Persistent Watery Diarrhea: Causes and When to Seek Help

Diarrhea for several days?

Hello Doctor, I asked you last time about having watery stools for several days, and today it has been a week.
I still have 4 to 6 watery bowel movements a day without any other symptoms.
Before I need to go, my stomach just makes gurgling sounds, but there is no pain.
I went to a large hospital today for a consultation, and they said if the medication doesn't help, I may need to be hospitalized for IV fluids.
I would like to know what is happening to me.
I have had gastroenteritis before, but it never lasted this long.
Am I at risk for colon cancer? I'm really scared.

Yeri, 20~29 year old female. Ask Date: 2015/10/02

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello, please take the medication first and see if there is any improvement.
If there is no improvement and you experience severe diarrhea, there is a concern about dehydration and electrolyte imbalance.
Additionally, monitor for any progression to abdominal pain or the onset of fever.
It's also important to pay attention to your diet, focusing on starchy foods and avoiding high-water-content fruits.
Generally, the incidence of colorectal cancer in young individuals is quite low, so you can continue to observe your condition.
If necessary, the clinical physician will arrange appropriate examinations, so there is no need to worry excessively.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2015/10/02

More Info

Persistent watery diarrhea can be a distressing symptom and may arise from various causes. Given your situation, where you have experienced this symptom for over a week with no other significant symptoms, it is essential to consider several potential causes and when to seek further medical help.

Possible Causes of Persistent Watery Diarrhea
1. Infectious Gastroenteritis: This is one of the most common causes of diarrhea. It can be viral (like norovirus or rotavirus), bacterial (like E. coli, Salmonella, or Campylobacter), or parasitic (like Giardia). Symptoms typically include watery diarrhea, nausea, vomiting, and abdominal cramps. While many infections resolve on their own, some can lead to dehydration, especially if diarrhea persists.

2. Food Intolerance or Allergies: Some individuals may have intolerances to certain foods, such as lactose or gluten, which can lead to diarrhea. If you have recently changed your diet or consumed new foods, this could be a factor.

3. Medications: Certain medications, particularly antibiotics, can disrupt the normal gut flora and lead to diarrhea. If you have recently taken antibiotics, this might explain your symptoms.

4. Chronic Conditions: Conditions such as Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD) (including Crohn's disease and ulcerative colitis), and celiac disease can cause persistent diarrhea. These conditions often require specific management and treatment.

5. Malabsorption Syndromes: Conditions that affect the absorption of nutrients in the intestines, such as pancreatic insufficiency or certain infections, can lead to diarrhea.

6. Stress and Anxiety: Psychological factors can also manifest physically, leading to gastrointestinal symptoms, including diarrhea.

When to Seek Help
Given that you have been experiencing watery diarrhea for over a week, it is crucial to monitor your condition closely. Here are some signs that warrant immediate medical attention:
- Severe Dehydration: Signs include excessive thirst, dry mouth, little or no urination, severe weakness, dizziness, or confusion.

- Blood in Stool: If you notice blood or black, tarry stools, this could indicate a more serious condition.

- High Fever: A fever over 101°F (38.3°C) may suggest a significant infection.

- Persistent Symptoms: If diarrhea continues despite treatment or worsens, further evaluation is necessary.

- Severe Abdominal Pain: While you mentioned no pain, any sudden onset of severe pain should be evaluated.

Conclusion
While your concern about conditions like colorectal cancer is understandable, especially with persistent symptoms, it is essential to remember that many cases of prolonged diarrhea are due to less serious causes. However, given your symptoms and the duration, it is wise to follow up with your healthcare provider, especially if the prescribed medications do not alleviate your symptoms. They may recommend further testing, such as stool studies, blood tests, or imaging, to determine the underlying cause of your diarrhea.

In the meantime, ensure you stay hydrated, as diarrhea can lead to significant fluid loss. Oral rehydration solutions can be beneficial in maintaining electrolyte balance. If you experience any alarming symptoms, do not hesitate to seek immediate medical care.

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