Chronic diarrhoea

Causes

Short-term diarrhoea can be due to drinking too much alcohol, a food allergy, and stomach bugs. Other factors that can affect your digestive system include stress, anxiety, and depression.

Certain medications can also cause loose stools. Speak to your doctor if you suspect it’s a side effect of a new medicine.

Long-term causes: 

• Coeliac disease 
• Bile acid malabsorption 
• Irritable bowel syndrome (IBS) 
• Inflammatory bowel disease (IBD) 
• Microscopic colitis 
• Diverticular disease and diverticulitis 
• Pancreatic exocrine insufficiency (PEI) 
• Small intestinal bacterial overgrowth (SIBO) 

 Another, much less common, cause is bowel cancer. Our experienced specialists will perform a series of tests depending on your symptoms to determine the cause.

Diagnosis

During your initial consultation, we’ll ask questions regarding your symptoms. We’ll need to know all your symptoms, how long you’ve had them, and if you are taking any medications. Let us know how often you need to visit the bathroom and what your stool looks like. This information will give us an idea of how severe your condition is.

Once we have discussed your symptoms, we may perform a physical exam of your abdomen. We might also conduct stool and blood tests to check for signs of blood in your poo, an infection, or IBD.

Continue to eat as usual before these tests. Coeliac disease, for example, causes high levels of gluten antibodies after consuming gluten (a protein found in wheat). If you stop eating gluten products before we conduct our tests, it could prevent us from making an accurate diagnosis.

If you are over 50, we may recommend a digital rectal examination (DRE). A DRE involves inserting a gloved finger into your bottom to feel for abnormalities. The DRE can help us diagnose bowel and rectal problems.

After your consultation, we may recommend additional tests to investigate your symptoms. These can include an upper endoscopy (gastroscopy), colonoscopy, or a hydrogen breath test.

Treatment

Once we have diagnosed the cause, we can advise on how to stop your diarrhoea. To avoid dehydration, sip water or other fluids regularly. We recommend avoiding sweet or fizzy drinks while you’re feeling unwell.

Medications

Acute cases are usually treated effectively with over-the-counter medicines from a pharmacy. Although these may stop your symptoms immediately, you should not take these medicines if there is blood in your stool.

Prescription medications include:  

• Absorbents to make the stools less watery 
• Antidiarrhoeal medicines, such as loperamide (the active ingredient in Imodium) 
• Muscle relaxants to reduce cramps and slow down the speed of digestion 
• Antibiotics, if you have a severe bacterial infection 
• Medicine to treat bile acid malabsorption

Dietary changes can also help you manage your symptoms, which is helpful for chronic cases due to conditions such as coeliac disease and IBS.