Diarrhoea is defined as an unformed, mushy or watery bowel movement, often with increased frequency and a sense of urgency. Diarrhoea may occur as an isolated acute condition, be ongoing (chronic), or a symptom of another condition. Other symptoms can be present, and these may help identify the underlying cause alongside testing.
The main symptom of diarrhoea is a watery or mushy stool, identified as types 5, 6 & 7 on the Bristol Stool Scale. Three or more watery or mushy movements within 24 hours would be considered as diarrhoea. The exception however, is loose stools (non watery) in exclusively breastfed babies which is considered as normal, however if there is concern, this should be checked with a practitioner or maternal health nurse.
Dehydration is the most severe threat posed by diarrhoea, where electrolytes (sodium, chloride, bicarbonate, potassium and magnesium) are lost through sweat, urine, vomit, breathing and watery stools, and can be life-threatening if allowed to persist. Dehydration signs in order of severity and usual onset include:
Diarrhoea can be acute or chronic, with possibly slightly varying symptoms.
Acute diarrhoea is often due to gastroenteritis from a food or water borne infectious pathogen (parasite, protozoa, virus or bacteria), or from contact with an infected person. If left untreated, it can be life-threatening, and medical attention should be sought if symptoms persist for more than 24 hours.
Infectious diarrhoea is often accompanied by any of the following symptoms:
Chronic diarrhoea affects around 5% of people in the western world. It is more commonly associated with other health conditions that have their own symptom patterns, and generally lasts for 4 weeks or more.
Some symptoms can help to differentiate the underlying cause of diarrhoea:
There are many underlying causes of chronic diarrhoea, which include:
Therefore, proper identification of the underlying cause of diarrhoea is important to establish effective treatment strategies of symptoms and underlying conditions, and rule out serious health conditions.
Research has found people with the ‘atopic triad’ have a defective barrier of the skin and upper and lower respiratory tracts.
These genetic alterations cause a loss of function of filaggrin (filament aggregating protein), which is a protein in the skin that normally breaks down to create natural moisturisation and protect the skin from penetration by pathogens and allergens.
Filaggrin mutations are found in approximately 30 percent of people with atopic dermatitis, and also predispose people to asthma, allergic rhinitis (hayfever), keratosis pilaris (dry rough patches and bumps on the skin), and ichthyosis vulgaris (a chronic condition which causes thick, dry, scaly skin.)If one parent carries this genetic alteration, there is a 50 percent chance their child will develop atopic symptoms. And that risk increases to 80 percent if both parents are affected.
The connection between the gut microbiome and skin health is complex, however, research has found the microbiota contributes to the development, persistence, and severity of atopic dermatitis through immunologic, metabolic and neuroendocrine pathways.
Deficiency of Omega-6 essential fatty acids (EFA) has been linked with the increased incidence of atopic dermatitis, along with the inability for the body to efficiently metabolise EFA’s to gamma linoleic acids (GLA) and arachidonic acids (AA).
Changing weather conditions can certainly aggravate eczema symptoms, but the triggers are subject to change among individuals.
Mould exposure and susceptibility to mould can cause Chronic Inflammatory Response Syndrome (CIRS), of which dermatitis is a manifestation.
Acute diarrhoea usually resolves quickly, provided patients maintain hydration and replace lost electrolytes. GPs may also prescribe bed rest, medications, and antibiotic treatment. In more severe cases/vulnerable people, hospitalisation with intravenous rehydration, antibiotic treatments, and antidiarrheal medications such as Loperamide (Imodium) or bismuth subsalicylate, and opioid derivatives diphenoxylate and dinenoxin may be required.
Diagnosis and treatment of chronic diarrhoea can be more complex with overlapping symptom pictures, particularly in long-standing cases, and in many conditions that include diarrhoea as a symptom. All cases of chronic diarrhoea create gut microbiome dysbiosis and intestinal hyperpermeability which may perpetuate diarrhoea, and extend treatment and recovery times.
Medications can have side effects, for example, antibiotic treatments which are non selective antibacterial agents can disrupt the diversity and species make up of the gut microbiome, killing beneficial as well as detrimental species which further can aggravate diarrhoea.
Testing may be used to identify/exclude parasites along with referrals for endoscopy and gastroscopy. GPs often don’t have the time in standard consultations for lengthy case taking, and therefore treatment either requires multiple visits or by trialling medications to reduce symptoms.
This process can take a long time and may be frustrating for patients, which is why many turn to functional medicine for alternative solutions.
Functional medicine practitioners use state of the art testing to identify the underlying cause of diarrhoea, and this may indicate conditions such as IBS, IBD, coeliac disease, or SIBO, or a range of other conditions that have diarrhoea as a symptom.
Identifying the root cause directs the treatment plan, making them personalised, holistic, targeted and effective.
Testing might include:
Functional medicine diarrhoea specialists at Melbourne Functional Medicine have a range of strategies for the treatment of diarrhoea.
Essential to identifying the root cause is the extensive investigation taken with each person with chronic diarrhoea. Our functional medicine diarrhoea specialists allow the time to properly dive into your medical case history, family health history, detailed investigation into the symptom picture, medications, diet, food allergies, nutritional deficiencies and environmental exposures.
Natural relief of diarrhoea symptoms may include a multifaceted approach such as:
Dietary changes personalised to your case, which may include:
Lifestyle strategies may include: Stress resilience techniques like:
Precision probiotics; specific strains that will restore, support and increase diversity and make up of the microbiome, including:
Supplementation of depleted nutrients and those required for repairing and restoring the gut linings and reducing inflammation such as:
Herbal medicines to soothe and tone the gut, heal gut linings and provide prebiotic fibre sources and polyphenols to support a healthy microbiome, such as:
As our functional medicine practitioners treat the whole person, strategies that aim to improve other aspects of health may also be included in your treatment plan. In our six month program, your practitioner will work closely with you to direct your treatment, and your health coach will be your ongoing guide to help you implement your plan with greater ease. This approach has been helping people in Australia with chronic diarrhoea and other chronic health issues get well again.
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To restore normal bowel function, it is important to identify the cause, of which there are many (see causes, above).
If diarrhoea is due to gastroenteritis, it is best to let the body clear out the pathogens naturally, while staying well hydrated and replacing lost electrolytes. Treatment may depend on how long the symptoms have been occurring, and dehydration in acute diarrhoea can be a life-threatening condition. If symptoms persist for more than 24 hours, seek medical assistance.
Fresh ginger tea may reduce nausea, and slippery elm powder may assist in relieving inflammation of the gut and will support gut microbes, which will in turn help restore gut linings.
Seeking the help of a naturopath trained in functional medicine can be helpful in identifying and treating the underlying cause, particularly where diarrhoea is chronic.
There are numerous causes of diarrhoea, from infections causing gastroenteritis, to food intolerances, medications, digestive disorders, other health conditions, allergy, and more.
Acute diarrhoea is usually caused by infectious agents, contracted from food or water borne pathogens or contact with an infected person causing gastroenteritis (or food poisoning), which is generally accompanied by fever, chills, shaking, vomiting and nausea. Dehydration is the greatest concern and if symptoms persist for 24 hours, then seek immediate medical care.
If symptoms have been occurring regularly for more than 4 weeks, you may be experiencing constant diarrhoea, which is often a symptom of another health condition. Testing and detailed case taking by a functional medicine diarrhoea specialist will help you get to the bottom of your problem.
Chronic persistent diarrhoea causes can vary from food intolerances, allergy, parasites, nutrient deficiencies, medications, anxiety, conditions such as IBS, SIBO, or coeliac disease or excessive alcohol, coffee, Vitamin C, magnesium or exercise.
There are a number of health conditions that have ongoing diarrhoea as a symptom, so seeking the help of a diarrhoea specialist may provide the relief you need.
If diarrhoea is acute, then ensuring you stay well hydrated is essential. Broths, from chicken, vegetable or other meats, particularly bone broths can be a good way to restore some lost electrolytes. Collagen containing broths can help to restore the gut linings.
Bland foods such as potatoes, steamed vegetables and dry crackers can usually be well tolerated.
Herbal teas such as ginger, chamomile, green tea, and black tea without dairy milk can all be soothing. Slippery elm powder in a glass of water can also help to soothe diarrhoea.
Avoid sugary, fatty, fast food, or spicy foods as they may aggravate the symptoms.
If symptoms are acute, and persist for 24 hours, seek medical assistance.
The best way to stop or treat diarrhoea is to first identify the cause. Is it due to another health condition, from medication or excess; alcohol, Vitamin C, coffee, magnesium or exercise?
There are natural chronic diarrhoea treatments that are effective and safe, but if your symptoms are acute, and have been occurring for more than 24 hours seek medical help.
If your symptoms are chronic, seeing a functional medicine practitioner who specialises in digestive health may help discover the root cause to treat your symptoms gently and effectively.
Functional medicine practitioners understand that digestive health is essential to all health, so are specialists in helping to restore digestive function as in the case of diarrhoea.
Our functional medicine diarrhoea experts will take a thorough case taking that may incorporate functional testing to provide holistic, personalised chronic diarrhoea treatment strategies that are natural, effective and safe.
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