Diarrhoea, what is it, what’s normal and how can you help it? We put your questions to Dr Sarah Jarvis and now it’s time for the answers.
What’s ‘normal’ when it comes to diarrhoea?
Diarrhoea – runny poos, usually three or more times a day - are never exactly normal, but they are very, very common. The most common cause of diarrhoea, if you look over the whole population, is tummy bugs.
Tummy bugs usually lead to five to seven days of diarrhoea, often along with tummy pain and vomiting. The vomiting usually settles over the course of about one day. But there are times when you do need to seek help for diarrhoea. This includes diarrhoea along with severe tummy pain, if the diarrhoea is so bad and you're vomiting as well, you can't keep any fluids down, and if you think you might be dehydrated.
The symptoms of dehydration include not weeing very often, passing very dark, concentrated urine, feeling dizzy, feeling lightheaded, particularly when you stand up, and having a very dry mouth.
In addition, you'd also want to seek help if you pass blood in your poo with your episodes of diarrhoea. You also need to see a doctor if you're passing black, tarry stools, or if you're vomiting and there's yellow or green vomit, or if you're vomiting coffee grounds. If the pain is severe and you can't keep anything down, then you should seek help too.
What triggers diarrhoea in women aged 30 to 35?
If you're a woman in your thirties there are lots of causes of diarrhoea, and they're often the same as they would be at any other time of your life. One of the most common is tummy bugs that tends to cause a one-off bout of few days of diarrhoea, often along with tummy pain, although that usually settles within a day or so.
Inflammatory bowel disease, Crohn's disease and ulcerative colitis can cause diarrhoea, and often it'll be blood stained, and you may have severe tummy pain. You may feel unwell in yourself, have fever, lose weight, and so on. That quite often affects people at a relatively young age and unlike a tummy bug, it doesn't settle in time, although it may go through peaks and troughs.
You may find that medications you’ve started in your 30s can cause diarrhoea. These include antibiotics, antidepressants, and proton pump inhibitors which are used for indigestion. It's always worth speaking to your pharmacist or checking the label.
Overactive thyroid is much more common in women than it is in men, and that can lead to diarrhoea along with losing weight without meaning, to feeling on edge, being very intolerant of the heat, and having changes to your period. If you've got any combination of those symptoms, it may be worth thinking about that diarrhoea being caused by an overactive thyroid. Speak to your doctor – a simple blood test can tell if your thyroid is overactive.
Irritable bowel syndrome usually starts earlier in life, although it can start in your thirties IBS can cause a combination of bloating, which tends to come and go, tummy pain (which is often colicky and may be relieved by passing wind or opening your bowels), and diarrhoea or constipation, or a mixture of the two.
Finally, there’s bowel cancer. This is very uncommon in women in their 30s, but it does happen. It’s essential to see your doctor if you have diarrhoea that doesn’t settle along with any other symptoms including being off your food, losing weight without meaning to, blood in your poo or black, tarry poos, or bloating that doesn’t settle down.
Why do I get diarrhoea when I travel?
If you're going anywhere outside Western Europe, the USA, Canada or Australasia, Australia and New Zealand, you may be at high risk of traveller’s diarrhoea. Unfortunately, it's important to remember that food and water hygiene standards are not necessarily the same as we expect and indeed take for granted in the UK.
Prevention is always better than cure. For instance, don't be tempted by street foods. Don't eat peeled fruit. Do stick to bottled or boiled drinks and don't put ice in your drinks because the water could be contaminated. But if you do get it, you're likely to have tummy pain, vomiting, which often settles within a day or so, and diarrhoea that can go on for 5 to 7 days.
Now, as with any other tummy bug, the real key is to keep yourself rehydrated. Lots and lots of fluids. You'll need as much fluid as you normally do, and then some on top, because you're losing more than you normally would when you have diarrhoea. Do remember that if you’re passing blood in your poo, or have very severe cramps or can’t keep fluids down, you must seek medical help.
How do you spot a trigger for diarrhoea?
It can be difficult if you're getting repeated diarrhoea to know what your triggers are. One of the easiest and most effective ways of finding out is to keep a food diary. Perhaps the first thing is you have to be truthful and include everything you eat, everything you drink, and not just the main food or the main drinks. You also need to keep a note of whether your food has artificial sweeteners in it, and whether you're having any sauces, condiments etc with it.
You also want to include the times that you ate, and you want to include any symptoms that you're getting and when you get them. Don’t forget that with food intolerance, for instance, you may not get symptoms straight away after you've eaten something. By keeping a really comprehensive food diary, you can work out any link between the two.
What are the treatments for diarrhoea?
The treatments for diarrhoea very much depend on the cause. Most people who have diarrhoea have a one-off episode, usually due to a tummy bug, often a virus, less often bacterial infection. Now, that will usually settle on its own. Your immune system will fight it off within a few days.
Here are some things that you can do to help:
- Keeping rehydrated is really, really important. Stick to plenty of clear fluids - not fruit juice or fizzy drinks because they can make things worse. And you should definitely steer clear of alcohol, which can dehydrate you. You need to drink as much as you usually do, and more, because you're losing more fluid when you have diarrhoea.
- Some studies have shown that in combination with rehydration therapy, taking probiotics can relieve your symptoms and help them to settle down within a couple of days. Your pharmacist may be able to offer advice on medicines that could relieve your symptoms, although they won't cure the problem. You'll have to wait for that to settle on its own.
There are also certain red flags which suggest that you need to get medical help for your diarrhoea. They would include:
- having blood in your poo
- passing black tarry stools
- vomiting up coffee grounds
- having yellow or green vomit
- very severe tummy pain
- not passing much urine
- passing very dark concentrated urine
- feeling very confused
- losing weight without meaning to
- being off your food for more than a few days
Read more from Dr Sarah Jarvis
The definition of constipation and how to ease it
12 common bloating questions answered
