Diarrhea

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Diarrhea?

You must be passing loose stools 3 or more times a day.
Pharmacist

This can go away on its own or be a sign of a serious problem or lead to dehydration.



Lady with diarrhea

Before we continue, let's make sure you are not looking at a medical emergency.

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The most common cause is a viral infection of the digestive track. Bacteria and parasites can also cause diarrhea and this can be very contagious. This will usually be preceded by nausea and vomiting.

Diarrhea of any duration may cause dehydration, which means the body lacks enough fluid and electrolytes to function properly.

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Diarrhea

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How serious?

In addition to this diarrhea are you also feeling faint or dizzy?
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Yes?
You have to watch out for dehydration which can be dangerous.
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Are you getting more confused with things around you?
Pharmacist

 

Seek urgent care or emergency room visit.
Pharmacist

Here is why:

  • You may be facing severe dehydration and electrolyte imbalance
  • If you are too weak, go to the nearest emergency room now.

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Is your mouth feeling dry or sticky?
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Seek urgent care or emergency room visit.
Pharmacist

Here is why:

  • You may be looking at severe dehydration and electrolyte imbalance.
  • If you are feeling very weak, go to the nearest emergency room now

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Do you feel you are breathing abnormally?
Pharmacist

 

Seek urgent care or emergency room.
Pharmacist

Here is why:

  • Sign of dehydration

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Would you say your heart rate has increased dramatically since this diarrhea?
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Seek urgent care or emergency room.
Pharmacist

Here is why:

  • Sign of dehydration

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Are your eyes looking blood shot?
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Seek urgent care or emergency room.
Pharmacist

Here is why:

  • Possibly suffering from severe dehydration
  • Possibly suffering from electrolyte imbalance.

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Has it been more than 8 hours since the diarrhea started..

..and you have not had a urine output?
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Seek urgent care or call the doctor.
Pharmacist

Here is why:

  • Sign of a possible dehydration.

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Gently pinch and release your skin in the stomach area.

Did it flatten back to normal right away?
Pharmacist

 

Seek urgent care or emergency room visit.
Pharmacist

Here is why:

  • Possibly getting dehydrated.
  • When dehydrated, the skin does not flatten back to normal right away after being gently pinched and released.

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You just went through signs of a posssible dehydration.
Pharmacist

If you were told to seek urgent care or emergency room visit, please do.

Dehydration can quickly result in coma, organ damage and ultimately death.

If this is not the case with you, let's take a look at the nature of the diarrhea and determine if you can ride it out or need to see a doctor as soon as possible.

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Diarrhea

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Need a doctor?

Any blood in the watery stool?
Pharmacist

 

Seek urgent care or emergency room.
Pharmacist

Here is why:

  • Possible bacteria or parasites invading your bowels.
  • Tests to determine the cause of the blood in the stool is required.
  • Maroon-colored or bright red blood often mean that the blood is coming from the small or large intestine, rectum, or anal area.
  • If this keeps happening you may be looking at an inflammatory bowel disease.

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Do you also have a fever above 101°F with this diarrhea?
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Seek urgent care or call the doctor.
Pharmacist

Here is why:

  • Possible bacteria, viral or parasite invasion.

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Is it watery, oily and you also have stomach cramps?

Including gas?
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Seek urgent care or call your doctor.
Pharmacist

Here is why:

  • You may have bacteria or parasite related diarrhea.
  • Need antibiotics for bacteria or parasite related diarrhea.
  • OTC antidiarrhea medications may prolong the problem.

Meanwhile, drink a lot of fluids to prevent dehydration and stay away from caffeine.

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Do you have middle abdominal pain, back pain with this diarrhea?

And a high fever?
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Seek urgent care or call your doctor.
Pharmacist

Here is why:

  • Symptoms of gallbladder disease
  • Symptoms of pancreatitis

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Are you experiencing severe lower abdominal pain, cramping with this diarrhea?

And feeling bloated?
Pharmacist

 

Seek urgent care or emergency room visit.
Pharmacist

Here is why:

  • May be looking at intestinal blockage.
  • Consider this an emergency especially if the pain is severe.

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What about stomach pain or cramps...

...And you also have blood and/or mucus in the stool?
Pharmacist

 

Seek urgent care or call your doctor.
Pharmacist

Here is why:

  • Your bowels may be inflammed.
  • Possibly looking at inflammatory bowel disease or Crohn's disease.

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Were you constipated before and all of a sudden you are having watery diarrhea?
Pharmacist

 

Seek urgent care or call your doctor.
Pharmacist

Here is why:

  • You may be looking at fecal impaction.
  • There may be a large mass of dry hard stool trapped in the rectum.

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Did you travel overseas lately?
Pharmacist

 

Seek urgent care or call your doctor.
Pharmacist

Here is why:

  • You may have traveler's diarrhea caused by contaminated food or drink.
  • You will need antibiotics to deal with this.

 


The nature of the diarrhea can help you make a good decision on what to do.
Pharmacist

Let's see what we can come up with.

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Diarrhea

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What is the nature?

Did the diarrhea start after you ate dairy products like ice cream, yogurt, cream cheese?

Or drank some milk?
Assuming they were in good condition.
Pharmacist

 

Yes?
The diarrhea may be due to lactose intolerance.
Pharmacist

In this case, you are having problems digesting lactose (sugar found in milk products).

Know that certain types of sugar substitutes in excessive quantities can also cause diarrhea.

 

Is the diarrhea watery and you have a low grade fever?

Including body ache, headache?
Pharmacist

 

Yes?
You may be looking at a stomach flu situation.
Pharmacist

You need to prevent dehydration by drinking lots of fluid. Get plenty of rest.

If the fever is very high or the symptoms last for more than 10 days, then you will have to see a doctor.

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Stomach Flu

 

Is the volume of the diarrhea large?

Very watery or fatty?
And you know it is not what you ate.
Pharmacist

 

Yes?
The problem is most likely with the small intestine.
Pharmacist

If it continues for more than 2 days, you will have to see a doctor for this.

It could be due to your gall bladder, nerves, something speeding up movement of the intestines or even has to do with your throid hormones.

 

Is this more like small but frequent stools?

Mostly with abdominal pain?
Pharmacist

 

Yes?
The problem is likely with the colons or large intestine.
Pharmacist

If you don't know what is causing this, give the doctor a call. You may need to do colonoscopy.

Another possible cause is IBS (Irritable bowel syndrome). With IBS, the abdominal pain will be relieved after using the bathroom.

 

Are you currently taking any of the medications listed below?
Pharmacist

Such as:

  • Laxatives
  • Magnesium containing antacids
  • Antibiotics
  • Colchicine
  • Quinine/quinidine
  • Caffeine
  • Antineoplastic drugs
  • Elixirs with lactose in them.
  • SSRIs
  • Cholinesterase inhibitors (Aricept, Exelon, Razadyne, Cognex)

 

Yes?
These can cause diarrhea. Discuss this with the doctor if it is severe.
Pharmacist

 

Have you taken any antibiotic within the past 2 months?
Pharmacist

 

Yes?
Antibiotics can cause diarrhea even up to 2 months later.
Pharmacist

They kill both the good and bad bacteria in the intestines. If the good ones are not replaced on time while the bad ones grew faster, this can lead to diarrhea.

Also diarrhea causing bacteria such as Clostridium difficile can grow after the use of antibiotics.

 

Alright.
The goal with diarrhea is to prevent dehydration and electrolyte loss.
Pharmacist

Signs of dehydration include:

  • Dark colored urine
  • Thirst
  • Dry or sticky mouth
  • Dry skin
  • Feeling dizzy or lightheaded
  • Low or no urine output
  • Sunken eyes

Let's see what a pharmacist recommend for diarrhea that is available over the counter.

But before that just one more question.

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Diarrhea

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How many times have you been to the bathroom since it all started?
Pharmacist


Pharmacist

Not too bad so far.

If you don't think you need to seek urgent care from the discussions so far, the goal will be to prevent dehydration.

Let's see what a pharmacist recommend for this or would you like to see the nearest urgent care clinic to you?

Getting bad?

If you don't think you need to seek urgent care from the discussions so far, the goal will be to prevent dehydration and let it run its course.

Let's see what a pharmacist recommend for this or would you like to see the nearest urgent care clinic to you?

Bad?

If you don't think you need to seek urgent care from the discussions so far, the goal will be to prevent dehydration and let it run its course.

If you think you are dehydrated, seek urgent care.

If for some reason you cannot seek urgent care, let's see what a pharmacist recommend over the counter to help prevent further dehydration.