Diarrhoea & Constipation
Diarrhea refers to an increase in the frequency or a decrease in the consistency of stools, making them loose or watery. It can be classified as:
Acute diarrhea – lasting less than 28 days
Chronic diarrhea – lasting more than 4 weeks
Acute diarrhea is usually infectious in origin and often resolves on its own. Treatment mainly includes oral or intravenous fluids to prevent dehydration, and in some cases, antibiotics or antiparasitic medications may be used.
Chronic diarrhea, on the other hand, is usually due to diseases of the small intestine, large intestine, or pancreatic disorders.
Causes of Chronic Diarrhea:
Small Intestinal Causes:
- Celiac disease
- Tropical sprue
- Giardiasis and other parasitic infections
- Whipple’s disease
- Small bowel tuberculosis
- Crohn’s disease of the small intestine
- Common variable immunodeficiency and other immune-related disorders
- Small intestinal bacterial overgrowth (SIBO)
Large Intestinal Causes:
- Ulcerative colitis
- Crohn’s disease (involving the colon)
- Microscopic colitis
- Colorectal cancer or polyps
- Lymphoma of the colon
- Radiation colitis (after radiotherapy)
- Ischemic colitis (due to poor blood flow to the colon)
Pancreatic Causes:
- Chronic pancreatitis
- Cystic fibrosis
Other Causes:
Hormonal or endocrine disorders that cause excessive fluid secretion in the intestines
Diagnosis:
To identify the cause, doctors usually recommend:
- Stool examination
- Blood tests
- Endoscopy and colonoscopy
- Biopsies of the intestine when needed
Treatment is then directed toward the underlying cause.
Constipation:
Constipation is defined as infrequent bowel movements (less than one stool every three days) or a noticeable change from a person’s normal bowel pattern.
Common Causes of Constipation:
- Slow bowel movement (lazy colon)
- Hormonal disorders such as hypothyroidism
- Diabetes mellitus
- Electrolyte imbalances, such as high calcium (hypercalcemia) or low potassium (hypokalemia)
- Side effects of certain medications (e.g., painkillers, iron supplements, antidepressants)
- Obstructive lesions in the colon, such as large polyps or tumors
- Anal fissures, which cause pain and make passing stool difficult
Evaluation:
To find the cause, tests may include:
- Blood investigations
- Colonoscopy
- Cross-sectional imaging (CT/MRI)
- Anal manometry (to assess rectal muscle function)
Diarrhoea and Constipation Treatment:
Treatment focuses on addressing the underlying cause — whether it’s a metabolic, structural, or functional problem — along with dietary changes and medications as needed.