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	Diarrhea
	Definition
	Diarrhea is an increase in the frequency, volume, or liquid content of the stool.
	Cause
	Diarrhea can result from the inability of the intestine to absorb nutrients, salt, and water properly, or from a number of conditions that cause the intestine to lose (secrete) fluid and salt. Infections of the gastrointestinal tract in otherwise healthy people. Viruses (e.g., rotavirus, adenovirus, Norwalk virus), bacteria (e.g., Campylobacter, Salmonella, Shigella, E. coli, Vibrio cholerae), and parasites (e.g., Giardia, amoeba) can each cause diarrhea. Various strains of E. coli are typical causes of traveler's diarrhea. Infections in immunocompromised hosts such as patients with AIDS or patients receiving immunosuppressive medication. In addition to getting the "usual" infections listed above, immunocompromised patients may become infected with more "unusual" organisms such as Mycobacterium avium and cytomegalovirus. Food poisoning and drug or food allergies. Acute conditions such as inflammation of the large or small intestine, as with ileitis or colitis, pelvic inflammation, and toxic shock syndrome. Rectal sexually transmitted diseases, especially in homosexual men. Chronic or recurrent diarrhea may be caused by irritable bowel syndrome, inflammatory bowel disease, parasitic and fungal infections, food allergies, colon cancer, diverticulitis, malabsorption syndromes, and heavy metal poisoning. Tumors, whether benign or malignant, can damage the cells of the intestine or cause the intestines to actively secrete increased amounts of salt and water, as with rare tumors found in carcinoid syndrome and Zollinger-Ellison syndrome. Antibiotics can cause alteration of the normal intestinal flora and production of colitis secondary to Clostridium difficile toxin. Other medications, such as quinidine, magnesium-containing antacids (Maalox, Mylanta), chemotherapy, bile acids, laxatives, potassium, and prostaglandins. Alcohol can increase intestinal contraction and cause diarrhea. See also: 'Effects of Alcohol Abuse' Running. "Runner's diarrhea" can occur during or immediately after jogging or running. The cause is unclear but may be related to diet (intake of sugar, causing an osmotic diarrhea, or fiber), abnormal gastric emptying and intestinal fluid absorption, or release of neuropeptides or prostaglandins during exercise. Preventive measures include gradually increasing exercise rather than plunging into a strenuous regimen, avoiding food for several hours prior to a run, and attempting to have a bowel movement prior to exercise. Under the guidance of a physician, medication may be attempted. Cystic fibrosis, chronic pancreatitis, and other diseases of the pancreas, an organ responsible for making digestive enzymes, can cause a decrease in enzyme formation, which can in turn lead to malabsorption, diarrhea, and malnutrition. Endocrine disorders such as hyperthyroidism, Addison's disease, and in some cases diabetes mellitus (which may also cause constipation).
	Diagnosis
	If you have diarrhea, you pass watery or loose stools (24 small unformed bowel movements daily are diarrhea). Often, the causes of diarrhea can be traced in a medical history. A variety of physical and laboratory tests, such as rectal examination to exclude occult blood in the stool, sigmoidoscopy, and culture of the stool for bacteria and parasites, may be undertaken depending on the circumstances. Patients should try to note whether the diarrhea stops during fasting, because this may establish malabsorption as a cause rather than a secretory disorder. Food poisoning may be suggested if multiple people eating the same meal develop diarrhea or vomiting.
	Treatment
	Most bouts of diarrhea are not associated with fever or intestinal bleeding and are self-limited they last a limited time and then cease without treatment. Unless significant dehydration occurs, it may be best not to treat mild diarrhea for the first few hours, since the body may be purging itself of an intestinal infection. If diarrhea persists, use of a kaolin-pectin preparation or bismuth is often helpful. Aluminum-containing antacid (such as Amphojel) can also give symptomatic relief. Temporarily avoiding high-fiber foods, dairy products, and sugar-containing drinks may also help until a self-limited infection is resolved. If these medications don't relieve the diarrhea promptly, or if there is fever, vomiting, abdominal pain, or blood in the stool, the patient should consult a doctor. In cases of severe diarrhea, the first line of treatment may be fluids for rehydration and to restore electrolyte balance. Diarrhea is sometimes caused by antibiotics and may necessitate their discontinuation. If C. difficile toxin is a cause, treatment with Vancomycin or Flagyl is usually prescribed. Infectious diarrhea may necessitate treatment with antibiotics; however, often the infection is self-limited and does not require treatment. Some physicians prescribe yogurt or lactobacillus as a way of restoring the normal ecological balance of the intestines by replacing intestinal bacteria destroyed by the antibiotics. Pregnant women should consult their doctors before taking any medication.
	Prevention
	If you have problems with periodic diarrhea, keeping a food diary may enable you to correlate diarrhea with ingestion of a particular food. Avoiding the offending food may then alleviate future diarrhea episodes.
	Home Remedies and Alternative Therapies
	Yogurt or lactobacillus may alleviate some cases of diarrhea, and rice may also be helpful. Oral hydration is extremely important, especially in infants, who may quickly become dehydrated. Chicken soup with rice is excellent because the glucose and amino acids help transport sodium and water from the intestine to the bloodstream. Rice-ORS (oral rehydration solution) has been found extremely effective in treating dehydration due to diarrhea and is a valuable form of treatment in underdeveloped countries. All cases of protracted diarrhea should be evaluated by a physician.