Understanding Diarrhoea

Diarrhoea is the act of excreting loose or watery faeces. Due to its widespread presence, most individuals react with discomfort when it is mentioned. The sight of emaciated, unhealthy faeces in the toilet bowl always disturbs me. Lack of knowledge about the cause and duration of diarrhoea exacerbates the unpleasant symptoms. Fortunately, diarrhoea often diminishes after a few days and is generally mild, with just a few trips to the loo each day.

Nevertheless, diarrhoea is sometimes indicative of a severe ailment. It results in a significant loss of fluids (dehydration) or hinders the absorption of essential nutrients. It is crucial to identify the indicators of diarrhoea to determine if medical care must be sought or would self-treatment be appropriate.

Types of diarrhoea

Diarrhoea is classified into many categories depending on its duration:

1. Acute diarrhoea: Acute diarrhoea refers to a period of one to two days characterised by loose, watery bowel movements. It is the most common kind and usually resolves spontaneously.
2. Persistent diarrhoea: The length of chronic diarrhoea often lasts for a period of two to four weeks.
3. Chronic diarrhoea: Chronic diarrhoea refers to a condition when the symptoms persist for more than four weeks or occur regularly over an extended period. This persistent diarrhoea indicates a more severe sickness that necessitates a visit to the doctor.

What are the Causes of Morning Diarrhoea?

Diarrhoea in the morning occurs due to:

1.    Caffeine or alcohol

Caffeine acts as a stimulant, accelerating bowel movements. Consuming excessive quantities of caffeinated beverages, such as tea or coffee, leads to the occurrence of diarrhoea. Alcohol use causes loose stools. Consuming alcohol in the evening leads to the manifestation of hangover symptoms the following morning, including diarrhoea.

2.   Laxatives

Laxatives are a kind of medication that promotes bowel movements. They are used to aid in alleviating constipation. Nonetheless, several individuals misuse them in a hazardous attempt to decrease body weight.

Consuming a laxative before going to sleep results in waking up with diarrhoea. When ingested in sufficient quantities, several foods have similar effects. This encompasses foods that are abundant in polyols, which include the following:

• Several fruits, including pears, apricots, and prunes
• Candy, gum, or mints without sugar
• Low-calorie sweeteners; cough syrups or lozenges

3.  Medications

In addition to laxatives, diarrhoea is a common side effect of several other medications. This includes, but is not limited to:

• Pharmaceutical treatment
• The medications in question include digoxin, colchicine, magnesium-containing antacids, and chemotherapy drugs.

Diarrhoea ceases upon completion of therapy or discontinuation of medication. However, it is essential to only change prescriptions after obtaining consent from a medical professional.

4.  Infections

Gastrointestinal distress, characterised by frequent loose bowel movements, starts in the early hours of the day and lasts throughout the whole day as a result of an infectious agent. Diarrhoea results from several infections, including a broad spectrum of causes.

• Pathogens, such as influenza and norovirus
• Bacteria, such as Escherichia coli and Salmonella
• Parasitic infections such as Giardiasis

Furthermore, these infections lead to symptoms such as fever, abdominal cramps, nausea, or vomiting. Although many stomach infections resolve on their own, others need medical intervention.

5.  Pregnancy

Although constipation is more common during pregnancy, some people have diarrhoea. Based on a study conducted in 2022, many potential factors have been identified as potential reasons, which include:

• Hormonal alterations
• Dietary modifications
• Adverse effects of prenatal vitamins
• Existing medical problems

Anyone who suspects they are pregnant obtains an over-the-counter pregnancy test to determine their pregnancy status. Alternatively, they seek advice from a medical practitioner.

6.  Food allergy or intolerance

Morning diarrhoea is caused by food allergies such as wheat, peanuts, or eggs, along with symptoms such as rashes, itching, and throat tightness.

The proteins in certain meals elicit an abnormal immune system response, leading to the manifestation of these symptoms.

Diarrhoea is a sign of lactose or gluten intolerance, accompanied by other symptoms such as bloating and flatulence. In contrast to an allergy, a food intolerance occurs when the body is unable to digest or metabolise a particular dietary component effectively.

Even individuals without any documented food allergies or intolerances experience morning sickness as a result of consuming meals that are rich in spicy ingredients, excessive oil, or artificial additives.

7.   Stress

Some persons get diarrhoea due to stress or anxiety. One common physical manifestation of mental health problems is gastrointestinal discomfort. Other physical symptoms of stress include

• Experiencing a decrease in appetite or engaging in excessive eating
• Nauseous
• Dyspepsia
• Body parts experiencing tension
• Heightened heart rate;
• Insomnia
• Enhanced understanding of stress and its mitigation.

8.  Irritable bowel syndrome (IBS)

IBS is a persistent medical condition that leads to either constipation, diarrhoea, or both. While experts are uncertain about the precise causes, some people find that stress or certain foods worsen symptoms.

In addition to constipation and diarrhoea, IBS lead to:

• Edoema
• Flatulence
• Abdominal cramps and pain

People with irritable bowel syndrome (IBS) who eat items that provoke their symptoms in the evening get diarrhoea the following day or throughout the night.

9.  Inflammatory bowel disease (IBD)

IBD is an umbrella term that includes many autoimmune disorders, such as Crohn's disease and ulcerative colitis, which cause inflammation in the gastrointestinal system.

Common symptoms of inflammatory bowel disease (IBD) include:

• Diarrhoea
• Presence of thick or bloody stools; abdominal pain; increased urgency in bowel movements

The likelihood of contracting diarrhoea due to food poisoning from ingesting contaminated food is greater in the United States. According to the CDC, contaminated food is responsible for more than one million instances of diarrheal illnesses in the United States annually.

What are the Symptoms of Morning Diarrhoea?

The main symptom of diarrhoea is the presence of watery or loose stools. Other common symptoms include:

• Elevated temperature
• Intense agony
• Experiencing nausea, vomiting, haemorrhaging, or experiencing a robust and urgent need to urinate.

Typically, these symptoms do not need a doctor's visit, especially if they resolve rapidly.

What are the Signs and symptoms of Severe Diarrhoea?

Severe episodes of diarrhoea are indicative of a significant sickness or medical condition that needs medical intervention.

If one has diarrhoea accompanied by:

• Intense and unbearable pain.
• Presence of faecal mucus.
• Weight loss (which suggests inadequate nutrient intake).

If a person sees any of the below indications in their child, or if they exhibit signs of dehydration, contact a healthcare professional:

• Dehydrated, reddened skin.
• Vertigo and cognitive disarray.
• Intense emesis and queasiness.
• Vertigo
• Infrequent urination, nocturia, or anuria.
• Fewer than six wet diapers per day in babies.
• Toddlers: Refrain from urinating or changing wet diapers for eight hours.
• Newborns and toddlers do not cry while they are sobbing.

Diagnosing Diarrhoea

To determine the underlying cause of diarrhoea, the healthcare practitioner gathers information about medical history, reviews the medication regimen, does a physical examination, and orders diagnostic testing. Possible assessments include:

• Blood test: An electrolyte assay, a comprehensive blood count, and a kidney function assessment help determine the severity of diarrhoea.
• Stool test: One physician recommends a stool examination to ascertain the aetiology of diarrhoea and whether a parasite or bacteria causes it.
• Hydrogen breath test: This test determines whether one has lactose intolerance. At regular intervals, the level of hydrogen in the breath is measured after the consumption of a beverage containing a high quantity of lactose. Excessive exhalation of hydrogen suggests inadequate digestion and absorption of lactose.
• Flexible sigmoidoscopy or colonoscopy: A medical professional examines the inside of the colon by inserting a small, illuminated tube into the rectum. The device is equipped with a tool that doctors use to extract a biopsy, a small sample of tissue from the colon. A flexible sigmoidoscopy provides the physician with a visual examination of the lower portion of the gut, whereas a colonoscopy offers a comprehensive view of the whole colon.
• Upper endoscopy: Doctors use a long and slender tube equipped with a camera to examine the top portion of the small intestine and stomach. A tissue sample was obtained for laboratory analysis.

What is the Treatment of Morning Diarrhoea?

Before treating morning diarrhoea, it is crucial to determine the specific cause accurately. To get an accurate diagnosis, it is advisable to consult with a physician. Here are a few home cures that provide temporary relief in the interim.

1.  ORS AND ZINC

Zinc and oral rehydration solution (ORS) are the globally accepted methods for treating diarrhoea.

ORS is mainly composed of a mixture of water, sugar, and salt. This combination accelerates the body's process of replenishing fluids. It is inexpensive and has successfully saved the lives of millions.

Administering a zinc micronutrient treatment after oral rehydration solution (ORS) reduces the duration and severity of diarrhoea. Three months of zinc supplementation helps prevent episodes of diarrhoea, enhance the immune system, and accelerate the healing process.

ORS with zinc is available to 15% of children globally, but less than 50% of children worldwide have access to ORS alone. Access tends to be lowest in areas where the load is highest.

In July 2019, the World Health Organization's Essential Medicines List included the addition of co-packaged ORS and zinc. This policy declaration acts as a catalyst to encourage countries to prioritise the co-pack in their budgets, purchasing, and supplies, as well as in provider training.

2.   Dietary changes

If one has regular concerns about diarrhoea in the mornings, it is beneficial to refrain from consuming the following foods:

• Cereals, pasta, bread, and other gluten-containing products
• Gas-producing foods and drinks, such as fresh fruit, broccoli, cauliflower, and carbonated beverages
• Several types of carbohydrates, such as fructose and lactose

3.  Medications

If a person is diagnosed with irritable bowel syndrome (IBS), doctors prescribe antidepressants as a potential treatment option. Desipramine and imipramine are beneficial in cases when morning diarrhoea is not accompanied by depression. Bentyl, an anticholinergic medication, helps alleviate spasms in the bowels that cause diarrhoea. In addition, loperamide, an anti-diarrhea medicine, can also be beneficial.

Anti-inflammatory drugs mitigate the symptoms of inflammation. Doctors also prescribe immunosuppressant drugs to reduce the presence of inflammatory substances in the stomach.

Antibiotics and antivirals are effective in treating infections, but it is important to note that some medications in these categories have adverse effects on health. An instance of this is diarrhoea. Therefore, use caution while discussing prescriptions with a physician or pharmacy. Suppose a person is experiencing physical illness every morning due to concern or emotional stress. In that case, it is advisable to consult with a doctor or therapist to explore more effective strategies for managing the stress.

How to Prevent Diarrhoea?

​​ While it is not always possible to completely prevent diarrhoea, one reduces the risk of becoming sick or ingesting contaminated food.

Adhere to good hygiene practices: After visiting the restroom or preparing and consuming meals, it is essential to cleanse your hands with soap and water. Using hand sanitiser is an optional decision.

Acquire a vaccination: The rotavirus vaccine is an effective measure for preventing diarrhoea, which is mainly caused by the rotavirus. The use of the COVID-19 vaccine reduces the likelihood of acquiring the disease and experiencing symptoms associated with COVID-19, such as diarrhoea.

Ensure proper food storage: Food should be prepared and kept at the appropriate temperature. To mitigate potential risks, avoid consuming any food or beverage that is beyond its expiration date.

Exercise caution with dietary intake when travelling:

1. Refrain from ingesting untreated water when travelling.
2. Avoid consuming ice cubes and tap water, and use tap water for oral hygiene.
3. Refrain from consuming juice or milk products that have not undergone pasteurisation.

Pasteurisation is a process that eradicates microorganisms from certain drinks. If one is uncertain, it is advisable to consume bottled water or pre-boiled liquids, such as tea or coffee.

Exercise caution with dietary choices when travelling: Avoid consuming raw or undercooked fruits, vegetables, meats, and shellfish. Although vegetables and fruits are often nutritious options, their skins harbour toxic chemicals.

Preventing traveller's diarrhoea

To minimise the likelihood of acquiring traveler's diarrhoea when travelling, one must take the following precautions:

• Requesting permission to start antibiotic treatment before leaving the premises
• While on vacation, it is advisable to avoid consuming ice cubes, fresh vegetables that have been cleaned with tap water, and tap water itself.

When to call a doctor

Most cases of acute diarrhoea often recover spontaneously, with symptoms generally improving within a few days.

Nevertheless, suppose symptoms persist for a duration exceeding two days. In that case, it is recommended by the National Institute of Diabetes and Digestive and Kidney Diseases to seek medical attention, as there is a possibility of dehydration and the need for intravenous fluids or other forms of medication and evaluation.

Moreover, diarrhoea is indicative of several significant medical conditions. If a person has loose, watery stools along with any of the following symptoms, it is advisable to seek immediate medical attention. The simultaneous occurrence of these symptoms suggests a significant underlying medical issue.

If a person's child exhibits any of the following symptoms, which are considered reliable sources, it is imperative to seek immediate assistance:

• They have been experiencing diarrhoea for a minimum of 24 hours.
• The individual's body temperature is 39°C (102°F) or above.
• They have blood in their faeces.
• They excrete faeces that contain pus.
• The consistency of their faeces is adhesive, and the colour is deep.

Each of these indications indicates a medical emergency.

People Also Ask

Are there any home remedies to treat the diarrhoea quickly?

Yes, taking plenty of water and following the BRAT (banana, rice, applesauce, and toast) diet can help relieve the symptoms of diarrhoea. To get enough probiotics, consume more yogurt during these symptoms. Moreover, it is also important to stay off certain foods such as dairy products, caffeinated drinks, and greasy foods to ease the gut and treat the diarrhoea quickly.

How can I tell if the cause of my diarrhoea is bacterial or viral?

The difference between bacterial and viral diarrhoea is based on its symptoms. Bacterial diarrhoea often presents with abdominal cramps, high fever, body aches and blood or mucus in the stools that improves upon taking the prescribed antibiotics. Whereas viral diarrhoea may present with watery stools, fever, vomiting and this type of diarrhoea won’t be relieved with antibiotics.

Conclusion

Diarrhoea is the act of excreting loose or watery faeces. Due to its widespread presence, most individuals react with discomfort when it is mentioned. Fortunately, diarrhoea often diminishes after a few days and is generally mild, with just a few trips to the loo each day. Nevertheless, diarrhoea is sometimes indicative of a severe ailment. It results in a significant loss of fluids (dehydration) or hinders the absorption of essential nutrients. Diarrhoea is broadly classified into acute, persistent, and chronic diarrhoea. Consuming excessive quantities of caffeinated beverages, such as tea or coffee, leads to the occurrence of diarrhoea. Consuming a laxative before going to sleep results in waking up with diarrhoea. Gastrointestinal distress, characterised by frequent loose bowel movements, starts in the early hours of the day, and lasts throughout the whole day as a result of an infectious agent such as influenza, Escherichia coli, Salmonella and Giardia. Morning diarrhoea is also caused by food allergies such as wheat, peanuts, or eggs, along with symptoms such as rashes, itching, and throat tightness. Diarrhoea is a sign of lactose or gluten intolerance, accompanied by other symptoms such as bloating and flatulence. The main symptom of diarrhoea is the presence of watery or loose stools. Other common symptoms include nausea, vomiting, haemorrhaging, or experiencing a robust and urgent need to urinate. Treatment of diarrhoea include ORS or zinc supplementation, dietary changes and medications that mainly include broad spectrum antibiotics. In cases of diarrhoea in which symptoms persist for a duration exceeding two days, it is recommended by the National Institute of Diabetes and Digestive and Kidney Diseases to seek medical attention, as there is a possibility of dehydration and the need for intravenous fluids or other forms of medication and evaluation.