Just let it flow....

There is a common thing that people do all the time, that really can be bad for your health.   People take anti-diarrheals (such as Immodium). Normally, your colon absorbs fluids form the foods you eat, creating semi-solid stools; if that fluid isn't absorbed then you have diarrhea.  There are numerous reasons for the body to have liquid stools such as viruses, bacteria and parasites, medications, lactose intolerance, fructose, surgery, artificial sweeteners, and chronic medical disorders.

Why can this cause diarrhea?
Viruses: such as Norwalk virus, Hepatitis A, cytomegalovirus, rotavirus which are transmitted as easily as the common cold from person to person.
Bacteria/Parasites: Giardia lambia, salmonella, E. Coli, cryptosporidium, campylobacter, and shigella can be transmitted through contaminated foods or new exposure while traveling.
Medications: Most common medication to cause diarrhea is antibiotics because they kill off the healthy bacteria in our colon as well as the 'bad' bacteria that it is prescribed to kill off.   Often, this leads to an infections called Clostridium Difficile, which can cause massive amounts of diarrhea.
Lactose Intolerance: lactose is the sugar found in milk that some people are unable to digest and break down; your body makes an enzyme that will break down lactose, but in some people the level of this enzyme drop off, and ingesting lactose will cause gas and diarrhea.
Fructose: the sugar found naturally in fruits and honey is difficult for some people to digest
Artificial Sweeteners: sorbitol/mannitol can cause diarrhea in small doses for some people but will definitely cause diarrhea in large doses as it is not absorbed by the body
Surgery: After gallbladder removal or various abdominal surgeries, you can experience diarrhea due to changes in the colon.
Medical Conditions: Chron's disease, ulcerative colitis, celiac disease,  and irritable bowel syndrome can all cause diarrhea.

So, what do I do??
Most bouts of diarrhea shouldn't last more than a day or two, if it is something that doesn't need to be treated, so drink lots of fluids, stay home, and ride out the storm.  Taking medications such as immodium will stop you from having diarrhea BUT it will trap whatever is causing the diarrhea in your colon.  Diarrhea is a way that your body can flush out something bad/unwanted, and keeping the virus/bacteria/etc inside can cause colon damage, like a perforation (a hole in the wall of your colon- which leads to BAD NEWS!!)

If it lasts more than a day or two (and you have a fever, weakness, etc):
call your HCP and be prepared to give a stool sample, have a physical exam, and possibly some blood work done.

Treatment depends on the cause:
Antibiotics may be given if you have a parasite or bacteria (as noted in my earlier blog about antibiotics it won't do anything to treat viruses).  Your doctor will encourage you to take in fluids to replace the ones lost from your diarrhea, and may give you some intravenously to replace electrolytes (a really good time to take in coconut water!)  If the diarrhea is caused by medications, they may change your dosage, or put you on yogurt along with your antibiotics (the probiotics replace the good bacteria!!) or have you take a probiotic supplement.  Or, they ,ay send you to a gastroenterologist for a further work-up to rule out a chronic medical condition (as listed above.)

Now that its starting to clear up, what should I do?
Reintroduce semisolid and fibrous foods slowly to see how you tolerate it. Avoid alcohol and caffeine as they can dehydrate you, and caffeine can cause more stools.  Try to avoid high fat content foods, spicy foods, and dairy products at first. As your stomach tolerates foods, you can add more slowly until you are back up to snuff!

Prevention is key!!
Wash your hands after using the bathroom/changing diapers/and anything yucky, and before preparing food, after sneezing/coughing/etc.  Wash your hands with a good lather for 20 seconds (or sing happy birthday twice...out loud or in your head!) And, if not possible to wash, use a hand sanitizer (although, I think people tend to get a little too bonkers with the hand sanitizer, in my opinion; it doesn't need to be reapplied every 5 minutes!)

To prevent diarrhea from food contamination, eat food right away or store immediately in the refrigerator. Wash the cutting boards/surfaces in between working with meats vs vegetables, etc. And, when thawing meats, put them in the fridge to thaw instead of on a counter.

When traveling, be careful to eat fully cooked foods, and try to avoid raw foods unless it is something like a fruit or veg that has been washed, and steer clear of dairy.  Try to avoid tap water and ice (country dependent), unless the water is boiled or filtered.  If you have medical conditions, ask your HCP if they want to put you on preventative antibiotics, just in case.

In general, just use good sense, but allow your body to get rid of the bad stuff, it is getting rid of everything in your colon for a reason.  Now you know what to do next time you get sick!!

Yours in Good Health
B