Diarrhea

What is diarrhea?

Diarrhea is loose, watery stools (bowel movements). You have diarrhea if you have loose stools three or more times in one day. Acute diarrhea is diarrhea that lasts a short time. It is a common problem. It usually lasts about one or two days, but it may last longer. Then it goes away on its own.

Diarrhea lasting more than a few days may be a sign of a more serious problem. Chronic diarrhea -- diarrhea that lasts at least four weeks -- can be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual, or they may come and go.

What causes diarrhea?

The most common causes of diarrhea include:

Bacteria from contaminated food or water
Viruses such as the flu, norovirus, or rotavirus . Rotavirus is the most common cause of acute diarrhea in children.
Parasites, which are tiny organisms found in contaminated food or water
Medicines such as antibiotics, cancer drugs, and antacids that contain magnesium
Food intolerances and sensitivities, which are problems digesting certain ingredients or foods. An example is lactose intolerance.
Diseases that affect the stomach, small intestine, or colon, such as Crohn's disease
Problems with how the colon functions, such as irritable bowel syndrome

Some people also get diarrhea after stomach surgery, because sometimes the surgeries can cause food to move through your digestive system more quickly.

Sometimes no cause can be found. If your diarrhea goes away within a few days, finding the cause is usually not necessary.

Who is at risk for diarrhea?

People of all ages can get diarrhea. On average, adults In the United States have acute diarrhea once a year. Young children have it an average of twice a year.

People who visit developing countries are at risk for traveler's diarrhea. It is caused by consuming contaminated food or water.

What other symptoms might I have with diarrhea?

Other possible symptoms of diarrhea include:

Cramps or pain in the abdomen
An urgent need to use the bathroom
Loss of bowel control

If a virus or bacteria is the cause of your diarrhea, you may also have a fever, chills, and bloody stools.

Diarrhea can cause dehydration, which means that your body does not have enough fluid to work properly. Dehydration can be serious, especially for children, older adults, and people with weakened immune systems.

When do I need to see a health care provider for diarrhea?

Although it is usually not harmful, diarrhea can become dangerous or signal a more serious problem. Contact your health care provider if you have:

Signs of dehydration
Diarrhea for more than 2 days, if you are an adult. For children, contact the provider if it lasts more than 24 hours.
Severe pain in your abdomen or rectum (for adults)
A fever of 102 degrees or higher
Stools containing blood or pus
Stools that are black and tarry

If children have diarrhea, parents or caregivers should not hesitate to call a health care provider. Diarrhea can be especially dangerous in newborns and infants.

How is the cause of diarrhea diagnosed?

To find the cause of diarrhea, your health care provider may:

Do a physical exam
Ask about any medicines you are taking
Test your stool or blood to look for bacteria, parasites, or other signs of disease or infection
Ask you to stop eating certain foods to see whether your diarrhea goes away

If you have chronic diarrhea, your health care provider may perform other tests to look for signs of disease.

What are the treatments for diarrhea?

Diarrhea is treated by replacing lost fluids and electrolytes to prevent dehydration. Depending on the cause of the problem, you may need medicines to stop the diarrhea or treat an infection.

Adults with diarrhea should drink water, fruit juices, sports drinks, sodas without caffeine, and salty broths. As your symptoms improve, you can eat soft, bland food.

Children with diarrhea should be given oral rehydration solutions to replace lost fluids and electrolytes.

Can diarrhea be prevented?

Two types of diarrhea can be prevented - rotavirus diarrhea and traveler's diarrhea. There are vaccines for rotavirus. They are given to babies in two or three doses.

You can help prevent traveler's diarrhea by being careful about what you eat and drink when you are in developing countries:

Use only bottled or purified water for drinking, making ice cubes, and brushing your teeth
If you do use tap water, boil it or use iodine tablets
Make sure that the cooked food you eat is fully cooked and served hot
Avoid unwashed or unpeeled raw fruits and vegetables

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Encephalitis

Encephalitis is an inflammation of the brain. Usually the cause is a viral infection, but bacteria can also cause it. It can be mild or severe. Most cases are mild. You may have flu-like symptoms. With a mild case, you may just need rest, plenty of fluids, and a pain reliever.

Severe cases need immediate treatment. Symptoms of severe cases include:

Severe headache
Sudden fever
Drowsiness
Vomiting
Confusion
Seizures

In babies, additional symptoms may include constant crying, poor feeding, body stiffness, and bulging in the soft spots of the skull.

Severe cases may require a stay in the hospital. Treatments include oral and intravenous (IV) medicines to reduce inflammation and treat infection. Patients with breathing difficulties may need artificial respiration. Some people may need physical, speech, and occupational therapy once the illness is under control.

NIH: National Institute of Neurological Disorders and Stroke

Fatty Liver Disease

What is fatty liver disease?

Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Fatty liver disease is a condition in which fat builds up in your liver. There are two main types:

Nonalcoholic fatty liver disease (NAFLD)
Alcoholic fatty liver disease, also called alcoholic steatohepatitis

What is nonalcoholic fatty liver disease (NAFLD)?

NAFLD is a type of fatty liver disease that is not related to heavy alcohol use. There are two kinds:

Simple fatty liver, in which you have fat in your liver but little or no inflammation or liver cell damage. Simple fatty liver typically does not get bad enough to cause liver damage or complications.
Nonalcoholic steatohepatitis (NASH), in which you have inflammation and liver cell damage, as well as fat in your liver. Inflammation and liver cell damage can cause fibrosis, or scarring, of the liver. NASH may lead to cirrhosis or liver cancer.

What is alcoholic fatty liver disease?

Alcoholic fatty liver disease is due to heavy alcohol use. Your liver breaks down most of the alcohol you drink, so it can be removed from your body. But the process of breaking it down can generate harmful substances. These substances can damage liver cells, promote inflammation, and weaken your body's natural defenses. The more alcohol that you drink, the more you damage your liver. Alcoholic fatty liver disease is the earliest stage of alcohol-related liver disease. The next stages are alcoholic hepatitis and cirrhosis.

Who is at risk for fatty liver disease?

The cause of nonalcoholic fatty liver disease (NAFLD) is unknown. Researchers do know that it is more common in people who:

Have type 2 diabetes and prediabetes
Have obesity
Are middle aged or older (although children can also get it)
Are Hispanic, followed by non-Hispanic whites. It is less common in African Americans.
Have high levels of fats in the blood, such as cholesterol and triglycerides
Have high blood pressure
Take certain drugs, such as corticosteroids and some cancer drugs
Have certain metabolic disorders, including metabolic syndrome
Have rapid weight loss
Have certain infections, such as hepatitis C
Have been exposed to some toxins

NAFLD affects about 25% of people in the world. As the rates of obesity, type 2 diabetes, and high cholesterol are rising in the United States, so is the rate of NAFLD. NAFLD is the most common chronic liver disorder in the United States.

Alcoholic fatty liver disease only happens in people who are heavy drinkers, especially those who have been drinking for a long period of time. The risk is higher for heavy drinkers who are women, have obesity, or have certain genetic mutations.

What are the symptoms of fatty liver disease?

Both NAFLD and alcoholic fatty liver disease are usually silent diseases with few or no symptoms. If you do have symptoms, you may feel tired or have discomfort in the upper right side of your abdomen.

How is fatty liver disease diagnosed?

Because there are often no symptoms, it is not easy to find fatty liver disease. Your doctor may suspect that you have it if you get abnormal results on liver tests that you had for other reasons. To make a diagnosis, your doctor will use:

Your medical history
A physical exam
Various tests, including blood and imaging tests, and sometimes a biopsy

As part of the medical history, your doctor will ask about your alcohol use, to find out whether fat in your liver is a sign of alcoholic fatty liver disease or nonalcoholic fatty liver (NAFLD). He or she will also ask which medicines you take, to try to determine whether a medicine is causing your NAFLD.

During the physical exam, your doctor will examine your body and check your weight and height. Your doctor will look for signs of fatty liver disease, such as:

An enlarged liver
Signs of cirrhosis, such as jaundice, a condition that causes your skin and whites of your eyes to turn yellow

You will likely have blood tests, including liver function tests and blood count tests. In some cases you may also have imaging tests, like those that check for fat in the liver and the stiffness of your liver. Liver stiffness can mean fibrosis, which is scarring of the liver. In some cases you may also need a liver biopsy to confirm the diagnosis, and to check how bad the liver damage is.

What are the treatments for fatty liver disease?

Doctors recommend weight loss for nonalcoholic fatty liver. Weight loss can reduce fat in the liver, inflammation, and fibrosis. If your doctor thinks that a certain medicine is the cause of your NAFLD, you should stop taking that medicine. But check with your doctor before stopping the medicine. You may need to get off the medicine gradually, and you might need to switch to another medicine instead.

There are no medicines that have been approved to treat NAFLD. Studies are investigating whether a certain diabetes medicine or Vitamin E can help, but more studies are needed.

The most important part of treating alcohol-related fatty liver disease is to stop drinking alcohol. If you need help doing that, you may want to see a therapist or participate in an alcohol recovery program. There are also medicines that can help, either by reducing your cravings or making you feel sick if you drink alcohol.

Both alcoholic fatty liver disease and one type of nonalcoholic fatty liver disease (nonalcoholic steatohepatitis) can lead to cirrhosis. Doctors can treat the health problems caused by cirrhosis with medicines, operations, and other medical procedures. If the cirrhosis leads to liver failure, you may need a liver transplant.

What are some lifestyle changes that can help with fatty liver disease?

If you have any of the types of fatty liver disease, there are some lifestyle changes that can help:

Eat a healthy diet, limiting salt and sugar, plus eating lots of fruits, vegetables, and whole grains
Get vaccinations for hepatitis A and B, the flu and pneumococcal disease. If you get hepatitis A or B along with fatty liver, it is more likely to lead to liver failure. People with chronic liver disease are more likely to get infections, so the other two vaccinations are also important.
Get regular exercise, which can help you lose weight and reduce fat in the liver
Talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices. Some herbal remedies can damage your liver.

Giant Cell Arteritis

Giant cell arteritis is a disorder that causes inflammation of your arteries, usually in the scalp, neck, and arms. It narrows the arteries, which keeps blood from flowing well. Giant cell arteritis often occurs with another disorder called polymyalgia rheumatica. Both are more common in women than in men. They almost always affect people over the age of 50.

Early symptoms of giant cell arteritis resemble the flu: fatigue, loss of appetite, and fever. Other symptoms include:

Headaches
Pain and tenderness over the temples
Double vision or visual loss, dizziness
Problems with coordination and balance
Pain in your jaw and tongue

Your doctor will make the diagnosis based on your medical history, symptoms, and a physical exam. There is no specific test for giant cell arteritis, but you may have tests that measure inflammation.

Treatment is usually with corticosteroids. Early treatment is important; otherwise there is a risk of permanent vision loss or stroke. However, when properly treated, giant cell arteritis rarely comes back.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Guillain-Barre Syndrome

Guillain-Barre syndrome is a rare disorder that causes your immune system to attack your peripheral nervous system (PNS). The PNS nerves connect your brain and spinal cord with the rest of your body. Damage to these nerves makes it hard for them to transmit signals. As a result, your muscles have trouble responding to your brain. No one knows what causes the syndrome. Sometimes it is triggered by an infection, surgery, or a vaccination.

The first symptom is usually weakness or a tingling feeling in your legs. The feeling can spread to your upper body. In severe cases, you become almost paralyzed. This is life-threatening. You might need a respirator to breathe. Symptoms usually worsen over a period of weeks and then stabilize.

Guillain-Barre can be hard to diagnose. Possible tests include nerve tests and a spinal tap. Most people recover. Recovery can take a few weeks to a few years. Treatment can help symptoms, and may include medicines or a procedure called plasma exchange.