Chronic causes
Chronic causes of watery diarrhea are those that are longer-lasting or more difficult to treat and may require hospitalization.
- Chronic infections (C. Difficile, Campylobacter): Some infections like C. difficile occur in part because of treatment for other diseases. C. difficile is a bacteria that lives peacefully in a normal bowel as it is often kept at low levels by normal gut bacteria. However, if you’re taking antibiotics or have a suppressed immune system, C. difficile may grow unchecked. Often treatment of C. difficile requires hospitalization for monitoring and proper treatment to avoid dangerous levels of dehydration. It is often (but not always) first treated with the antibiotic vancomycin.
- Inflammatory bowel disease: This can affect either the small intestine, large intestine, or both. It may produce watery diarrhea, bloody diarrhea, mucus-laden diarrhea or a mixture of the three. It is commonly treated with drugs that temper and lower the immune response. If you have long-standing watery diarrhea that does not respond to antibiotics, you may have inflammatory bowel disease or irritable bowel syndrome. However, a proper diagnosis will require a colonoscopy (or a scope usually inserted through the anus) to examine the walls of the intestines.
- Irritable bowel syndrome (IBS): This can have many different kinds of symptoms. It can cause constipation (IBS-C), diarrhea (IBS-D), or mixed (IBS-M). Irritable bowel syndrome with diarrhea also causes abdominal pain or discomfort. Treatments vary widely from avoiding food triggers and lactose and increasing consumption of fiber and physical activity levels. IBS is only diagnosed after inflammatory bowel disease or cancer has been ruled out.
Food poisoning
Food poisoning, also called foodborne illness or "stomach flu," is an acute infection of the digestive tract from food contaminated with bacteria, viruses, parasites, or other toxins. It actually has no relation to influenza.
Any food can become contaminated if not prepared under clean conditions, cooked thoroughly, or stored at cold temperatures. Meat, fish, dairy products, and fresh fruits and vegetables are some of the most easily contaminated foods.
Symptoms include nausea, vomiting, diarrhea, and abdominal pain, and sometimes fever and chills.
Most people recover on their own with supportive care, meaning rest, fluids, and over-the-counter pain relievers and fever reducers.
However, dehydration can result if the vomiting and/or diarrhea are not controlled and IV fluids may be needed.
If there is also blurred vision, dizziness, or paralysis, the nervous system may be affected due to botulism. This is a medical emergency. Take the patient to the emergency room or call 9-1-1.
Proper food preparation and storage, along with frequent and thorough handwashing, is the best prevention.
Rarity: Common
Top Symptoms: nausea, abdominal pain (stomach ache), headache, abdominal cramps (stomach cramps), dizziness
Symptoms that never occur with food poisoning: severe fever, being severely ill, bloody diarrhea
Urgency: Self-treatment
Diarrhea caused by a bacteria called vibrio
The Vibrio genus of bacteria causes nausea, vomiting, and diarrhea that can be very serious. Vibrio parahaemolyticus and Vibrio vulnificus are two of the species that cause this illness, which is also called vibriosis.
The primary risk factor is eating raw or undercooked seafood, especially oysters from any coastal waters and from the Gulf of Mexico in particular. People with weakened immune systems or liver disease are especially vulnerable to this infection.
Symptoms include fever, vomiting, and diarrhea, sometimes with mental confusion. These symptoms in a person who has recently eaten raw seafood, or has been swimming in ocean or bay water, are considered a medical emergency. Take the patient to the emergency room or call 9-1-1.
Some types of Vibrio-caused illness can worsen very quickly and lead to dehydration and septicemia, which can be life-threatening.
Diagnosis is made through patient history, physical examination, and lab tests on blood, urine, and stool samples.
Treatment will usually involve hospitalization for intravenous fluids, antibiotics, and supportive care.
Rarity: Rare
Top Symptoms: diarrhea, nausea, stomach bloating, headache, abdominal cramps (stomach cramps)
Symptoms that always occur with diarrhea caused by a bacteria called vibrio: diarrhea
Urgency: Self-treatment
Viral (norovirus) infection
Norovirus infection is caused by the highly contagious Norwalk virus. It spreads when any trace of stool or vomit from an infected person contaminates food or drink, or gets onto any surface. Anyone who consumes the food or drink, or touches the surface and then their mouth, will become infected.
Norovirus brings on severe gastrointestinal upset which is very unpleasant but rarely dangerous. Symptoms include diarrhea, vomiting, stomach pain, fever, and body aches for one to three days. The greatest risk is dehydration due to the severity of the symptoms.
Because norovirus is, indeed, a virus, antibiotics will not help. The best treatment is good supportive care, which means providing plenty of fluids along with mild pain relievers until the patient recovers. Do not give aspirin to children.
If the dehydration does not improve quickly, medical help should be sought. Doctors can provide IV fluids through recovery.
The best prevention is frequent and thorough handwashing, as well as washing all fruits and vegetables. All foods must be properly cooked, especially shellfish.
Traveler's diarrhea
Traveler's diarrhea is a digestive tract disorder that commonly causes loose stools and abdominal cramps. It's caused by eating contaminated food or drinking contaminated water.
You can safely treat this condition by drinking lots of fluids to avoid dehydration. Taking an antidiarrheal medication such as loperamide (Imodium) may help as well.
Rarity: Common
Top Symptoms: diarrhea, nausea, abdominal pain (stomach ache), fever, stomach bloating
Symptoms that always occur with traveler's diarrhea: diarrhea
Symptoms that never occur with traveler's diarrhea: anxiety
Urgency: Self-treatment
Shigella infection
Shigella infection, or shigellosis, is an intestinal infection caused by a strain of Shigella bacteria.
Shigellosis is highly contagious through fecal matter. Anyone coming into contact with any trace of feces in food, drink, or surfaces can get the disease. Swimming in contaminated water, even in a chlorinated pool or hot tub, is another source of infection.
Most susceptible are young children; travelers to less developed regions; and anyone with a weakened immune system.
Symptoms include fever; abdominal pain and cramps; and severe diarrhea, which may contain blood.
If not treated, there is the risk of dehydration due to the diarrhea and fever. Young children are especially susceptible.
Diagnosis is made through patient history, physical examination, and testing of a stool sample.
Treatment involves rest and fluids. Most cases clear up within a week. Sometimes antibiotics are used in more severe cases, though antibiotics are not effective against some forms of Shigella bacteria.
The best prevention is frequent and thorough handwashing, and good hygiene when preparing food.
Rarity: Rare
Top Symptoms: diarrhea, general abdominal pain, severe diarrhea, watery diarrhea, fatigue
Symptoms that always occur with shigella infection: diarrhea
Urgency: Self-treatment
Normal occurrence of diarrhea
Diarrhea can be an indication of serious illness – especially in young children – but in some cases it has a much simpler cause and can be easily cured.
If there are simply frequent loose stools – three or more times per day – without other symptoms of illness, the most common cause is food or drink.
Overuse of caffeine, beer, or wine has a laxative effect on some individuals. The artificial sweeteners sorbitol and mannitol are known laxatives, as are some herbal supplements and some over-the-counter vitamin and mineral preparations.
Lactose intolerance, or the inability to digest the natural sugar in milk, causes digestive upset and diarrhea.
Diarrhea can cause dehydration and mineral imbalance no matter what the cause, so it is still important to manage it.
The best treatment is to remove some items or supplements from the diet and watch the results. This will show which items are causing the diarrhea.
It's always wise to use any new supplements in moderation so that if the trouble recurs, the cause will be plain.
Rarity: Common
Top Symptoms: diarrhea, mild diarrhea
Symptoms that always occur with normal occurrence of diarrhea: diarrhea
Symptoms that never occur with normal occurrence of diarrhea: bloody diarrhea, severe diarrhea, worsening diarrhea, being severely ill, ill appearance
Urgency: Self-treatment
Microscopic colitis
Microscopic colitis is caused by inflammation of the large intestine than can only be seen with a microscope. It is believed that microscopic colitis is caused by an overly aggressive immune response to a certain trigger that can be related to medication, an infection, autoimmune diseases, genetics, or a malabsorption of bile.
Symptoms primarily include watery diarrhea accompanied by abdominal pain, cramps or discomfort, and an urgency to use the restroom.
Treatment depends on the cause, such as halting offensive drugs and taking anti-diarrheal medication or steroids. It is also important to make sure you stay hydrated throughout the recovery period.
Rarity: Rare
Top Symptoms: fatigue, nausea, diarrhea, abdominal pain (stomach ache), stomach bloating
Symptoms that always occur with microscopic colitis: diarrhea
Symptoms that never occur with microscopic colitis: bloody diarrhea
Urgency: Primary care doctor
Intestinal infection with ameba parasite
Visiting or living in places with poor sanitation can lead to parasite infections that can cause long-lasting diarrhea and stomach pain.
You should go see a primary care physician (PCP) soon. Diagnosing parasite infections reuires stool samples at a PCP, and its treatment involves prescription anti-parasitic medications that a PCP would then prescribe.
Rarity: Rare
Top Symptoms: nausea, loss of appetite, diarrhea, constipation, general abdominal pain
Urgency: Primary care doctor
Food poisoning by the staphylococcus bacteria
Food poisoning, also called foodborne illness or "stomach flu," is an acute infection of the digestive tract from food contaminated with bacteria, viruses, parasites, or other toxins. It actually has no relation to influenza.
Any food can become contaminated if not prepared under clean conditions, cooked thoroughly, or stored at cold temperatures. Meat, fish, dairy products, and fresh fruits and vegetables are some of the most easily contaminated foods.
Symptoms include nausea, vomiting, diarrhea, and abdominal pain, and sometimes fever and chills.
Most people recover on their own with supportive care, meaning rest, fluids, and over-the-counter pain relievers and fever reducers.
However, dehydration can result if the vomiting and/or diarrhea are not controlled and IV fluids may be needed.
If there is also blurred vision, dizziness, or paralysis, the nervous system may be affected due to botulism. This is a medical emergency. Take the patient to the emergency room or call 9-1-1.
Proper food preparation and storage, along with frequent and thorough handwashing, is the best prevention.
Rarity: Uncommon
Top Symptoms: nausea, nausea or vomiting, diarrhea, abdominal cramps (stomach cramps), vomiting
Symptoms that always occur with food poisoning by the staphylococcus bacteria: nausea or vomiting
Urgency: Self-treatment
Questions your doctor may ask about watery diarrhea
- Any fever today or during the last week?
- Have you experienced any nausea?
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
- Have you lost your appetite recently?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
