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ZOE Science And Nutrition Summary : Chronic diarrhea? Here's what to do | Dr. Will Bulsiewicz

Podcast: ZOE Science And Nutrition
9 min. read

— Description —

We’ve all had unpleasant toilet experiences in our time. It can be distressing to deal with and not something we like talking about. But when does normal diarrhea become chronic? And when do we need to seek medical care? In today’s episode, Jonathan and Dr Will ask what is chronic diarrhea and how can we rule out something more serious? Will also shares tricks of the trade to ease your symptoms and tells us how our amazing guts work to keep our whole body healthy. Download our FREE guide — Top 10 Tips to Live Healthier: If you want to uncover the right foods for your body, head to and get 10% off your personalized nutrition program. Mentioned in today’s episode: Chronic Diarrhea by Garrett J. Descoteaux-Friday; Isha Shrimanker from the National Library of Medicine Chronic Diarrhea by Cleveland Clinic Diarrhea From John Hopkins Medicine Diarrhea From Stamford Medicine Healthcare Exocrine Pancreatic Insufficiency (EPI) From Loma Linda University Health Episode transcripts are available here. Is there a nutrition topic you’d like us to explore? Email us at [email protected], and we’ll do our best to cover it.

Chronic diarrhea? Here's what to do | Dr. Will Bulsiewicz

Key Takeaways

  • Chronic diarrhea is defined as loose or watery stools occurring three or more times within 24 hours for at least four weeks
  • Symptoms include anal irritation, loss of bowel control, abdominal discomfort, and an urgent need to use the restroom
  • Red flag signs to look for include rectal bleeding, intense abdominal pain, fever, and low iron levels without explanation
  • Gastroenterologists recommend seeking medical care earlier for those with a family history of inflammatory bowel disease or colorectal cancer, as well as for individuals over age 50
  • Chronic diarrhea can be caused by various conditions such as inflammatory bowel disease, C
  • difficile infection, celiac disease, and food intolerance
  • It can also be a side effect of gallbladder removal
  • Diagnosis of chronic diarrhea may involve stool tests, blood tests, and imaging tests, as well as invasive procedures like sigmoidoscopy or colonoscopy
  • Treatment strategies include dietary modifications, hydration, and the use of probiotics and prebiotic supplements
  • It is important to address chronic diarrhea early to avoid dehydration and malnutrition
  • Seeking help from a GP and discussing symptoms openly can make a difference in improving health and quality of life

- Understanding and Managing Chronic Diarrhea: Symptoms, Causes, and Treatment

  • The most important thing is to understand the underlying cause of the diarrhea.
  • Chronic diarrhea is defined as loose or watery stools, which happens three or more times within 24 hours
  • This is at least four weeks of this type of diarrhea
  • Anal irritation and loss of bowel control are common symptoms of chronic diarrhea
  • Abdominal discomfort and urgent need to use the restroom are also symptoms to watch out for
  • Chronic diarrhea should be seen by a doctor to avoid dehydration or malnutrition
  • Diarrhea could be a sign of something more serious and should be addressed early
  • Gastroenterologists look for red flag signs in such cases

- Medical Care and Diagnosis for Gastrointestinal Issues: When to Seek Help and Diagnostic Procedures

  • Red flag signs to look for include rectal bleeding, progressive or intense abdominal pain, fever, and low iron levels without explanation
  • Family history of inflammatory bowel disease or colorectal cancer are also reasons to seek medical care earlier
  • Age is a factor to consider, and people over age 50 should take these conditions more seriously
  • There are different ways to diagnose chronic diarrhea
  • Colonoscopy and sigmoidoscopy are conceptually similar diagnostic tools
  • With a sigmoidoscopy, the prep is more straightforward and you don't have to completely evacuate your bowels
  • Colonoscopy is recommended for colon cancer screening in the United States, which is a different approach compared to the UK

- Infectious Causes and Treatment of Chronic Diarrhea: Focus on C. Diff Infection

  • Viruses should not be causing chronic diarrhea.
  • Usually, we think about things like something called Clostridioides difficile, which you've probably heard of and I've mentioned it before as C. diff.
  • This usually occurs after people take antibiotics.
  • If you've had chronic diarrhea, my question is, have you had any recent courses of antibiotics?
  • One of the classic antibiotics where people develop C. diff infection afterwards is clindamycin
  • The way that we would diagnose C. diff is with a stool test and you don't have to go to the hospital to get a stool test
  • Diagnose C. diff with a stool test, which can be done at a GP's office
  • Avoid taking anti-diarrhea medicine when you have an infection, as it can slow down the body's process of shedding the infection
  • Before taking anti-diarrhea medicines, get stool tests done to confirm it's not a bacterial infection causing the diarrhea

- Effective Management of Chronic Diarrhea: Saccharomyces bouardii and Prebiotic Supplements

  • Using dietary strategies is important for managing chronic diarrhea
  • Temporarily cutting out dairy and artificial sweeteners can potentially improve symptoms
  • Removing gluten-containing foods, alcohol, and caffeine can also help alleviate symptoms
  • Consuming alcohol or coffee can exacerbate the problem and lead to chronic diarrhea
  • Many medications and supplements such as magnesium, non-steroidal anti-inflammatory drugs, vitamin C supplements, metformin, and antibiotics can cause diarrhea
  • Classic medications for chronic diarrhea include magnesium, non-steroidal anti-inflammatory drugs like ibuprofen or aspirin, vitamin C supplements, metformin for diabetes, and antibiotics
  • Staying hydrated is crucial for managing chronic diarrhea
  • Water, broth, and the BRAT diet (bananas, rice, applesauce, and toast) are recommended for managing symptoms of chronic diarrhea
  • For short-term improvement of diarrhea symptoms, trying bananas, rice, applesauce, and toast can be beneficial as they are starchy and help to bind up the stool.
  • Transitioning away from water towards more solid foods can substantially improve symptoms, including urgency.
  • Supplements like Saccharomyces bouardii have clear data to be helpful and beneficial in managing diarrhea.
  • Saccharomyces bouardii is a probiotic with a recommended dose of five grams per day
  • It is a yeast probiotic, which is beneficial and good for health
  • It has been extensively studied, with more research than many other probiotics
  • It is not a trendy new probiotic, but a tried and true one
  • Prebiotic supplements, specifically fiber supplements, can help in forming up the stool
  • Partially hydrolyzed guar gum (PHGG) is one of the prebiotic supplements that can really help in forming up the stool
  • Chronic diarrhea is defined as three or more loose watery stools per day for at least four weeks

- Comprehensive Understanding and Improvement of Digestive Issues: Quality of Life and Treatment Approaches

  • Chronic diarrhea is defined as three or more loose, watery stools per day for at least four weeks
  • Important questions to understand the cause of chronic diarrhea include: Are you pooping at night? Have you taken antibiotics recently? Did you have your gallbladder removed?
  • Testing for chronic diarrhea could include stool tests, blood tests, imaging tests, sigmoidoscopy, or colonoscopy
  • Invasive testing like sigmoidoscopy or colonoscopy may be essential for diagnosis and should not be avoided
  • It's absolutely essential in order to get the diagnosis and so don't be fearful or avoidant of those things because they can be so beneficial and helpful in terms of understanding it.
  • There's certain dietary strategies that we could use, specifically a temporary elimination of dairy, artificial sweeteners, caffeine, alcohol, spicy foods, fatty foods.
  • Try to improve those symptoms while we get to the bottom of this.
  • A big part of what I have done throughout my career as a gastroenterologist is to focus on improving people's quality of life.
  • Focus on improving people's quality of life is a big part of the speaker's career as a gastroenterologist
  • Many people are suffering with gastrointestinal issues and may not want to talk about it openly
  • Delivering information and seeking help from a GP can make a difference in improving health