Diarrhea, Age 12 and Older

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Diarrhea, Age 12 and Older

Topic Overview

Diarrhea occurs when there is
an increase in the number of bowel movements or bowel movements are more watery
and loose than normal. When the intestines push stools through the bowel before
the water in the stool can be reabsorbed, diarrhea occurs. It can also occur
when inflammation of the bowel lining causes excess fluid to leak into the
stool. Abdominal cramps, nausea, vomiting, or a fever may occur along with the

Diarrhea is one of the most commonly occurring health
problems affecting all ages. Most adults will have 4 episodes of diarrhea each
year. Diarrhea that comes on suddenly may last up to 14 days.

Diarrhea has many causes.

  • Diarrhea is often caused by stomach flu (gastroenteritis) or
    food poisoning. Diarrhea is your body's way of quickly
    clearing viruses, bacteria, or toxins from the digestive tract. Since most
    cases of diarrhea are viral, they will clear up in a few days with good home
    E. coli is a common bacteria that causes diarrhea.
    E. coli infection is related to improper food
  • Drinking
    untreated water or unpasteurized dairy products can
    cause viral, bacterial, or parasitic infections, such as
    Giardia lamblia. Giardia lamblia parasite can cause diarrhea that develops 1 to 4 weeks later.
    These infections can also occur when you use untreated water to brush your
    teeth, wash your dishes or vegetables, or make ice for drinks.
  • Diarrhea can also occur from infections passed on by animals.
  • Many
    prescription and nonprescription
    medicines can cause diarrhea.

    • Antibiotics may cause mild diarrhea that
      usually clears up without treatment. A more serious type of diarrhea caused by
      the bacteria Clostridium difficile (sometimes called
      C-diff) may occur while taking an antibiotic or shortly after finishing the
    • Laxatives, such as Correctol, Dulcolax, Ex-Lax, or
      bisacodyl, may cause diarrhea.
  • Using too much of products that contain sorbitol
    (such as chewing gum) or fructose can cause diarrhea.
  • Some people
    get infections that cause diarrhea while they are traveling (traveler's diarrhea).
  • For
    some people, emotional stress,
    irritable bowel syndrome, anxiety, or food digestion
    problems (such as
    lactose intolerance) cause
  • Repeated episodes of diarrhea may be caused by
    inflammatory bowel disease.
  • Diarrhea may
    also be caused by
    malabsorption problems and certain types of
  • Diarrhea may develop after stomach, bowel, or gallbladder
    surgery, or after bariatric surgery for

Many times the exact cause of diarrhea is hard to
determine. Almost everyone has an occasional bout of diarrhea. Although
diarrhea is annoying, most cases are not serious and will clear up with home

Check your symptoms to decide if and
when you should see a doctor.

Check Your Symptoms

Do you have diarrhea?
How old are you?
11 years or younger
11 years or younger
12 to 55 years
12 to 55 years
56 years or older
56 years or older
Are you male or female?
Are you pregnant?
Yes, you know that you're pregnant.
No, you're not pregnant, or you're not sure if you're pregnant.
Do you have moderate or severe belly pain?
This is not the cramping type of pain you have with diarrhea.
Abdominal pain
Abdominal pain
Do you think you may be dehydrated?
May be dehydrated
May be dehydrated
Are the symptoms severe, moderate, or mild?
Severe dehydration
Moderate dehydration
Mild dehydration
Are you having trouble drinking enough to replace the fluids you've lost?
Little sips of fluid usually are not enough. You need to be able to take in and keep down plenty of fluids.
Unable to maintain fluid intake
Able to maintain fluid intake
Symptoms of serious illness
Symptoms of serious illness
Are your stools black or bloody?
Black or bloody stools
Black or bloody stools
Have you had:
At least 1 stool that is mostly black or bloody?
At least 1 stool mostly black or bloody
At least 1 stool that is partly black or bloody?
At least 1 stool partly black or bloody
Streaks of blood in your stool?
Streaks of blood in stool
Do you think you may have a fever?
Possible fever
Possible fever
Did you take your temperature?
Temperature taken
Temperature taken
How high is the fever? The answer may depend on how you took the temperature.
High: 104°F (40°C) or higher, oral
High fever: 104°F (40°C) or higher, oral
Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Mild: 100.3°F (37.9°C) or lower, oral
Mild fever: 100.3°F (37.9°C) or lower, oral
How high do you think the fever is?
Feels fever is high
Feels fever is moderate
Mild or low
Feels fever is mild
How long have you had a fever?
Less than 2 days (48 hours)
Fever for less than 2 days
At least 2 days but less than 1 week
Fever for at least 2 days but less than 1 week
1 week or more
Fever for 1 week or more
Do you have a health problem or take medicine that weakens your immune system?
Disease or medicine that causes immune system problems
Disease or medicine that causes immune system problems
Do you have shaking chills or very heavy sweating?
Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off you or soaking through your clothes.
Shaking chills or heavy sweating
Shaking chills or heavy sweating
Does the fever come and go?
Recurrent fever
Recurrent fever
Have you traveled to another country in the past 6 weeks?
Recent travel
Recent travel
Do you have diabetes?
Is your diabetes getting out of control because you are sick?
Diabetes is affected by illness
Diabetes is affected by illness
Do you and your doctor have a plan for what to do when you're sick?
Diabetes illness plan
Diabetes illness plan
Is the plan helping get your blood sugar under control?
Diabetes illness plan working
Diabetes illness plan not working
How fast is it getting out of control?
Quickly (over several hours)
Blood sugar quickly worsening
Slowly (over days)
Blood sugar slowly worsening
Is the diarrhea severe, moderate, or mild?
Severe diarrhea
Moderate diarrhea
Mild diarrhea
Have you had diarrhea for more than 1 week?
Diarrhea for more than 1 week
Diarrhea for 1 week or less
Do you think that a medicine could be causing the diarrhea?
Think about whether the diarrhea started after you began taking a new medicine or a higher dose of a medicine.
Medicine may be causing diarrhea
Medicine may be causing diarrhea

Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:

  • Your age. Babies and older
    adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
    disease, you may need to pay closer attention to certain symptoms and seek care
  • Medicines you take. Certain
    medicines, herbal remedies, and supplements can cause symptoms or make them
  • Recent health events, such as surgery
    or injury. These kinds of events can cause symptoms afterwards or make them
    more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
    use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.

  • Try home treatment to relieve the
  • Call your doctor if symptoms get worse or you have any
    concerns (for example, if symptoms are not getting better as you would expect).
    You may need care sooner.

If you're not sure if a fever is high, moderate, or mild,
think about these issues:

With a high fever:

  • You feel very hot.
  • It is likely one of
    the highest fevers you've ever had. High fevers are not that common, especially
    in adults.

With a moderate fever:

  • You feel warm or hot.
  • You know you have
    a fever.

With a mild fever:

  • You may feel a little warm.
  • You think
    you might have a fever, but you're not sure.

Temperature varies a little depending on how you measure it.
For adults and children age 12 and older, these are the ranges for high,
moderate, and mild, according to how you took the temperature.

Oral (by mouth) temperature

  • High:
    104°F (40°C) and
  • Moderate:
    100.4°F (38°C) to
    103.9°F (39.9°C)
  • Mild:
    100.3°F (37.9°C) and

A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature.

Ear or rectal temperature

  • High:
    105°F (40.6°C) and
  • Moderate:
    101.4°F (38.6°C) to
    104.9°F (40.5°C)
  • Mild:
    101.3°F (38.5°C) and

Armpit (axillary) temperature

  • High: 103°F (39.5°C) and higher
  • Moderate:
    99.4°F (37.4°C) to
    102.9°F (39.4°C)
  • Mild: 99.3°F (37.3°C) and lower

Symptoms of serious illness may

  • A severe headache.
  • A stiff
  • Mental changes, such as feeling confused or much less
  • Extreme fatigue (to the point where it's hard for you to
  • Shaking chills.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease,
    and HIV/AIDS.
  • Long-term alcohol and drug
  • Steroid medicines, which may be used to treat a variety
    of conditions.
  • Chemotherapy and radiation therapy for
  • Other medicines used to treat autoimmune
  • Medicines taken after organ transplant.
  • Not
    having a spleen.
  • Severe diarrhea means having
    more than 10 loose, watery stools in a single day (24 hours).
  • Moderate diarrhea means having more than a few but not more
    than 10 diarrhea stools in a day.
  • Mild diarrhea means having a few diarrhea stools in a day.

You can get dehydrated when
you lose a lot of fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For

  • You may feel tired and edgy (mild dehydration), or
    you may feel weak, not alert, and not able to think clearly (severe
  • You may pass less urine than usual (mild
    dehydration), or you may not be passing urine at all (severe

Severe dehydration means:

  • Your mouth and eyes may be extremely
  • You may pass little or no urine for 12 or more
  • You may not feel alert or be able to think
  • You may be too weak or dizzy to stand.
  • You may
    pass out.

Moderate dehydration means:

  • You may be a lot more thirsty than
  • Your mouth and eyes may be drier than usual.
  • You may
    pass little or no urine for 8 or more hours.
  • You may feel dizzy
    when you stand or sit up.

Mild dehydration means:

  • You may be more thirsty than usual.
  • You may pass less urine than usual.

Many prescription and nonprescription medicines can cause
diarrhea. A few examples are:

  • Antibiotics.
  • Antidepressants.
  • Antacids.
  • Proton
    pump inhibitors, such as omeprazole (Prilosec) and lansoprazole (Prevacid).
  • Medicines used to treat cancer (chemotherapy).

It is easy for your diabetes to become out of control when
you are sick. Because of an illness:

  • Your blood sugar may be too high or too
  • You may not be able take your diabetes medicine (if you are
    vomiting or having trouble keeping food or fluids down).
  • You may
    not know how to adjust the timing or dose of your diabetes
  • You may not be eating enough or drinking enough

An illness plan for people with diabetes usually covers things like:

  • How often to test blood sugar and what the target
    range is.
  • Whether and how to adjust the dose and timing of insulin
    or other diabetes medicines.
  • What to do if you have trouble keeping
    food or fluids down.
  • When to call your doctor.

The plan is designed to help keep your diabetes in control even
though you are sick. When you have diabetes, even a minor illness can cause

Blood in the stool can come from
anywhere in the digestive tract, such as the stomach or intestines. Depending
on where the blood is coming from and how fast it is moving, it may be bright
red, reddish brown, or black like tar.

A little bit of bright red
blood on the stool or on the toilet paper is often caused by mild irritation of
the rectum. For example, this can happen if you have to strain hard to pass a
stool or if you have a hemorrhoid.

Certain medicines and foods can affect the color of stool. Diarrhea
medicines (such as Pepto-Bismol) and iron tablets can make the stool black.
Eating lots of beets may turn the stool red. Eating foods with black or dark
blue food coloring can turn the stool black.

If you take aspirin or some other medicine (called a blood thinner) that prevents blood clots, it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.

Seek Care Today

Based on your answers, you may need care soon. The
problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms
    and arrange for care.
  • If you cannot reach your doctor or you don't
    have one, seek care today.
  • If it is evening, watch the symptoms and
    seek care in the morning.
  • If the symptoms get worse, seek care

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and
    arrange for care.
  • If you cannot reach your doctor or you don't have
    one, seek care in the next hour.
  • You do not need to call an
    ambulance unless:

    • You cannot travel safely either by driving
      yourself or by having someone else drive you.
    • You are in an area
      where heavy traffic or other problems may slow you down.

Make an Appointment

Based on your answers, the problem may not improve without medical

  • Make an appointment to see your doctor in the
    next 1 to 2 weeks.
  • If appropriate, try home treatment while you
    are waiting for the appointment.
  • If symptoms get worse or you have
    any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need
emergency care.

Call 911 or other emergency services now.

Abdominal Pain, Age 12 and Older
Pregnancy-Related Problems
Diarrhea, Age 11 and Younger

Home Treatment

Home treatment can help you treat
your diarrhea and avoid other related problems, such as

  • Take frequent, small sips of water or a
    rehydration drink and small bites of salty crackers.

    • Try to increase your fluid intake to at least
      1 qt (1 L) per hour for 1 to 2
      hours, or longer if you keep having large amounts of diarrhea. Note: If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • Begin eating mild foods the next day or sooner,
    depending on how you feel.

    • Avoid spicy foods, fruits, alcohol, and
      caffeine until 48 hours after all symptoms have disappeared.
    • Avoid
      chewing gum that contains sorbitol.
    • Avoid
      milk for 3 days after symptoms disappear.
      You can eat cheese or yogurt with probiotics.

Nonprescription medicines for diarrhea

If you are
pregnant, talk with your doctor before taking any medicines for

Nonprescription medicines may be helpful in treating your
diarrhea. Follow these tips when taking a nonprescription medicine for

  • Use nonprescription antidiarrheal medicine if
    you have diarrhea for longer than 6 hours. Do not use nonprescription
    antidiarrheal medicines if you have bloody diarrhea, a high fever, or other
    signs of serious illness.
  • Read and follow
    all label directions on the nonprescription medicine bottle or box. Be sure to
    take the recommended dose.
  • Long-term use of nonprescription
    antidiarrheal medicine is not recommended. To avoid constipation, stop taking
    antidiarrheal medicines as soon as stools thicken.
  • If your child or
    teen gets
    chickenpox or
    flu, do not treat the symptoms with over-the-counter
    medicines that contain bismuth subsalicylate (such as Pepto-Bismol and
    Kaopectate). Subsalicylate has been linked to
    Reye syndrome, a rare but serious illness. If your
    child has taken this kind of medicine and he or she has changes in behavior
    with nausea and vomiting, call your doctor. These symptoms could be an early
    sign of Reye syndrome.

There are several types of antidiarrheal medicines: those
that absorb water and thicken the stool, and those that slow intestinal

  • Thickening mixtures (such as psyllium) absorb water. This helps bulk up the stool and make it more firm.
  • Antispasmodic antidiarrheals, such as Imodium A-D and Pepto
    Diarrhea Control, slow intestinal spasms. Some products contain both thickening
    and antispasmodic ingredients.
  • Probiotics, such as Lactobacillus, are available in either pills or powder. This
    bacteria occurs naturally in the intestine and may help with digestion. When
    diarrhea is present, the number of these bacteria is reduced.

General tips

Learn how to clean up diarrhea safely. Protect your hands with gloves while cleaning up. Wash your hands after you are done cleaning up.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home

  • Signs of dehydration
  • Severe diarrhea (10 or more loose watery stools in 24 hours) develops.
  • Black or bloody stools develop.
  • A fever
  • Your symptoms become
    more severe or more frequent.


Food poisoning
is a common cause of diarrhea in children and adults. Most cases of food
poisoning may be prevented by taking a few precautions when preparing and
storing food
at home. Perishable foods, such as eggs, meats, poultry, fish,
shellfish, milk, and milk products, should be treated with extra care. Also,
precautions should be taken if you are pregnant, have an
impaired immune system or a chronic illness, or are preparing foods for other high-risk groups, such as young children or older

The U.S. Department of
Agriculture (USDA) recommends the following steps to prevent food poisoning:

Many counties in the United States have extension services
listed in the phone book. These services can answer your question about safe
home canning and food preparation.

When you travel in wilderness areas or to other countries of the world, it is common to get traveler's diarrhea from food or water because the methods of food preparation are different.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions:

  • How long have you had diarrhea?
  • How
    many times per day are you having diarrhea?
  • What does your diarrhea
    look like? Describe the color, consistency (watery, mushy), and other
    characteristics (contains blood or mucus).
  • When was your last
    episode of diarrhea?
  • Have you recently increased the amount of
    fiber in your diet (more fresh fruit, vegetables, or other high-fiber
  • What prescription and nonprescription medicines do you

    • Are you taking any new
    • Did you recently increase the dose of a
    • Have you taken any antibiotics recently?
    • Did
      you recently receive an antibiotic while in the hospital?
  • Do you routinely use laxatives or stool
  • Have you been under an unusual amount of stress at home,
    work, or both?
  • Does anyone you live with or work with have
  • Did your diarrhea start after eating at a restaurant? Has
    anyone who ate there with you become ill?
  • Did you drink lake or
    stream water or untreated well water?
  • Have you recently visited a
    foreign country or taken a ship cruise?
  • Do you have any risk
    factors that make you more susceptible to diarrhea, such as irritable bowel
  • What home treatment measures have you tried? Be sure to
    include any nonprescription medicines you have taken.
  • Do you have
    other symptoms, such as vomiting, fever, or dehydration?
  • Do you
    have any
    health risks?


ByHealthwise StaffPrimary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine Adam Husney, MD - Family Medicine Specialist Medical Reviewer Kathleen Romito, MD - Family Medicine

Current as ofDecember 1, 2017

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