Diarrhoea

Author: Dr. Veena Deo

Diarrhoea:

Abnormally frequent intestinal evacuations with more or less fluid stools. It is also defined as the passage of loose, watery stools with increased frequency. Diarrhea is common in all age groups. Diarrhea is subjective, but the regular passage of more than three stools per day, or the passage of a large amount of stools (more than 300 gm per day) can certainly be known as Diarrhea.

Gastroenterologists define Diarrhea as the passage of more than 200g of stool daily, and measurement of stool volume helps confirm this. It occurs as a result of dietary indiscretion or due to viral or bacterial infection. Diarrhoea is common in all age groups. Mostly, it occurs due to an infection in the alimentary canal by viruses & bacteria. If sanitation is poor, then the food gets contaminated by Enterotoxigenic E-coli & produces diarrhoea. The growth of bacteria in the small intestine, inflammatory bowel diseases, infectious diseases, intake of polluted water, etc., causes diarrhoea. Non-steroidal anti-inflammatory drugs, antibiotics, and chemotherapy drugs also cause diarrhoea. The parasite Cyclospora produces diarrhoea. The most severe symptom in a number of patients is an urgency of defecation, and faecal incontinence is common in acute and chronic diarrheal illness.

Acute Diarrhea:

This is extremely common and usually due to fecal-oral transmission of bacteria, viruses, and parasites. The infective diarrhoea is usually short-lived.

Chronic or relapsing diarrhoea:

Chronic diarrhoea should raise the possibility of inflammatory bowel disease or malabsorption with steatorrhea. Steatorrhea is the passage of pale, bulky stools containing excess fats that commonly float in water and are difficult to flush away. The most common cause of Chronic or relapsing diarrhoea is irritable bowel syndrome. In this type of Diarrhea, the frequency of defecation and loose watery or pellet stools increased.

Symptoms: Diarrhea rarely occurs at night. It becomes more severe before and after breakfast. In the remaining time, the patient has a problem of constipation and there may be the symptoms of irritable bowel syndrome. Mucus is present in the stools. 24-hour stool volume is less than 200g.

Chronic Diarrhea can be categorized as a disease of the colon or small bowel or malabsorption.

Malabsorption:

Diarrhoea and weight loss in patients with a normal diet will always lead to the suspicion of malabsorption. A few patients may have normal bowel habits, but diarrhoea is usual and it may be watery and voluminous. In some patients, Bulky pale stools, and offensive stools which float in the toilet show fat malabsorption. Cramps, weight loss, abdominal distension, and undigested food may be present in the stools. Some patients complain about malaise and lethargy.

We can summarize it as:

Colonic –

Clinical Features: Blood and mucus in stool, cramping lower abdominal pain.

Causes: Inflammatory bowel disease, Neoplasia (the presence or formation of new, abnormal growth of tissue.), irritable bowel syndrome.

Malabsorption -

Clinical Features: Steatorrhea, undigested food in the stool, weight loss, nutritional disturbances.

Causes: Cancer of the pancreas, Cystic fibrosis.

Small bowel -

Clinical Features: Large volume watery stool, abdominal bloating, cramping mid-abdominal pain.

Causes: Drug-induced - NSAID, Aminosalicylates.

Ref: Hutchison’s Clinical Methods – Edited by – Michael Glynn. William Drake Davidson’s Principles and Practice of Medicine

Herbs To Treat Diarrhea:

Aegle marmelos (Bael) – The fruits are always used in chronic diarrhoea. Possesses anti-amoebic, carminative, astringent, and digestive properties.

Ref: (Wealth of India, rev Vol 1, 1985 CSIR, 80-90- Ayurvedic Drugs & their plant sources, Sivarajan VV & Indira Balachandan, 1994, 515)

Cyperus rotundus (Musta) is Useful in diarrhoea, dysentery, and other disorders of the stomach & irritation of the bowels.

(IMM, 429, ADPS, 316, Glossary of Indian Medicinal plants, Chopra RN et al, 1956, 88)

Holarrhena antidysenterica (Katu Indrajao)( Kurchi) is a popular drug for chronic dysentery & diarrhoea. A decoction of Holarrhena antidysenterica & Aegle marmelos (Bael) fruit is found to be beneficial in mucous diarrhoea with blood.

Punica – granatum (Pomegranate) Highly effective in chronic diarrhoea, dysentery, dyspepsia & colitis Ref (ADPS, 123, IMM, 1034)

Natural Home Remedies:

Intake of curd along with ginger juice is advisable.
Barley water and carrot soup are beneficial.
Drink buttermilk after adding a little amount of roasted cumin seed powder & a little amount of black salt.
Drink boiled water.
Increase fluid intake.
Avoid dairy products.
Add lemon juice & sugar to the fresh juice of Indian gooseberry and drink it.

In diarrhoea, it is necessary to replenish the potassium which the body loses during diarrhoea. Hence eat bananas. Bananas are an excellent source of potassium.

Drink buttermilk after adding a little amount of roasted cumin seed powder & a little amount of black salt. Add a little pinch of Turmeric powder in buttermilk & drink it.

Prepare the juice of the Drumstick, then mix it with a glass of coconut water & ½ teaspoon of honey it. Take this twice a day.

Mix fresh mint juice with honey & lime juice & drink it.

Drink a mixture of boiled water, salt & sugar. Sip it. This prevents dehydration of the body. Eat freshly cooked food.

Make a mixture of Sonth (Dry ginger) with rock salt. Take it along with jaggery twice a day. It will help to reduce diarrhoea occurring due to indigestion.

Pomegranate juice is also advisable.

Powdered dry seeds of Mango. Then mix this powder with a little bit of honey & take it.

Though I have mentioned the quantity of ingredients in some Natural Home Remedies, consult the Ayurvedic Physician for the quantity of ingredients and also for Natural Home Remedies before taking it.