Acute Diarrhoea

Advice and Guidance for Managing Symptoms of Acute Diarrhea

Understanding Acute Diarrhea

• Acute diarrhea is defined as the sudden onset of loose or watery stools that last for less than 2 weeks. It is typically caused by viral, bacterial, or parasitic infections, often through contaminated food or water. Common symptoms include frequent watery stools, abdominal cramps, bloating, nausea, and occasionally vomiting or fever.

Self-Management Tips for Acute Diarrhea

In most cases, acute diarrhea resolves on its own within a few days. Here are steps to help manage symptoms at home:

• Stay Hydrated:

  • Oral Rehydration Solutions (ORS): ORS packets, available at pharmacies, help replace lost fluids and electrolytes and are especially recommended for children, older adults, or those with severe diarrhea. Follow the instructions on the packet to prepare.
  • Fluids: Drink plenty of clear fluids, such as water, diluted fruit juices, or broth. Avoid caffeinated, alcoholic, or sugary drinks, as they can worsen dehydration.
  • Encourage Frequent Sips in Children: Young children are especially prone to dehydration. Offer small, frequent sips of water or ORS to keep them hydrated.

• Dietary Adjustments:

  • Eat Light and Bland Foods: Gradually return to a normal diet as tolerated. Start with easy-to-digest foods like rice, bananas, applesauce, toast, or plain crackers. Avoid fatty, greasy, spicy, or high-fiber foods, which can worsen symptoms.
  • Avoid Dairy if Necessary: Temporary lactose intolerance is common during acute diarrhea. If dairy worsens symptoms, avoid milk products until symptoms improve.
  • Avoid High-Sugar Foods: Sugary foods and drinks can make diarrhea worse by pulling water into the intestine.

• Rest:

  • Diarrhea and its associated symptoms can be draining. Get plenty of rest to allow your body to recover and fight off the infection.

• Hygiene Practices to Prevent Spread:

  • Wash Hands Thoroughly: Wash hands with soap and water, especially after using the bathroom, before eating, and after handling food, to prevent spreading infection to others.
  • Clean Surfaces: Disinfect surfaces in shared areas, especially bathrooms, and avoid preparing food for others while symptomatic.

When to Seek Further Help

While most cases of acute diarrhea resolve on their own, contact a healthcare provider if any of the following occurs:

• Signs of Dehydration:

  • Seek help if you or your child shows signs of dehydration, including:
    • Dark, reduced urine output or lack of urine for several hours
    • Dry mouth, excessive thirst, or sunken eyes
    • Dizziness, fatigue, or confusion (especially in older adults)
    • In young children and babies, look for fewer wet diapers, sunken fontanel (soft spot on a baby’s head), or extreme irritability

• Prolonged Symptoms:

  • If diarrhea lasts longer than 5–7 days, especially if symptoms are not improving, seek medical advice, as this may indicate a more persistent infection or another underlying condition.

• High Fever or Severe Abdominal Pain:

  • Seek help if you or your child has a fever above 38.5°C (101.3°F) or experiences severe abdominal pain. These may indicate a bacterial infection or another complication that requires medical treatment.

• Blood or Mucus in Stools:

  • If you notice blood, mucus, or pus in the stools, contact a healthcare provider. This may be a sign of bacterial or parasitic infection or other more serious gastrointestinal issues.

• Recent Travel or High-Risk Exposure:

  • If symptoms develop after recent travel (especially to areas with lower sanitation standards), or if you suspect food poisoning (e.g., after consuming raw or undercooked food), consult a healthcare provider. You may need specific treatment for infections like Giardia, Salmonella, or E. coli.

• For Infants, Young Children, and Vulnerable Individuals:

  • Infants, young children, pregnant individuals, elderly people, and those with weakened immune systems are at higher risk for complications. Seek medical advice promptly for diarrhea in these groups, especially if symptoms are severe or last more than a day.

Treatment Options

• Over-the-Counter Medications:

  • Anti-Diarrheal Medications (Loperamide): Medications like loperamide can help reduce diarrhea frequency but should be used with caution and only in adults without fever or blood in the stool. These are not recommended for young children and should only be used if approved by a healthcare provider.
  • Probiotics: Some studies suggest that probiotics may help reduce the duration of diarrhea, particularly in viral cases. Consult your healthcare provider before using them, as evidence varies.

• Antibiotics:

  • Usually Not Needed: Most cases of acute diarrhea are viral and do not require antibiotics. Antibiotics are only needed for certain bacterial or parasitic infections, and inappropriate use can lead to side effects or antibiotic resistance.
  • Antibiotics May Be Prescribed If: A bacterial infection is confirmed, particularly if there are severe symptoms like high fever, blood in the stool, or if there is a high risk of complications.

Preventing Future Episodes of Acute Diarrhea

• Food and Water Safety:
  • When eating or drinking, particularly in high-risk areas, ensure food is properly cooked, avoid raw or undercooked meats, and drink bottled or boiled water if the water supply is questionable.
• Hygiene and Handwashing:
  • Practice good hand hygiene, especially after using the bathroom, before meals, and when preparing food. Encourage young children to wash their hands frequently.
• Vaccination (for Travelers):
  • For those traveling to high-risk areas, vaccinations for infections like typhoid and hepatitis A can help prevent some causes of infectious diarrhea. Speak with a travel health provider for advice on preventive measures.

Summary of Key Points

• Self-Management: Focus on staying hydrated with ORS or clear fluids, eat bland foods, and get plenty of rest. Avoid fatty or sugary foods, and practice good hygiene.
• Seek Medical Help: Contact a healthcare provider if there are signs of dehydration, blood in stools, high fever, severe abdominal pain, symptoms lasting more than a week, or if you belong to a high-risk group (e.g., young children, elderly, or immunocompromised).
• Antibiotics and Other Treatments: Antibiotics are not typically required for viral diarrhea but may be needed for confirmed bacterial or parasitic infections. Speak with a healthcare provider before using anti-diarrheal medications or probiotics.

This guidance, based on recommendations from CKS, RCPCH, the Royal College of Gastroenterology, and BMJ Best Practice, provides an evidence-based approach to managing acute diarrhea and knowing when to seek further medical help.