You should seek medical attention if you experience the following signs and symptoms.

  • Warning signs such as:
    • Bloody diarrhoea
    • Severe diarrhoea
    • Abdominal pain, especially if it occurs in the night
    • Increasing abdominal pain
    • Unexplained weight loss
    • Fever
  • If you are 50 years old and above
  • Abnormalities such as a low red blood cell count (haemoglobin)
  • Family history of inflammatory bowel disease (IBD) or colorectal cancer

The cause of your diarrhoea can be identified from your symptoms, medical history, physical examination and test results.

Your doctor may perform some blood or stool tests to determine the cause of your diarrhoea. In some cases, procedures such as sigmoidoscopy or colonoscopy may be required to take a look inside your inte.


Inside of the large intestine using colonoscopy

What Treatment Options Are Available?

Depending on the cause of the chronic diarrhoea, treatments could include:

  1. Antibiotics may be given to treat your diarrhoea if your doctor suspects you of having a bacterial infection
  2. Long-term treatment and follow-ups are usually required for patient with inflammatory bowel disease

What Is the Outlook for Chronic Diarrhoea?

Chronic diarrhoea can have a significant impact on your quality of life and overall health. If you have mild symptoms, you may experience discomfort. However, if your symptoms are severe, these may suggest serious health problems.

If you have tried to change your lifestyle to improve your symptoms but to no success, please seek medical advice.

Prevention Tips

  1. Avoid dairy products if you are lactose intolerant
  2. Avoid certain food ingredients such as sorbitol (used as a sugar-free alternative), which can induce diarrhoea
  3. Be careful about what you eat and drink when you travel to developing countries:
  • Only drink from bottled water
  • Eat foods that are fully cooked and served hot
  • Avoid eating unwashed or unpeeled raw fruits and vegetables ​

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