Painless Diarrhea: Causes and When to Seek Help

Diarrhea without abdominal pain?

On the first day, I experienced lower back pain, followed by a headache, and then I had a fever at night.
The next day, I didn't feel much discomfort, but after lunch, I vomited.
On the third day, I still didn't feel much discomfort.
On the fourth day, I started having diarrhea, but my stomach didn't hurt.
Initially, my bowel movements were uncontrollable; it was more like watery stools.
It felt like the watery stool was separating.
After taking "Zhenlu Pills," I didn't have to run to the bathroom constantly and could hold it in, but my stomach still didn't hurt by night.
The stools remained watery (I thought I might have food poisoning, but my parents, who ate with me, are fine...).
I would like to know what could be causing this and which specialist I should see.
I previously had surgery for appendicitis and peritonitis; could that be related?

BW, 10~19 year old female. Ask Date: 2012/08/06

Dr. Gao Qingyun reply Family Medicine

Hello,
1.
Based on your description, it may not be significantly related to the previous appendectomy or peritonitis surgery.

2.
Your description suggests a possibility of bacterial or viral gastroenteritis, but a complete medical history and physical examination are still necessary.
I recommend that you consult with a gastroenterologist for further discussion.

Thank you! Wishing you peace and good health.

Sincerely,
Dr.
Gao Qingyun
Attending Physician, Department of Family Medicine
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2012/08/06

More Info

Understanding painless diarrhea can be quite complex, especially when accompanied by other symptoms such as back pain, headache, fever, and vomiting. Based on your description, it seems that you experienced a sequence of symptoms that could indicate a viral or bacterial infection, food poisoning, or even a gastrointestinal disorder.
Initially, you mentioned experiencing back pain, followed by headaches and fever. These symptoms can often be associated with a systemic infection, such as a viral illness (like the flu) or a bacterial infection. The subsequent vomiting and diarrhea suggest that your gastrointestinal system is involved, which could be due to a variety of causes.

The fact that your diarrhea is painless is noteworthy. Painless diarrhea can sometimes be associated with non-inflammatory causes, such as viral gastroenteritis or certain types of food poisoning. In contrast, inflammatory diarrhea, which is often painful, is usually caused by bacteria or parasites that irritate the intestinal lining. Since you mentioned that your parents, who ate the same food, did not experience similar symptoms, this could point towards a viral infection rather than food poisoning, as foodborne illnesses typically affect multiple people who consumed the same contaminated food.

Your history of appendicitis and peritonitis could also be relevant. While it is unlikely that your previous surgery directly caused your current symptoms, any abdominal surgery can lead to changes in bowel function or even complications such as adhesions, which might affect how your digestive system operates. However, given that your symptoms are primarily gastrointestinal and you are not experiencing significant abdominal pain, it seems less likely that your previous surgery is the primary cause of your current condition.

In terms of when to seek medical help, it is advisable to consult a healthcare professional if you experience any of the following:
1. Persistent diarrhea lasting more than two days.

2. Signs of dehydration, such as excessive thirst, dry mouth, reduced urine output, or dizziness.

3. Severe abdominal pain or cramping.

4. High fever (above 101°F or 38.3°C).

5. Blood or mucus in your stool.

6. Symptoms that worsen or do not improve with time.

Given your symptoms and medical history, it would be prudent to consult a gastroenterologist. They can perform a thorough evaluation, which may include stool tests to check for infections, imaging studies if necessary, and a review of your medical history to rule out any complications from your previous surgery.

In summary, while your symptoms could be indicative of a viral infection or foodborne illness, the painless nature of your diarrhea and your medical history warrant a professional evaluation. Early intervention can help prevent complications and ensure that you receive appropriate treatment.

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