FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

IF DIARRHEA LASTS MORE THAN A FEW DAYS, SEE YOUR DOCTOR

Question: What is the best medicine for diarrhea? Is it "OK" to eat lettuce and tomatoes, and to occasionally have a drink or two?

Diarrhea is defined as the passage of unformed stool. And as we all know, cramping and gas usually accompany it. Since you have taken the time to write me about your diarrhea, I assume that you have had it for more than a few days -- the typical duration of the mild condition most of us experience occasionally. I also assume that it has not been so severe that immediate medical attention was necessary. Therefore, I'll only address the problem of chronic diarrhea.

Diarrhea, since it is a symptom rather than a specific disease, can have many causes. Diarrhea that lasts for more than three or four days but less than three weeks is often caused by infection in the digestive tract from either bacteria or viruses, or infestation with parasites. Your doctor will ask you to bring several stool samples to the lab so that they can be studied for these conditions.

A problem as simple as dietary habits must be considered as the cause of persistent diarrhea. I know that too many green seedless grapes will "get me movin!" Some individuals eat sufficient fruit every day to cause diarrhea without realizing the obvious connection. There are other less obvious dietary causes of diarrhea as well.

Sorbitol, a sweetener used in some foods instead of sugar, can cause diarrhea. Dairy products contain lactose, a sugar that produces diarrhea and gas for most adults. This condition, called lactose intolerance, may develop slowly. Consequently, the individual doesn't make the connection between his or her diarrhea and the consumption of milk or milk products. Some individuals have similar digestive difficulties caused by gluten, the protein found in wheat. This is called gluten intolerance.

Many medicines can cause diarrhea. This includes a wide assortment of products used to treat heart conditions, high blood pressure, depression, asthma, cancer, stomach ulcers and other diseases. Antibiotics are particularly prone to causing diarrhea, as are some non-prescription antacids. Therefore, be sure to tell your doctor about all the medicines, including herbal preparations and non-prescription products, you take. Diarrhea that also includes blood or mucus increases the likelihood of having a disease of the colon. Ulcerative colitis and Crohn's disease are common causes, but the most frequent is also the most important -- colon cancer.

Diarrhea caused by any of these conditions shouldn't necessarily be made worse by eating lettuce or tomatoes, although each individual is different. If they make you worse, don't eat them. Alcohol, on the other hand, can irritate the digestive tract and make diarrhea a bit worse.

The important point is that any diarrhea that lasts more than a few days is not only annoying but may also be a sign of a potentially serious condition. You should see your doctor to determine the cause of it rather than trying non-prescription and herbal treatments. Once the reason for of your diarrhea is determined, proper treatment can be instituted.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.