Occasional bowel movements that are watery and loose are not uncommon in most people. However, if this condition lasts for extended periods of more than a few weeks, it needs to be taken seriously and has to be treated accordingly.

If left untreated, it can be life-threatening. Statistics show that at least two billion cases of diarrhea occur annually worldwide and it has been the cause of death of nearly 1.5 million children below the age of five.

What is diarrhea?
Frequently passing loose, watery or soft stools, with or without accompanying stomach cramps, flatulence, bloating, and stomach pressure, which is excreted suddenly is termed as diarrhea.

This condition may also be complicated when there is blood in the stools, severe pain, fever, nausea, and uncontrollable urge to pass stools. It can happen to people of any age, but children and senior citizens are at a higher risk.

Complications
The most serious complication of diarrhea is dehydration—loss of water and electrolytes in the body—which happens because the water passes out from the body without getting absorbed by the intestines. Drinking copious amounts of water does not always compensate for the corresponding loss.

Types of diarrhea
The condition is classified into the following types:

• Chronic:  This typically lasts for more than two weeks
• Enteritis:  It involves the inflammation of the intestine
• Gastroenteritis:  It involves stomach flu, with nausea and vomiting
• Dysentery:  It involves loose stools with pus, mucus, and blood

Common causes of diarrhea
The most common chronic causes of diarrhea and acute diarrhea include microbial attacks by viruses, bacteria, or certain microorganisms that enter the intestinal tract.

Viruses: They cause various mild to moderate symptoms. These may last for 3–7 days and comprise watery, frequent stools, stomach cramps, and a mild fever. Common viruses include rotavirus (common in children), Norwalk virus, cytomegalovirus, adenovirus, and hepatitis virus.

Treatment
In most cases, the condition caused as a result of viruses clears without any particular treatment. The focus is mainly on preventing dehydration by drinking lots of liquids, juices, energy drinks, soups, and eating saltines to maintain the electrolyte balance. Over-the-counter medications along with probiotics can help relieve symptoms.

Bacteria: Salmonella, Campylobacter, Shigella, and E.coli are some of the common types of bacteria that can cause diarrhea. Diarrhea that is caused by bacterial infection is more serious and they are often caused by consuming contaminated food or water. This condition is commonly termed “food poisoning.”

Frequent, “explosive” diarrhea, severe cramps, fever, nausea or vomiting, and blood in the stools are some of the common symptoms. “Traveler’s diarrhea,” on the other hand, is caused by consuming contaminated food or water while traveling.

Treatment
To prevent dehydration, antibiotics are prescribed after testing for the particular organism.

Microorganisms: Entamoeba histolytica, Cryptosporidium, and Giardia lamblia are some of the common parasitic microorganisms that may enter the body and cause diarrhea symptoms.

Treatment
Testing for the parasite is followed by appropriate prescriptions by the doctor. Dehydration must be prevented. Pregnant women and those who are prone to abscesses or irritable bowel syndrome must exercise extreme caution.

Others causes:  Other common causes of chronic diarrhea include medicinal reactions, microscopic colitis, irritable bowel syndrome, allergies, lactose or other food intolerance, alcohol and laxative abuse, cancer, radiation or chemotherapy, and surgery.

When to call a doctor
In most cases, simple diarrhea clears up in a few days, but if it persists beyond two weeks, causes dehydration, is accompanied by rectal bleeding, bloody or black stools, and/or high fever, then one must consult their doctor immediately. In children, dehydration is a primary concern. Therefore, one should not delay visiting a doctor.

Over-the-counter medications
Though doctors don’t recommend self-medication, certain OTC medicines can be taken for managing some symptoms. These generally prevent further passing of stools but may not address the root cause of the problem.

In fact, many doctors suggest that one may have to wait for a few days till the cause for diarrhea such as a virus, bacteria, or microorganism passes out of the body along with the stools. However, dehydration is a huge risk and most people prefer to take simple prescription drugs or OTC medication to deal with the symptoms so that they can continue with their routine activities or travel.

Some effective OTC medicines include Loperamide and bismuth subsalicylate. One should, however, consult a doctor in order to know which type of OTC medication could suit them.

Electrolyte replacement
One of the most hazardous and life-threatening aspects of diarrhea is that it results in dehydration. Frequent passing of watery stools results in the elimination of essential fluids and electrolytes from the body. Primary electrolytes that are vital for human beings include sodium, potassium, magnesium, chloride, hydrogen phosphate, and hydrogen carbonate.

These help to maintain the balance between intra- and extra-cellular environments and any imbalance that can lead to serious cardiac and neurological complications.

Preventive measures

• Wash your hands often, especially after a visit to the washroom, changing your baby’s diapers, before preparing food, and before breastfeeding. If washing isn’t possible, use an alcohol-based hand-sanitizer except while handling children or breastfeeding.
• Take precautions while traveling. Eating uncooked food, salads, or cold foods can cause issues and are common risk factors for causing diarrhea.
• Consult a doctor immediately if the symptoms persist.
• Tests like colonoscopy, X-rays, stool/urine tests could be prescribed in certain cases.