About diarrhea and IBS
What is diarrhoea?
Our gastrointestinal tract has the task of digesting food and providing the body with nutrients and water. Muscle contractions transport food throughout the gastrointestinal tract (motility) and the body releases various substances in the gastrointestinal tract that help to break down and transport food further through the intestine (secretion). Nutrients and fluids are transported through the intestinal wall into the body (absorption). Different parts of the gastrointestinal tract specialize in secretion and absorption to take advantage of food and fluid that we put in us.
Diarrhea occurs when there is an imbalance in these systems, which leads to more than three stools with loose consistency per day. The rapid passage through the intestines in case of diarrhea means that the stool contains up to 90 percent water and undigested food. Diarrhea can be acute or chronic (more than four weeks). It is also be considered chronic if it comes and goes in periods. Prolonged diarrhoea can give rise to fluid and nutrient deficiencies and disturbances in the salt balance.
Why do you get diarrhea?
The imbalance can be caused, for example, by infections, an inflammation, problems with absorbing nutrients (so-called malabsorption), tumors or disorders of intestinal motility. Underlying factors can be viruses or bacteria, but also diet (for example gluten intolerance and lactose intolerance), alcohol, drugs, surgery and many different diseases (for example IBS, IBD – inflammatory bowel disease, pancreas, appendicitis, tumors) may be behind. Stress and anxiety can also cause diarrhea through the physiological stress response which is the body’s response to a potentially disturbing or threatening situation.
What are the symptoms?
- Loose stools: Sometimes it is obvious, but in order to be able to make a demarcation, a scale has been developed called the Bristol Stool Form Scale) which can be used to determine the consistency of the stool.
- Fever, blood and mucus in the stool: In addition to the loose stools, other symptoms such as fever, blood or mucus in the stool and weight loss may appear at the same time.
- Different symptoms can in turn give clues as to what is behind the diarrhea and in order for the doctor to be able to investigate the causes of diarrhea, it is important to go through all the symptoms and circumstances that could contribute.
Diarrhea in IBS
IBS (Irritable Bowel Syndrome) is mainly characterised by other symptoms such as recurring symptoms of pain or discomfort in the abdomen. In order for diarrhea to be part of a IBS diagnosis , it must therefore occur at the same time as the pain / discomfort is relieved after the toilet visits or that the frequency of the stools also changed.
IBS B, IBS M or IBS U
The subgrouping of IBS to IBS-D (Colon irritable (IBS) with diarrhea) is based on the fact that more than one in four stools is loose (Bristol Stool Scale 6-7, see above) while less than one in four stools is hard (Bristol stool scale 1-2 If more than one of four stools is loose as above but that also more than one of four stools is hard then the subtype of IBS is instead called IBS-M (mixed). IBS also does not have to be associated with a such a clear change in the consistency of the stool and is then called undifferentiated IBS or IBS-U (unsubtyped).
Common examination methods for diarrhea
The doctor investigates possible different causes of the diarrhea by finding out more about the patient. Have you been abroad? Do you eat medicines? Could you have been infected by someone close to you? How did the symptoms occur? etc. You can be asked to give blood samples to examine various substances in the blood that can, among other things, provide clues about fluid balance, inflammation and bleeding.
It may also be necessary to have an examination of the bowel through so-called rectoscopy and / or colonoscopy. You may also need to submit one or more stool samples.
How is diarrhea treated?
Because you loose a lot of water when you have diarrhea, it is important to get fluids, especially if you have a fever. If you have difficulty drinking water, fluid replacement can be an option. It is usually recommended to drink small amounts at all times and avoid sweet drinks. In the first instance, the doctor does not treat the symptoms themselves, but the doctor must find the underlying cause, which can therefore vary greatly. When it comes to symptomatic treatment, there are, among other things, drugs with loperamide (Dimor, Loperamide, Imodium, Primodium).
