(Woodpath is an education site focused exclusively on gut health. Our articles are researched by clinical nutritionists and contain citations at the end of the page.)
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Chronic diarrhea is a digestive disorder that causes loose stools that persist for a minimum of four weeks.
People suffering from chronic diarrhea usually have three or more loose bowel movements each day, often accompanied by abdominal pain.
Chronic diarrhea can have a significant impact on your overall health. At its most severe it can be life-threatening, as is the case when an infection such as Clostridium difficile is the cause.
Fortunately, there are effective ways to treat it. We recommend specific supplements at the bottom of this page. But first let’s understand the causes behind chronic diarrhea, as well as the multitude of ways to treat it, including dietary changes.
Causes
Several conditions can cause chronic diarrhea, including:
Crohn’s Disease
Crohn’s disease is an inflammatory bowel disease, which impedes the body’s ability to absorb nutrients. In people who suffer from this disorder, the digestive tract becomes inflamed.
This inflammation can cause a number of symptoms including chronic diarrhea and severe abdominal pain.
Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. IBS is a common cause of chronic diarrhea, bloating, gas, and abdominal pain. In some cases of IBS,
chronic diarrhea can alternate with bouts of constipation.
Ulcerative Colitis
Ulcerative colitis is an inflammatory bowel disease that causes inflammation and ulceration of the lining of the large intestine and the rectum. Ulcerative colitis is a debilitating disease that can cause chronic diarrhea. This chronic diarrhea may contain blood or mucus. Ulcerative colitis may also lead to unwanted weight loss.
Celiac Disease
Celiac disease is an autoimmune condition. Sufferers of this disease are unable to eat gluten because it will cause damage to their small intestine. Gluten can be found in rye, wheat, triticale, oats, and barley. Some people who have celiac disease also experience chronic diarrhea.
Bacteria and Parasite
Contaminated food or water can cause an infection in your body. Common bacterial causes of chronic diarrhea include:
- Salmonella
- Escherichia coli
- Shigella
- Campylobacter
- Clostridium difficile (often acquired in hospital settings)
These bacteria can cause chronic diarrhea, particularly when you are traveling in developing countries. You can detect this type of infection with a stool sample test or, in some cases, blood tests.
Sugars and Artificial Sweeteners
Some sugars and artificial sweeteners can cause chronic diarrhea if they are consumed daily. These include:
- Fructose: This naturally occurring sugar is found in fruit and honey. It may also be added to carbonated beverages and candy.
- Sorbitol: This is a sugar substitute used in gum, candy, and other sugar-free foods.
- Mannitol: This is also a sugar substitute used in gum, candy, and other sugar-free foods.
- Xylitol: A popular sugar substitute used in baking and processed foods.
- Erythritol: Behaves differently to the other sugar alcohols (-ols) listed above. The body mostly absorbs it, preventing it from reaching the colon where digestive side effects typically occur.
Lactose Intolerance
Lactose intolerance can also cause chronic diarrhea because the body is unable to absorb this sugar. It is the most common food intolerance and can cause abdominal pain as well as watery stools.
Allergies
Although uncommon, food allergies can be a cause of chronic diarrhea. If you are not sure which food is causing your allergic reaction, allergy testing may help. If the test shows up nothing, yet symptoms remain, consider an elimination diet.
This is a diet where certain suspect foods are avoided for a few weeks, then gradually reintroduced. It allows you to determine which food is causing the problem.
Medications
Certain medications — such as chemotherapy, antibiotics or Metformin for diabetes — can cause chronic diarrhea. As well as reacting to the medication itself, an additive such as a filler, flavoring, or color can trigger chronic diarrhea. Some medications can also disrupt the balance of beneficial bacteria in your gut, which may also cause chronic diarrhea.
How to Treat Your Chronic Diarrhea
Traditionally, chronic diarrhea is treated with anti-diarrheal medications such as a kaolin-pectin suspension or bismuth subsalicylate.
While these medications may reduce the severity of your symptoms, they do not speed up recovery or treat the underlying causes. In some circumstances, they can prolong or worsen chronic diarrhea.
The BRAT Diet
If you suffer from chronic diarrhea, the first thing to do is make dietary adjustments. You could try following the BRAT diet.
BRAT stands for Banana, Rice, Applesauce, and Toast. By minimizing your meals to these food options, you can prevent overstimulation of the lining of your bowel and slow down the frequency of bowel movements.
However, this diet should only be followed in the short-term — it is hardly nutritionally adequate.
Dietary Modifications
There are other dietary modifications you can make to alleviate chronic diarrhea; these include:
- Drink 8-10 cups of liquid per day, such as broth, water, diluted juice, or weak tea.
- Eat small meals frequently throughout the day.
- Limit your intake of fried or fatty foods.
- Add soluble fiber to your diet to help firm bowel movements.
- Avoid foods and beverages with high sugar content.
Fiber Supplements
Soluble fiber can help chronic diarrhea by absorbing excess water in the bowel and bulking up the stool. Women should aim for 25 grams of fiber per day. Men should aim for 38 grams. Introduce fiber gradually each day over two to three weeks so that you do not experience gas and bloating.
Probiotic Supplements
A large group of microorganisms that make up the ecosystem of the normal gastrointestinal tract is known as the gut microbiome. They keep your digestive system healthy, protect your immune system, and promote good health.
Probiotic supplements match those found in the gut microbiome, which makes up the ecosystem of the normal gastrointestinal tract. However, the strains available in supplements are just the tip of the iceberg compared to the thousands of strains in the gut.
An imbalanced population of microorganisms in your gut is known as dysbiosis. One of the symptoms of dysbiosis is chronic diarrhea. Taking a daily probiotic supplement can reduce your symptoms of chronic diarrhea and get your bowel movements back to normal.
The most helpful probiotic strain for diarrhea is Saccharomyces boulardii, a friendly yeast. Taking this form of probiotic during and after a course of antibiotics can reduce your chance of having diarrhea, as long as they are taken a few hours away from antibiotics. It is also helpful for a chronic infection that causes diarrhea such as Clostrium difficile.
If your chronic diarrhea is due to an inflammatory or immune disorder, Saccharomyces boulardii and Lactobacillus acidophilus can help.
Chronic diarrhea should not be ignored. Make the necessary dietary changes as soon as possible so that you can minimize your symptoms and reduce their duration.
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