From the Guidelines
Diarrhea is defined as the passage of 3 or more loose or liquid stools per 24 hours, or more frequently than is normal for an individual person. This definition is based on the World Health Organization's (WHO) criteria, as stated in the 2017 Infectious Diseases Society of America (IDSA) clinical practice guidelines for the diagnosis and management of infectious diarrhea 1.
Classification of Diarrhea
Diarrhea can be classified into different types, including:
- Acute watery diarrhea, which lasts less than 7 days
- Acute bloody diarrhea, which lasts less than 7 days
- Prolonged diarrhea, which lasts 7-13 days
- Persistent diarrhea, which lasts 14-29 days
- Chronic diarrhea, which lasts 30 days or longer 1
Causes and Symptoms
The causes of diarrhea can be viral, bacterial, or parasitic infections, food intolerances, medications, inflammatory bowel diseases, and irritable bowel syndrome. Symptoms often include abdominal cramps, urgency, bloating, and sometimes fever or blood in stool.
Treatment and Management
Treatment typically involves rehydration with water and electrolyte solutions, while medications like loperamide (Imodium) can help reduce frequency in adults. Probiotics may help restore normal gut flora. Severe or prolonged diarrhea requires medical attention, especially in children, elderly, or immunocompromised individuals, as dehydration can become life-threatening if not addressed promptly.
Prevention
Prevention of diarrhea can be achieved through general measures, including use of hand hygiene, proper food preparation and storage, avoidance of high-risk foods, and avoidance of unsafe water 1. The use of rotavirus vaccine in infants has also been shown to reduce the burden of acute gastroenteritis 1.
In terms of defining diarrhea in adults, the British Society of Gastroenterology guidelines suggest that diarrhea may be defined in terms of stool frequency, consistency, volume, or weight, but recommend using the Bristol stool chart to determine fecal consistency, with type 5 and above indicating diarrhea 1. However, the IDSA guidelines provide a more specific and widely accepted definition of diarrhea, which is based on the WHO criteria 1.
From the Research
Definition of Diarrhea
- Diarrhea is defined as reduced stool consistency, increased water content, and number of evacuations per day 2
- It can also be described as the passage of loose stools often with more frequent bowel movements 3
- Diarrhea is characterized by an increase in bowel movements (more than three per day) and an increased liquidity of stools 4
- It is defined as the frequent passage of loose or watery stools 5
Key Characteristics
- Increased water content in stools 2
- Increased number of evacuations per day 2
- Loose or watery stools 3, 5
- More frequent bowel movements 3, 4
Types of Diarrhea
- Acute diarrhea: lasts less than four weeks 4
- Chronic diarrhea: persists for more than four weeks 4
- Osmotic diarrhea: results from malabsorption or maldigestion 2
- Secretory diarrhea: due to an increase of fluid secretion in the small bowel lumen 2
- Watery, bloody, and fatty diarrhea can be distinguished based on stool characteristics 2, 4