Diarrhea with Uncertain Cause (Adult)

Diarrhea is when stools are loose and watery. This can be caused by:

  • Viral infections

  • Bacterial infections

  • Food poisoning

  • Parasites

  • Irritable bowel syndrome (IBS)

  • Inflammatory bowel diseases such as ulcerative colitis, Crohn's disease, and celiac disease

  • Food intolerance, such as to lactose, the sugar found in milk and milk products

  • Reaction to medicines like antibiotics, laxatives, cancer medicines, and antacids

Along with diarrhea, you may also have:

  • Abdominal pain and cramping

  • Nausea and vomiting

  • Loss of bowel control

  • Fever and chills

  • Bloody stools

In some cases, antibiotics may help to treat diarrhea. You may have a stool sample test which is done to see what is causing your diarrhea, and if antibiotics will help treat it. The results of a stool sample test may take up to 2 days. The healthcare provider may not give you antibiotics until they have the stool test results.

Diarrhea can cause dehydration. This is the loss of too much water and other fluids from the body. When this occurs, you must replace those body fluids. This can be done with oral rehydration solutions. Oral rehydration solutions are available at drugstores and grocery stores without a prescription. Sports drinks are not the best choice if you are very dehydrated. They usually have too much sugar and not enough electrolytes.

Home care

Follow all instructions given by your healthcare provider. Rest at home for the next 24 hours, or until you feel better. Avoid caffeine, tobacco, and alcohol. These can make diarrhea, cramping, and pain worse.

If taking medicines:

  • Over-the-counter nausea and diarrhea medicines are generally OK unless you experience fever or blood in the stool. Check with your healthcare provider first in those circumstances.

  • You may use acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen to reduce pain and fever. Don’t use these if you have chronic liver or kidney disease, or ever had a stomach ulcer or gastrointestinal bleeding. Don't use NSAID medicines if you are already taking one for another condition (like arthritis) or are on daily aspirin therapy (such as for heart disease or after a stroke). Talk with your healthcare provider first.

  • If antibiotics were prescribed, be sure you take them until they are finished. Don’t stop taking them even when you feel better. Antibiotics must be taken exactly as prescribed.

To prevent the spread of illness:

  • Remember that washing with soap and clean, running water and using alcohol-based sanitizer is the best way to prevent the spread of infection. Dry your hands with a single-use towel (like a paper towel).

  • Clean the toilet after each use.

  • Wash your hands before eating.

  • Wash your hands before and after preparing food. Keep in mind that people with diarrhea or vomiting should not prepare food for others.

  • Wash your hands after using cutting boards, counter tops, and knives that have been in contact with raw foods.

  • Wash and then peel fruits and vegetables.

  • Keep uncooked meats away from cooked and ready-to-eat foods.

  • Use a food thermometer when cooking. Cook poultry to at least 165°F (74°C). Cook ground meat (beef, veal, pork, lamb) to at least 160°F (71°C). Cook fresh beef, veal, lamb, and pork to at least 145°F (63°C).

  • Don’t eat raw or undercooked eggs (poached or sunny side up), poultry, meat, or unpasteurized milk and juices.

Food and drinks

The main goal while treating vomiting or diarrhea is to prevent dehydration. This is done by taking small amounts of liquids often.

  • Keep in mind that liquids are more important than food right now.

  • Drink only small amounts of liquids at a time.

  • Don’t force yourself to eat, especially if you are having cramping, vomiting, or diarrhea. Don’t eat large amounts at a time, even if you are hungry.

  • If you eat, avoid fatty, greasy, spicy, or fried foods.

  • Don’t eat dairy foods or drink milk if you have diarrhea. These can make diarrhea worse.

During the first 24 hours you can try:

  • Oral rehydration solutions.  Sports drinks may be used if you are not too dehydrated and are otherwise healthy.

  • Soft drinks without caffeine

  • Ginger ale

  • Water (plain or flavored)

  • Decaf tea or coffee

  • Clear broth, consommé, or bouillon

  • Gelatin, ice pops, or frozen fruit juice bars

The second 24 hours, if you are feeling better, you can add:

  • Hot cereal, plain toast, bread, rolls, or crackers

  • Plain noodles, rice, mashed potatoes, chicken noodle soup, or rice soup

  • Applesauce, unsweetened canned fruit (no pineapple)

  • Bananas

As you recover:

  • Limit fat intake to less than 15 grams per day. Don’t eat margarine, butter, oils, mayonnaise, sauces, gravies, fried foods, peanut butter, meat, poultry, or fish.

  • Limit fiber. Don’t eat raw or cooked vegetables, fresh fruits except bananas, or bran cereals.

  • Limit caffeine and chocolate.

  • Limit dairy.

  • Don’t use spices or seasonings except salt.

  • Go back to your normal diet over time, as you feel better and your symptoms improve.

  • If the symptoms come back, go back to a simple diet or clear liquids.

Follow-up care

Follow up with your healthcare provider, or as advised. If a stool sample was taken or cultures were done, call the healthcare provider for the results as instructed.

Call 911

Call 911 if you have any of these symptoms:

  • Trouble breathing

  • Confusion

  • Extreme drowsiness or trouble walking

  • Loss of consciousness

  • Rapid heart rate

  • Chest pain

  • Stiff neck

  • Seizure

When to get medical advice

Call your healthcare provider right away if any of these occur:

  • Abdominal pain that gets worse

  • Constant lower right abdominal pain

  • Continued vomiting and inability to keep liquids down

  • Diarrhea more than 5 times a day

  • Blood in vomit or stool

  • Dark urine or no urine for 8 hours, dry mouth and tongue, tiredness, weakness, or dizziness

  • Drowsiness

  • New rash

  • You don’t get better in 2 to 3 days

  • Fever of 100.4°F (38°C) or higher, or as advised by your provider

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