Diarrhoea is an extremely common symptom involving loose or liquid bowel movements and frequent or speedy trips to the loo. It is also often accompanied by cramping pain in the lower abdomen. It can make you feel quite exhausted and if you’re on holiday it can ruin your fun.
Most attacks of diarrhoea are caused by gastro-intestinal infections – you can think of them as the body’s way of getting rid of harmful substances. If more than one member of your family suffers at the same time, it is likely the diarrhoea was caused by something you’ve all eaten. If you have just come back from a trip away, you might have been exposed to standards of hygiene that do not match up to what you are used to, resulting in what we know as lioliday tummy’. If your diarrhoea is accompanied by vomiting, food poisoning is also a likely cause. Gastric flu could be the culprit, too.
Another common cause of diarrhoea is stress. A job interview or a driving test can reduce the toughest of us to a bundle of nerves. Eating large amounts of food with laxative properties, such as prunes, can have an adverse effect. Diarrhoea can be a side-effect of taking certain drugs – antibiotics, for example. Tetracycline, a commonly prescribed antibiotic, can destroy friendly bacteria which normally live in the bowel and are part of our natural defences against more harmful bacteria. Consequently, if they are destroyed, the harmful ones – perhaps resistant to the antibiotic – can thrive. But if this happens to you, don’t just stop taking the antibiotics. Ring your doctor and ask for advice.
Whatever the cause, most attacks of diarrhoea usually clear up quickly and without medical attention. The best way to treat yourself is not eating for 24 hours and drinking plenty of watery drinks. Frequent bursts of diarrhoea can make you feel even more ill as your body becomes dehydrated. The greatest risk from diarrhoea, and from vomiting too, is that the body’s essential minerals are lost at the same time. Mineral depletion of this nature can make you feel weak and eventually faint. In a healthy person, water is essential to maintain normal body functions. Its importance is underlined by the fact that around half our body weight is water. Normally our kidneys balance the water lost in the urine and through perspiration against our fluid intake – we feel more thirsty and therefore drink more in hot weather, for instance.
Diarrhoea or sickness causes excessive loss of fluid, but if we are feeling ill, we may not feel thirsty. This means that our water balance is upset and we will continue to feel unwell until the fluid balance is restored.
To prevent mineral loss and dehydration you can buy ready-prepared sachets to be mixed with water, which are a combination of essential salts, minerals and energy-giving glucose. (This is known as oral rehydration therapy.) When these are mixed with the correct quantity of water as instructed, they are just the right strength for quick absorption, even by an inflamed stomach.
Medicines used to treat diarrhoea include powders which form a bulky mass inside the bowel to help carry away irritant substances. Typical examples are aluminium silicate (kaolin), calcium carbonate (chalk) and pectin (a purified carbohydrate product made from citrus fruits). Preparations made with these powders contain particles that swell up as they absorb water from the large intestine. This makes the faeces firmer and less runny. It’s thought that these powders may absorb irritants and harmful chemicals along with the excess water.
Other drugs act on the muscular bowel wall to slow down bowel movements, relieving the familiar griping pains caused by diarrhoea. Typical examples are drugs from the opium family like codeine phosphate or morphine, which is usually mixed with kaolin.
In normally healthy adults, diarrhoea is rarely a serious condition – children and the elderly may suffer much more. This is because they are more sensitive to the problems of dehydration and often have less body fluid to lose. Babies under six months old are at the greatest risk from dehydration – their metabolic rate is high, their kidneys don’t yet retain water very efficiently and they lose a greater proportion of water compared to their weight than adults do.
But even if you’re a healthy adult, you should always consult your doctor if the condition doesn’t improve within 48 hours, if the faeces contain blood, if there is severe abdominal pain or vomiting, or if you’ve just returned from a foreign country.
To help avoid gyppy tummy and the holiday runs – or worse – be careful with the ice in those long, cool drinks. Researchers writing in the British Food Journal pointed out some time ago that in Central America, four harmful germs were shown to survive even when frozen for 24 hours – and were still flourishing when melted in 86% proof tequila!
In the UK, hygiene standards can sometimes be inadequate when ice-making machines are sited in dirty, poorly ventilated areas, like cellars, and are not cleaned or serviced regularly. Ice is often put into the glass with the server’s fingers and, in one survey, only half the ice-buckets were found to have lids – so dust and germs could float in. The researchers found germ contamination in ice-making machines as well as ice-buckets at the bar. More than one in two samples in the survey contained germs – and a large proportion of those were of the kind that could occur if someone didn’t wash their hands after using the loo.
So, in future, when you are being careful about the cleanliness of your food and drink on holiday, beware of the If the only available restaurant or bar doesn’t look too clean, stick to the contents of mass-produced bottled drinks and thoroughly cooked food.
Arret, Adult Kao-C and Junior Kao-C, Gluco-Lyte, Imodium, Opazimes, Rapolyte