Diarrhoea

Normal stool frequency ranges from three times per week to three times per day. Diarrhoea may be defined as an excess of stool being passed, usually accompanied by an increased frequency and liquidity of the stool.

Diarrhoea may be accompanied by abdominal and rectal pain, urgency to go, and incontinence. If the diarrhoea is caused by food poisoning, there may be concomitant vomiting.

The diarrhoeal stool is more liquid than usual, may contain more fats when caused by malabsorption (steatorrhoea) and may contain pus or blood in cases of bowel inflammation.

Diarrhoea is usually acute or of short duration, although it can be chronic or long lasting.

Acute onset of diarrhoea is usually due to infection, and one would look at ingestion of suspicious foods; foreign travel; or contact with a person with similar symptoms.

Diet:

It is worth considering the link between input and output – has the diet changed recently?
· Has there been increased intake of dairy produce?
· High fibre cereals?
· Stimulants such as coffee?
· Increase in alcohol consumption?

Medications:

Diarrhoea commonly occurs with certain drugs:
· Metformin
· Colchicine
· Digoxin
· Purgatives
Broad spectrum antibiotics such as the cephalosporins, penicillins and macrolides like erythromycin commonly cause diarrhoea as a result of alteration of the gut flora.