Diarrhea means there are frequent, loose or liquid stools. There may be a gripey abdominal pain (colic) which is less after a stool is passed.
Acute diarrhea – comes on suddenly and lasts a short time.
Chronic diarrhea – affects someone over a long period of time.
Some people pass frequent, small solid stools with a sense of urgency. This is not true diarrhea and occurs when the rectum is irritable as in the irritable bowel syndrome or inflamed as in colitis.
Criteria for Diarrhea
- Diarrhea is present if one of the following criteria is fulfilled:
- Frequent defecation: > three times per day
- Altered stool consistency: water content > 75%
- Increase in stool quantity: more than 200–250 g per day
- Acute diarrhea: lasting less than 14 days
- Chronic diarrhea: lasting more than 14 days
What causes Acute Diarrhea?
- Food poisoning
- Gastroenteritis (see separate leaflet on the prevention and treatment of travellers’ diarrhea)
- Sometimes treatment with an antibiotic
- Alcohol (to excess)
What causes Chronic Diarrhea?
A wide range of problems can cause chronic diarrhea; some of the most common causes include-
Irritable bowel syndrome — Irritable bowel syndrome is one of the most common causes of
Inflammatory bowel disease — Crohn disease and ulcerative colitis. These conditions may develop when the body’s immune system attacks parts of the digestive tract.
Infections — Intestinal infections are a cause of chronic diarrhea. Intestinal infections can develop after eating contaminated food or drinking contaminated water or unpasteurized milk or in people who travel or live in tropical or developing countries.
Endocrine disorders — An overactive thyroid (hyperthyroidism) can cause chronic diarrhea and weight loss. Diabetes can cause chronic diarrhea if the nerves that supply the digestive tract are injured.
Food allergy or sensitivity — Food allergies and hypersensitivity can cause chronic diarrhea. People with celiac disease are sensitive to gluten, a major component of wheat flour which can cause diarrhea and weight loss.
The workup for diarrhea includes a detailed patient history (e.g., recent travel), physical examination, and laboratory tests to assess severe cases.
Laboratory tests for Diarrhea
Laboratory tests are usually not required in acute cases and but needed in diagnosis of severe or chronic disease.
- Indications for investigation in case of diarrhea.
- Diarrhea lasting > 4 days
- High fever
- Blood in stools
- Possibility of Irritable bowel syndrome.
- Autoimmune diseases or Immuno-suppression
- CBC: may show anemia or leukocytosis
- Stool examination for Blood, ova and parasites
- Bacterial stool culture
- Indications: suspicion of invasive bacterial enteritis, moderate to severe illness
- Colonoscopy: in patients with chronic diarrhea without identifiable cause
- CT: if diverticulitis or Irritable bowel syndrome is suspected
Conventional treatment for Diarrhea
Most cases of acute diarrhea are self-limited, treatment is symptomatic, focusing on oral rehydration, and rarely requires medication.
Supportive treatment includes
- Rehydration (especially in children)
- Mild to moderate dehydration: oral administration of electrolyte-containing fluids (e.g., apple juice or Pedialyte®)
- Severe cases: needs hospitalization; hydration with intravenous fluid.
- Antidiarrheal agents (e.g., loperamide): may be given in mild to moderate cases; should be avoided if there is fever or blood in stools (indicative of systemic disease)
- Antibiotics: do not shorten course of disease and are generally not indicated
- Treatment of the underlying condition in cases of chronic diarrhea
Diarrhea – Homeopathy Treatment & Homeopathic Remedies
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines for diarrhea are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The homeopathic remedies for diarrhea given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a homeopathic remedy for diarrhea. To study any of the following remedies in more detail, please visit our Materia Medica section. None of these homeopathic medicine for diarrhea should be taken without professional advice.
- Veratrum album
- Cinchona officinalis
- Aloes socotrina
- Croton tiglium
- Argentum nitricum
Arsenicum. Stools in small quantities. Restlessness, anguish and intolerance of pain. Thirst for small quantities and often. The prostration and weakness are out the stool, of all proportion to stool.
The grand characteristics of Arsenicum in diarrhea , therefore, are:
- The small quantity.
- The dark color.
- The offensive odor.
- The great prostration following.
Another grand feature is the burning in the rectum, which almost amounts to a tenesmus. The stools of arsenicum are dark yellow, undigested, slimy or bloody ; they are often dark green and very offensive; they are worse at night and after eating or drinking. An additional indication, is chilling of the stomach by cold food, ice water or ice cream. It is also the remedy for diarrhea from tainted food and so-called ptomaine poisoning. It hardly seems possible that arsenicum with these characteristics could be misprescribed.
The characteristics of Veratrum album are no less well marked than are those of Arsenicum. They are as follows:
- A profuse watery stool, forcible evacuated.
- Pain in the abdomen preceding stool.
- Great prostration following stool.
- Cold sweat , coldness and blueness of the body generally.
The stools of Veratrum are watery, containing therein flakes, and are commonly called rice-water discharges. Preceding the stool is a severe pinching colic in the abdomen , and this pain is apt to continue during the stool. Nausea,too, is often an accompaniment. Cramps in the feet and legs may also be present.
Among the prominent general symptoms of Veratrum is the great thirst for very cold water in large draughts.
Arsenicum and Veratrum in a certain case having been excluded, perhaps the next remedy coming to mind is Cinchona. Indeed, it may come to mind at once if the diarrhea be a painless one. Or, if the stool be undigested.The characteristic Cinchona diarrhea is a painless one, of a cadaverous odor. It is slimy, bilious, blackish and mixed with undigested food; it is worse at night and after eating , with a rapid exhaustion and emaciation, and this exhaustion, emaciation and debility at once distinguish the remedy from Phosphoric acid, which is similar, lacking the debility , but having the following:
- Rumbling in abdomen.
- Perspiration of the whole body.
- Thin watery painless stools.
- Much thirst.
The Cinchona diarrhea is worse after eating. If it be caused or made worse by fruit, it is an additional characteristic indication for its use. It is a great favorite in summer diarrhea. Cinchona has a similar thirst to Arsenicum, the patient drinks little and often , but it lacks the burning to Arsenicum. Diarrhea coming on after attacks of acute illness are often met by Cinchona. It also corresponds to the chronic diarrhea of aged persons.
The diarrhea of sulphur is very characteristic. It has changeable stools, yellow , watery, slimy, and in scrofulous children may contain undigested food. It is worse in the morning about four or five O’clock, when it wakens the patient and drives him out of bed in great haste. For these early morning diarrhea we have a number of remedies. There is with Sulphur a tendency to rectal soreness, there is itching and soreness at the anus, the stools being acrid and excoriating.
The stools of Sulphur are offensive and the odor of the stool follows the patient about as if he had soiled himself.The stools often alternate between constipation and diarrhea, and if haemorrhoids be present it is an additional good indication for Sulphur. A diarrhea of mucus streaked with blood, preceded by colic, is also often found under the remedy.
Aloes is a remedy whose chief action is on the rectum. It produces a constant desire to stool, and the passages are accompanied with a great deal of flatus. The great characteristic of the drug feeling of uneasiness, weakness, and certainly about the rectum; there is a constant feeling as if stool would escape, the patient dares not pass flatus for fear of the escape of faeces. This condition is met with in children sometimes, they pass faeces when passing flatus. It is worse from eating but it seldom continues during the day. The weakness of the sphincter ani. The Aloes patient will also pass stool when urinating. Haemorrhoids which are characteristically swollen and sore accompany the Aloes stool. The stool themselves are yellow and pasty or lumpy and watery, and before the stool there are griping pains across the lower part of the abdomen and around the navel. These pains also continue during stool and passage usually relieves them. The essentials are:
- The lumpy, watery stool.
- The intense griping across the lower parts of the abdomen before and during stool, leaving after stool.
- The extreme prostration and perspiration following.
Croton tiglium is one of the great homoeopathic remedies for diarrhea , which might readily be imagined from the prompt action of the drug in the minutest doses of the crude substance in the intestinal canal. Its characteristics are a yellowish, watery stool pouring out like water from a hydrant, and especially associated with nausea and vomiting and aggravated by eating and drinking.
This has a stool expelled “all at once”, with much relief following. Stools thin and watery. The characteristics of the stool of Croton tiglium are:
- The yellow, watery stool.
- The sudden expulsion.
- The aggravation from drink and food; and to this we may add the quite common accompaniment of nausea, preceded by a little pain in the abdomen.
One symptom always leads to the thought of this drug, and that is sourness of stools and of the whole body, though Rheum is not only remedy for sour stools nor are sour stools the only indication for Rheum; indeed, they may be wanting in sourness and Rheum still be the remedy. Debility is also characteristic of the remedy.
Characteristic among the symptoms of Rheum, besides the sourness, is a griping colic often followed by tenesmus. In color, the stools are brown and frothy, and usually sour; they are worse from motion and after eating. Chilliness during stool is also characteristic. The continuance of the colic after the stool also suggests the remedy.
Podophyllum, as we have seen, has an early morning diarrhea. The stools are watery, yellow, profuse,forcible and occur without pain any time from three o’clock to nine in the morning, and a natural stool is apt to follow later in the day. It occurs, too, immediately after eating and colic, which is relieved by warmth and bending forward. Sensation of great weakness in the abdomen and rectum, this weakness of the rectum being a great characteristic of the remedy. The rectum prolapses before the faeces are evacuated; here it differs from the prolapses of rectum.
Podophyllum has proved useful in the diarrhea of dentition when cerebral symptoms are present. Sometimes a headache will alternate with the diarrhea.
The great characteristics of Podophyllum may be thus summed up:
- Early morning stools.
- Watery, pasty yellow or undigested stools, forcibly expelled.
- Weakness in the rectum following stool.
Straining at stool is the great characteristic of Mercurius, and this is more marked under Mercurius corosivus than under the solubilis. The former is the great homoeopathic remedy for dysentery. It may be remarked, in passing, that the allopaths have recently discovered this application of Mercurius corrosivus. The stools of Mercury are slimy and bloody, accompanied by a straining and tenesmus which does not seem to let up; so we have what is characteristically described as a never-get-done-feeling. There is accompanying, much hepatic soreness, flabby tongue taking imprint of the teeth, and before the stool there is violent urging and perhaps chilliness. Bayes praises Mercurius in a diarrhea of yellow or clay-colored stool. A sickly smell from the mouth is characteristic of the remedy, and if the ready perspiration so characteristic of Mercurius be present the choice is easy. Prolapsus of the rectum may follow the stool.
Calcarea should never be overlooked in any intestinal trouble; as we have seen, it is one of the great remedies for sour stools, and for undigested stools. It is one of our best remedies for chronic diarrhea, its symptoms produced by the provers are very few, yet prescribed for its general symptoms it has proved very useful, for it is just in a genuine Calcarea patient that one usually finds diarrhea. Diarrhea occurring during dentition in infants with open fontanelles call for Calcarea. Calcarea carbonica is more suited to fat children. In the Calcarea carbonica patient there is usually a ravenous appetite, and, as in Phosphoric acid, the stools do not seem to weaken.
Phosphorous is especially a remedy for chronic forms of diarrhea. It has green mucous stools worse in the morning, often undigested and painless. The stools pass as soon as they enter the rectum,and contain white particles like rice or tallow. Chronic,painless diarrhea of undigested food call sometimes for Phosphorus. It is profuse and forcible and aggravated by warm food, and the patient often vomits; in fact, one of the characteristics of Phosphorous is the vomiting of what has been drunk as soon as it becomes warm in the stomach. With the diarrhea there is a weak, gone feeling in the stomach, and perhaps burning between the shoulders. The frog spawn, or sago, or grain of tallow stool is most characteristic of the remedy.
Argentum nitricum is quite similar to Arsenic in many ways. The stools are green, slimy and bloody,like chopped spinach in flakes. Aconite has a green stool like spinach. With the stool there is a discharge of flatus and much spluttering, as in Calcarea Phosphorica. The stools are worse from any candy, sugar, or from drinking. The sudden attacks of cholera infantum in children who have eaten too much candy will often be removed by Argentum nitricum. The children are thin, dried up looking, and it seems as if the child had but one bowel and that extended from the mouth to the anus. Another characteristic of Argentum nitricum is its use in diarrhea brought on by great mental excitement, emotional disturbance, etc.
It is one of the most prominent remedies for diarrhea produced by fright or fear; it appears suddenly and the stools are yellow and papescent. Opium has diarrhea from fright and so has Veratrum album. Pulsatilla, too, may be indicated in diarrhea from fright; the stools are greenish yellow and changeable. Dulcamara has diarrhea from changes in the weather or in temperature, as in those employed in packing house who change frequently from hot to cold, or diarrhea in the mountains where the midday is hot and the nights excessively cool.There are a number of minor remedies for diarrhea , but these very minor remedies become of major importance when they are closely indicated.