Diarrhea is a common health problem. Even healthy adults and children can experience diarrhea several times a year. In most cases, symptoms are acute (short-term) and resolve within a few days.
Diarrhea that lasts more than three days is a reason to consult your healthcare provider, as it may be a symptom of a more serious health condition, such as a gastrointestinal infection (such as from a disease called Clostridium difficile or C. Differences.), celiac disease, irritable bowel syndrome (IBS), or inflammatory bowel disease (IBD).
Persistent diarrhea that lasts more than four days or chronic diarrhea that lasts more than four weeks can lead to other complications, including dehydration and unexpected weight loss. It is important to get a diagnosis so that the underlying cause of the diarrhea can be addressed.
This article discusses potential causes of chronic diarrhea and how it can lead to unintended weight loss. It also explains how to diagnose and treat the condition.
diarrhea and weight loss
Diarrhea is loose and watery stools. Loose stools may be accompanied by changes in bowel movements, including increased frequency and/or urgency or incontinence. Over time, increased stool frequency may lead to weight loss.
Diarrhea can be acute, persistent or chronic. Acute diarrhea, lasting less than two weeks, is one of the most common illnesses in the United States.
Diarrhea that lasts two to four weeks is considered persistent. Diarrhea that lasts more than 4 weeks is called chronic diarrhea. Chronic diarrhea affects approximately 5% of the population at any given time.
How Digestive Problems Can Cause Weight Loss
When you have chronic diarrhea over days or weeks, you may lose a lot of fluids. This loss of body fluids may show up on the scale as weight loss.
Diarrhea can also be accompanied by other symptoms, such as nausea or loss of appetite, which can also make it difficult for people to keep food and fluids down. This reduces your calorie intake, which also aids in weight loss.
Depending on the duration of diarrhea and the severity of symptoms, weight loss can be significant. However, the weight lost during diarrhea is mostly water weight and may return once your bowel movements and appetite return to normal.
Why You May Lose Weight When You’re Sick
Chronic diarrhea may be accompanied by other symptoms that may indicate an underlying medical condition. Associated symptoms may include:
- stomach ache
- blood in stool
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Causes of persistent or chronic diarrhea
Diarrhea can have many causes. Most cases of acute diarrhea are caused by infection. The infection may be bacterial, viral or parasitic. Usually, this type of diarrhea resolves on its own within a few days.
In some cases, acute diarrhea can be caused by dietary changes, such as excessive intake of artificial sweeteners or alcohol, or other lifestyle factors, including stress.
Persistent or chronic diarrhea can be caused by a number of underlying health conditions or other factors. These include:
- Medications: Diarrhea is a side effect of some medications, including antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), and chemotherapy.
- C. Differences. Infection: This type of infection usually occurs during or after a course of antibiotics, or may be found in a hospital or nursing home.
- Inflammatory bowel disease: IBD includes Crohn’s disease and ulcerative colitis, chronic diseases that cause inflammation of the gut with diarrhea.
- Irritable Bowel Syndrome: Irritable Bowel Syndrome is a disorder in which the muscles that move waste through the gut are highly sensitive to certain triggers.
- Celiac disease: This is an autoimmune disease in which the immune system overreacts to wheat protein gluten and attacks the lining of the small intestine.
- Food allergies or intolerances: Food intolerances are caused by a lack of enzymes needed to digest specific foods. Lactose intolerance, the inability to digest the sugars in milk, is the most common, but intolerances to other foods are also possible.
- Diverticulitis: This condition causes the diverticula (pouches of tissue in the large intestine) to become inflamed, leading to diarrhea, often with abdominal pain.
Causes and Risk Factors of Diarrhea
Diagnose the problem
If your diarrhea lasts more than a few weeks and you lose weight unintentionally, it’s important to make an appointment with your healthcare provider. To make a diagnosis, your healthcare provider will take a health history, perform a physical exam, and more.
When taking a complete health history, your doctor will ask you some questions. These may include:
- Details about how long you have had diarrhea
- how often do you have diarrhea
- how many stools do you have
- If you have other symptoms that accompany diarrhea
- Details about what the stool looks like
- what food and drink do you eat
- If you are taking any medicines or have taken them in the past
- If you have been to a developing country
- If you have been in contact with a sick person
Your healthcare provider may also ask about your family history and whether anyone in your immediate family has the following conditions:
- ulcerative colitis
- Crohn’s disease
- irritable bowel syndrome
- Celiac disease
- Lactose intolerance
diet and lifestyle
If your healthcare provider thinks you may have a food intolerance or allergy, they may ask you to make some changes to your diet to see if it helps your symptoms.
Changes may include avoiding foods that contain common food allergens, such as wheat, dairy, eggs, tree nuts, corn, and soy, for about two weeks.
You will be asked to keep a food diary and record your symptoms as you slowly reintroduce certain foods. This can help your doctor determine which foods may be triggering your symptoms.
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Many tests are available to determine the cause of diarrhea. These include:
- Stool testing: This usually involves testing a stool sample for infection.
- colonoscopy: During this procedure, a long, thin tube with a camera is inserted into the anus and through the intestines. It is used to take images and tissue samples. This test can show if the tissue is inflamed, if there are sores or ulcers, if there are abnormal growths, or if there are signs of bleeding.
- Sigmoidoscopy: Similar to colonoscopy, this test examines only the inside of the lower part of the large intestine. Tissue samples can also be collected.
- Imaging tests: Ultrasounds, X-rays, or other imaging tests can be used to look at organs and look for abnormalities.
- Blood test: A blood test can be used to detect the presence of infection, evidence of bleeding, thyroid disease, celiac disease, and low vitamin levels, which may indicate malabsorption of nutrients in the gut.
Treat diarrhea and lose weight
Treatment of diarrhea and associated weight loss will depend on the underlying cause. If diarrhea is found to be caused by a virus, bacteria, or parasite, your healthcare provider may prescribe medication to treat the infection.
If the cause of the diarrhea is celiac disease or a food allergy or intolerance, you may be advised to start a special diet. Dietary changes are also often recommended to manage IBS and IBD.
Prescription medications may also be required to treat the underlying cause of chronic diarrhea. This includes medicines for the following diseases:
- Crohn’s disease
- irritable bowel syndrome
- ulcerative colitis
In some cases, your healthcare provider may also recommend taking probiotics or eating more foods and beverages rich in probiotics, such as yogurt, kefirand kombucha. These foods and supplements contain beneficial bacteria that can help increase the amount of similar healthy bacteria found naturally in your digestive tract.
Chronic diarrhea is diarrhea that lasts more than four weeks. This can lead to weight loss, along with a variety of other symptoms, including fatigue, nausea, and abdominal pain.
Chronic diarrhea can be caused by infection, stress, certain medications, or an underlying medical condition such as IBS, IBD, or celiac disease. Determining the cause of diarrhea will help determine the best treatment for diarrhea and associated weight loss.
Diarrhea that lasts for weeks can be painful, embarrassing, and disrupt your daily life. It can also lead to other complications such as fatigue, nutritional deficiencies, and unexpected weight loss.
If your diarrhea has not resolved on its own, or you are losing weight without trying to lose weight, consider making an appointment with your healthcare provider. They will be able to help you identify the cause of diarrhea and weight loss and provide treatment options.
Frequently Asked Questions
Can chronic diarrhea lead to nutritional deficiencies?
Chronic diarrhea lasting more than four weeks can lead to malnutrition. So be sure to talk to your healthcare provider if diarrhea persists.
When Should You Be Concerned About Unexplained Weight Loss?
Loss of more than 10 pounds (4.5 kg), or 5 percent of normal body weight, over a period of 6 to 12 months without a deliberate attempt to lose weight is considered unexplained weight loss and requires medical attention. You should also contact your healthcare provider if you have lost weight below a healthy level for your age and height.
Can anxiety or chronic stress cause weight loss?
Weight loss can be caused by many factors, including stress, anxiety, and depression. Other causes include chronic disease, chronic infections, substance abuse, and cancer.