Diarrhoea

Bowel habits vary, not just between different people, but even within the same person. If the stools become more liquid in consistency – which is likely to mean the individual goes to the toilet more frequently than usual – they have diarrhoea. This may be an acute or chronic problem, with the latter requiring a GP referral, as it is usually caused by an underlying issue.

Acute diarrhoea can have a number of causes, from dietary overindulgence to an infection or as a side effect of medication.

One of the most common causes of drug-induced diarrhoea are antibiotics, which may irritate the bowel or upset the balance of bacterial flora in the GI tract. Many medicines can cause diarrhoea as a side effect, including metformin, proton pump inhibitors and statins, as well as more obvious culprits such as orlistat and laxatives.

There are some diarrhoea symptoms that indicate a medical referral is warranted, including signs of dehydration, fever, vomiting, severe pain, or if there is blood or mucus in the stools. Babies, young children and the elderly should also all be referred, as should anyone who has recently returned from abroad, has had diarrhoea for more than a few days, or is on a medicine that may be causing the symptom.

The most important aspect of managing diarrhoea is replacing fluids. Oral rehydration therapy replaces lost fluids and salts, but sipping water and eating a light diet of easily digestible foods such as soup, rice and bread are good options too. For patients who are unable to stay at home and let the condition resolve on its own, taking an antidiarrhoeal such as loperamide will slow the passage of food through the GI tract and mean more water is absorbed, while products containing bismuth subsalicylate can help symptoms with a bacterial origin.