Prolonged Diarrhea: What Could It Be?

Diarrhea is defined as passage of loose or watery stools more frequently than usual. Experts consider diarrhea as stooling 3 or more times in a day. Usually, people with diarrhea pass watery or loose stools.  


Diarrhea can be acute, persistent or chronic depending on how long it lasts. Acute diarrhea lasts for a few days usually; persistent diarrhea lasts for about 2-4 weeks while chronic diarrhea lasts for a month or more. Acute diarrhea is typically caused by viruses or bacteria that infect the gut from contaminated food and drinks, and usually resolves on its own; but when diarrhea lasts more than a few days, there is something much more to worry about.   

Causes of prolonged diarrhea include  


  1. Irritable Bowel Syndrome (IBS): This is a disorder of the gut that has diarrhea or constipation as a major feature. Diarrhea in IBS is usually recurrent and can last for prolonged periods. This syndrome is identified by a combination of symptoms (abdominal pain, abdominal distension, etc.) in the absence of an identifiable disease. It is one of the common causes of prolonged diarrhea and is often associated with psychological disorders including depression.  
  2. Inflammatory Bowel Disease (IBD): In IBD, there is damage to all or part of the digestive tract. It is composed of two types; Crohn’s disease and ulcerative colitis. IBD is characterized by diarrhea, blood in stools, abdominal pain, fatigue, and weight loss. The cause of IBD is not known but some risk factors include heredity, age (common in 15-35 years), race, cigarette smoking and use of over-the-counter pain killers, such as Ibuprofen and Diclofenac.  
  3. Malabsorption syndromes: These are conditions that prevent absorption of nutrients through the small intestine. These diseases result in bloating, weight loss and diarrhea. Causes range from infection, surgery, worm infestations, and prolonged antibiotic use to digestive diseases such as celiac disease, chronic inflammation of the pancreas.  
  4. HIV/AIDS: Acquired Immune deficiency syndrome depletes the body’s immune system, making all parts of the body vulnerable to minor infections. In the gut, immune cells become depleted and opportunistic infections including worms infect the gut and cause prolonged diarrhea that does not stop until the virus is subdued and the immune system is boosted.  
  5. Small intestinal bacterial overgrowth (SIBO): This disorder occurs when there is an abnormal increase in the overall bacterial population in the small intestine. SIBO usually occurs when there is a slowing of food and waste products as they pass through the digestive tract which can be due to disease processes or surgical complications. Symptoms include loss of appetite, diarrhea, bloating and unintentional weight loss. It is usually treated with antibiotics and surgery.  


Diarrhea is a very common symptom and in most cases resolves on its own or with just rehydration; however, diarrhea could last several weeks. In this case, it is usually caused by a serious condition that needs to be addressed first. If you notice continuous stooling, especially if watery or loose, visit your doctor for evaluation and treatment.   

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