Diarrhea is loose and watery stool that happens more than three times per day. Diarrhea is common — most adults will experience it at least once a year, and children at least twice a year.
Diarrhea has many causes, including bad food, infection, and medication side effects. It can also be related to another medical condition. Diarrhea is often short lived and resolves on its own within a few days. Other times, it’s related to a chronic (long-term) medical issue or becomes a chronic issue itself. Here’s a general breakdown of diarrhea categories by time:
Acute diarrhea lasts several days (and not more than 2 weeks). It usually gets better on its own. Often the cause is a virus or something you ate or drank.
Chronic diarrhea lasts more than 4 weeks. Causes include another health condition or medications you take.
It’s important to see your healthcare provider when diarrhea is ongoing or associated with other symptoms, like dehydration, weight loss, or pain.
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Everyone gets loose stools every now and then. When it’s brief and gets better, it’s likely nothing to worry about. Diarrhea can cause a range of symptoms — including loose, frequent, and watery stool. It can also cause abdominal pain, bloating, or nausea and vomiting.
While most cases of diarrhea get better on their own, there are some warning signs to look out for. It’s very important to see a healthcare provider if you have any of the following:
Diarrhea that doesn’t improve after 2 days
Severe abdominal pain
High fevers (102°F or above)
Blood or pus in your stool
Ongoing vomiting
Black, tarry stools (which can be from bleeding in the gastrointestinal tract)
Dehydration and inability to drink fluids
Infections with bacteria, viruses, or parasites can all cause diarrhea. The most common ways to catch these infections are from contact with other people, unsanitary conditions, or contaminated water or food. Here are some common causes of infectious diarrhea:
Viruses, such as norovirus and rotavirus (viral gastroenteritis)
Bacteria, including Campylobacter, Escherichia coli, Salmonella, and Shigella
Parasites, such as Giardia lamblia, Entamoeba histolytica, and Cryptosporidium enteritis
There are many medical conditions that can cause diarrhea. These include:
Irritable bowel syndrome (IBS)
Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis
Food intolerance, such as celiac disease or lactose intolerance
Gallbladder disease
Malabsorption or digestive enzyme deficiencies
Many medications may cause diarrhea, too. Common medications that can cause diarrhea as a side effect include:
Antibiotics: including penicillins, like amoxicillin, cephalosporins, like cephalexin and clindamycin
Laxatives: including senna
Acid-blocking medications: such as proton pump inhibitors, like pantoprazole (Protonix)
Diabetes medications: including metformin
Antidepressants: including SSRIs, like sertraline (Zoloft) and escitalopram (Lexapro)
Blood pressure medication: such as beta blockers, like metoprolol, and ACE inhibitors, like lisinopril
If you have ongoing diarrhea, you’ll need to see your healthcare provider to get to the bottom of the cause. They’ll first ask you questions about your symptoms and then consider additional testing.
Diarrhea can have different characteristics that help identify the underlying cause. It can be helpful to bring your healthcare provider a symptom journal that includes:
Timing: How long have you had the diarrhea?
Color: Is your diarrhea watery, green, yellow, bloody, or black?
Other symptoms: Do you have any abdominal pain, fevers, weight loss, or vomiting with the diarrea?
Consistency: Is the diarrhea very loose and watery, or is it more pebbly and formed? The Bristol Stool Scale can help describe this.
Triggers: What other factors might contribute, such as food, medications, or stress levels?
Your provider may order additional testing to help figure out what is causing your diarrhea, such as:
Blood tests: to check for a thyroid disorder, anemia, or other vitamin or nutrient deficiencies
Stool tests: to look for bacterial or parasitic causes of diarrhea
Breath test: to look for lactose intolerance
Imaging studies: such as an X-ray, CT scan, or MRI to evaluate organs
Sigmoidoscopy or colonoscopy: to look inside the intestines
Treatment for diarrhea often depends on the cause. Foodborne or other viral causes of diarrhea often resolve on their own within a few days. But there may be some ways to ease your symptoms.
If your diarrhea doesn’t get better within a few days, you’ll want to talk with your healthcare provider about the cause and what treatment might be right for you.
Treatments for diarrhea include:
Taking antibiotics for bacterial infections
Taking antiparasitic medication for parasitic infections
Making diet changes to avoid fatty, fried, or fibrous foods (you can try a simple and bland BRAT diet for a short time)
Avoiding food triggers, such as with an elimination diet
Taking over-the-counter treatments may help control your diarrhea, such as loperamide (Imodium), to slow down movement through the intestines
Getting intravenous (IV) fluids if you’re dehydrated and can’t drink enough liquids
Taking probiotics (healthy gut bacteria) for some types of diarrhea (these can help restore a healthy balance of gut microbes)
Since many causes of diarrhea are common viruses and bacteria, you can often prevent them with some basic healthy habits, like:
Washing your hands regularly
Cooking and cleaning your food
Drinking pasteurized milk and cheese
Not eating foods that have been sitting out
Not drinking tap water when traveling
Not eating raw meat or fish
Diarrhea can be serious when it causes dehydration. You can lose a lot of fluid through diarrhea, which is why it’s important to drink fluids and stay hydrated when you have it. Signs of dehydration include fatigue, headache, dry lips, and decreased urination.
Stress can lead to physical changes in your body, such as diarrhea. The nerves in your gut can react to anxiety, fear, and stress. This commonly happens in people with irritable bowel syndrome (IBS), but it can also happen in people without underlying gut conditions.
Antibiotics can be lifesaving, but they commonly cause stomach upset and diarrhea. While they treat harmful bacteria, they can also affect healthy bacteria that we need. You’ll want to talk with your healthcare provider about ways to keep your microbiome healthy, such as through fiber, food choices, and probiotics.
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MedlinePlus. (2016). Diarrhea.
National Center for Complementary and Integrative Health. (2019). Probiotics: What you need to know.
National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Diarrhea.
National Institute of Diabetes and Digestive and Kidney Diseases. (2016). Diagnosis of diarrhea.
National Institute of Diabetes and Digestive and Kidney Diseases. (2016). Symptoms & causes of diarrhea.
Nemeth, V., et al. (2021). Diarrhea. StatPearls.