Diarrhea: Major Causes and How to Get Over It
Everyone experiences diarrhea during their lives. This common problem is typically acute (short-lived) but can be chronic and last for long periods. Acute diarrhea is usually caused by infections from bacteria or viruses. Chronic diarrhea is typically caused by a persistent infection, SIBO, irritable bowel disorder, or inflammatory bowel disease.
When you have diarrhea, there are steps you can take to resolve immediate symptoms. There are also strategies that can help your body heal from diarrhea. This article will discuss causes and guide you through the ways to get over diarrhea.
What is Diarrhea?
Diarrhea is loose, watery, and possibly more frequent bowel movements. On the Bristol Stool Chart below, it is a type 6 or 7. It is usually short lived and lasts for a few days. When diarrhea lasts for longer periods, such as weeks or more, this may indicate that you have an underlying problem (1).
Signs and symptoms of diarrhea include:
- Loose, watery stools
- Abdominal cramps
- Abdominal pain
- Fever
- Blood in the stool
- Mucus in the stool
- Bloating
- Nausea
- Urgent need to have a bowel movement
Major Causes of Diarrhea
There are only 6 major causes of chronic diarrhea. Most cases of acute diarrhea have to do with food or water poisoning or the stomach flu that causes a temporary set back.
However, if the diarrhea persists for more then 3-4 days it is most likely due to one of the following conditions. It is not uncommon for people to encounter long-standing issues with diarrhea after having contaminated food or water. It is always wise to make sure food is cooked and water is filtered appropriately and very important to take care of your immune system so your body can fend itself against pathogens it comes in contact with.
1. Food/Water Poisoning
Acute diarrhea can be caused by bacteria transmitted through contaminated food and water. Most exposure occurs via fecal-oral transmission, most often due to the use of contaminated water sources or improper hand hygiene.
This may include eating raw foods washed or harvested in contaminated water, improper handwashing, or drinking contaminated water. Some of the most common bacteria that lead to diarrhea are Salmonella, E. coli, Shigella, Campylobacter, and Clostridium difficile.
Salmonella
Salmonella causes about 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths in the U.S. every year (2). The source for most of these illnesses is fecal contamination of foods, most commonly eggs, poultry, meat, unpasteurized milk, and raw, fresh, ready-to-eat produce such as tomatoes, leafy greens, sprouts, berries, and melons.
Exposure to pet reptiles, amphibians, and baby chicks an also spread salmonella. Symptoms include fever, vomiting, and severe diarrhea and last a few days.
E. Coli
Escherichia coli (E. coli) are bacteria found in the intestines of people and animals. They can also be found in foods. Most E coli are harmless, but some cause diarrhea, and other illnesses.
The two types of E. coli that cause diarrhea in the U.S. are Shiga toxin-producing E. coli (STEC) and enterotoxigenic E. coli (ETEC) (3). The Shiga toxin causes diarrhea, which can be bloody. ETEC is the leading cause of traveler’s diarrhea and a major cause of diarrhea around the world.
E coli infections are usually caused by fecal contamination of food and liquids such as dairy, undercooked beef, vegetables, and juices. Symptoms include severe abdominal cramps and watery diarrhea and usually last 3-7 days, depending on the type.
Shigella
Shigellosis is an infection caused by a group of bacteria called Shigella (4). Shigella is very contagious. Some ways you can get Shigella include eating food that is prepared by someone who has the germs, eating raw foods or fruits and vegetables that are grown in fields containing human waste, or swallowing recreational water while swimming.
People infected with Shigella develop diarrhea, fever, and stomach cramps. These symptoms usually last 5-7 days, but some people have irregular bowel movements for months.
Campylobacter
Campylobacter is one of the most common causes of foodborne illness in the U.S causing an estimated 1.3 million illnesses each year (5). Campylobacter infections are usually caused by fecal contamination of poultry and water. Symptoms include diarrhea (often bloody), abdominal pain, fever, and malaise and can last for several days to several weeks.
C. Diff
Clostridium difficile (C. diff) is a bacterium that can trigger an infection at high levels. Infections are most common while on, or immediately after, antibiotics or in health care facilities.
The most common symptoms of C. diff are watery diarrhea and abdominal cramping. When severe, a C. diff infection can also cause colitis (inflamed colon), severe intestinal inflammation, enlarged colon, and sepsis.
2. Parasites
Parasite infections are a major cause of diarrhea. Parasites are common in the U.S. and affect millions of people. Some of the parasites that cause diarrhea are Giardia, Entamoeba histolytica, helminths, and cryptosporidium. Here is a helpful article on parasites and what you can do about them.
Giardia
Giardia is one of the most common parasite infections of people worldwide. It is spread by fecal-oral contamination, so it is more prevalent in areas with poor sanitation. Giardia is commonly water-borne and frequently infects people who spend a lot of time camping, backpacking or hunting.
Giardia typically has an incubation period of one to two weeks and then symptoms may develop. These include diarrhea, nausea, vomiting, gas, cramping and weight loss. Key indicators of giardia are symptoms lasting two to four weeks and significant weight loss.
Entamoeba Histolytica
Entamoeba histolytica is a parasite that causes amebiasis. It is most common in tropical areas and cause diarrhea, stomach pain, and cramping.
Helminths
Parasitic worms (or helminths) often cause diarrhea along with nutrient deficiencies, weakness and disease in the host. There are many types of worms, including roundworms, whipworms, tapeworms and hookworms.
Cryptosporidium
Cryptosporidium (Crypto) is a microscopic parasite that causes cryptosporidiosis. The most common symptom of cryptosporidiosis is watery diarrhea which usually begins a week after becoming infected with the parasite.
Crypto is usually spread through water, both drinking water and recreational water. It is the leading cause of waterborne disease in the U.S. (6).
3. IBS-D
Irritable bowel syndrome (IBS) is a common and usually chronic disorder that affects the large intestine. While a specific cause of IBS is unknown, intestinal inflammation, dysbiosis, and bacterial or viral infections may play a role.
There are three types of IBS: constipation-predominant, diarrhea-predominant, and mixed. Other symptoms include abdominal pain and cramping, bloating, and gas. IBS-D means that it is IBS that is characterized by chronic diarrhea where more then 50% of the bowel movements are classified as loose and watery.
4. SIBO
There are trillions of bacteria in our intestinal tract. Most of these bacteria are located in the large intestine with a relatively small amount in the small intestine.
Small intestinal bacterial overgrowth (SIBO) occurs when there are excess bacteria in the small intestine. These bacteria cause carbohydrates to ferment which produces hydrogen and methane gases. Hydrogen-dominant SIBO typically leads to diarrhea.
In addition to diarrhea, symptoms of SIBO include gas, bloating, and abdominal pain. SIBO can lead to intestinal permeability (leaky gut), autoimmune conditions, food sensitivities, nutrient deficiencies, inflammation, and other health issues. To learn more about causes and how to beat SIBO naturally, read this article.
5. Viruses
A virus is a small infectious agent with genetic material, RNA or DNA, surrounded by a coat of protein, lipid (fat), or glycoprotein. Viruses that can cause diarrhea include Norwalk virus, cytomegalovirus, and rotavirus.
Noroviruses (or Norwalk virus) are a group of related viruses that cause acute gastrointestinal illness sporadically or in outbreaks. Norovirus infections are spread by exposure to infected people or contaminated food and water. Diarrhea may accompany the more common symptoms which are nausea, vomiting, and stomach cramps.
Cytomegalovirus (CMV) is a beta herpesvirus that is common and can affect almost anyone. When first infected with CMV, your symptoms may be similar to mono, including fatigue, fever, sore throat, and muscle aches. People with weakened immune systems, especially babies, may experience more serious signs and symptoms affecting their eyes, lungs, liver, esophagus, stomach, intestines, and brain.
Rotavirus is a contagious virus that can cause gastroenteritis (inflammation of the stomach and intestines). Symptoms include severe watery diarrhea, vomiting, fever, and abdominal pain. Infants and young children are most likely to get rotavirus, but anyone can get it. This article has more information on symptoms and natural solutions to chronic viral infections.
6. Liver/Gallbladder issues
The liver is the largest internal organ and main organ of detoxification. It filters everything we put into our bodies and clears these toxins while retaining the nutrients the body needs. The liver removes pathogens and fights infections that can cause diarrhea. When there is stress on the liver and it is not functioning optimally, this can lead to digestive and other health issues.
Bile is a digestive fluid that is produced in the liver, secreted into the biliary tracts, and stored in the gallbladder. It aids in digestion by emulsifying fats and creating fatty acids that can be absorbed and used by the body. Fat-soluble toxins are released in the bile to be excreted through the bowels. Bile also has antimicrobial properties and can kill off unwanted pathogens and help regulate our gut microbiome.
Gallbladder issues such as an obstruction, biliary sludge, or a removed gallbladder, can affect how bile is released. When bile flow is sluggish, this can result in malnutrition and the accumulation of toxins in the body. Built up toxins can contribute to bacterial overgrowth, chronic inflammation, and digestive issues like IBS.
Quick Diarrhea Fix Protocol
Here is a quick fix protocol for diarrhea that works! The most important components are the charcoal and the glutamine but the GI Clear helps to get rid of any sort of microbial overgrowth you may be dealing with from food or water poisoning or from a chronic infection that may be aggravated. Here is what you want to do!
Take Activated Charcoal
Activated charcoal is one of the oldest detoxifying remedies. It is an absorbent agent that binds to and eliminates toxins in the body. It has an amazing capacity to absorb enormous amounts of water, pathogenic microbes and endotoxins in the gut.
For acute diarrhea, take 2-6+ caps of Activated Charcoal with meals. Start with one capsule for every 50 pounds of body weight. Then, continue to increase the dosage until you find a dosage that stops the diarrhea. For many people, I just have them mega dose with 6-8 caps every 2 hours until the diarrhea stops…which is usually within 4 hours at that dosage.
Use GI Clear
A fantastic antimicrobial supplement to include in your diarrhea protocol is GI Clear. GI Clear is a blend of botanical extracts with antimicrobial properties. The herbs within it include tribulus, berberine, black walnut, barberry, sweet wormwood and bearberry.
These herbs help to reduce pathogenic bacteria, yeast, and parasites which create infections in your gut and may cause diarrhea. Take 1-2 caps of GI Clear, three times daily away from meals.
L-Glutamine:
Glutamine is the most abundant amino acid in the body and in the intestinal cells. It is the primary nutrient for the cells of the intestinal lining where it helps regulate cellular reproduction. Through this mechanism, glutamine helps prevent and rebuild a leaky gut, which is common in people with inflammatory and auto-immune conditions.
Glutamine also helps regulated cells absorb water across the junction between the small intestine and blood stream. This is a very important part of keeping the body from losing fluid and becoming dehydrated. When water is not absorbed back into the body diarrhea is the result. Glutamine has been shown to reduce the frequency and severity of diarrhea. I recommend using 1-2 scoops (4-8 grams) – 3 times daily in water or in broth until the diarrhea stops.
Close Ileocecal Valve To Reduce Diarrhea
The ileocecal valve connects the large intestine to the small intestine and acts as a barrier between the two. It allows each environment to support different temperatures, pH levels, microflora and digestive processes. The ileocecal valve also prevents harmful toxins and microbes from backing up into the small intestine.
Problems occur when the ileocecal valve malfunctions and is stuck open or closed. An open valve will often result in SIBO or diarrhea. To close this valve, you can try pushing it closed with your fingers or using an ice pack over the value for 15-20 minutes. You can learn more about the ileocecal valve here.
Dietary Strategies To Reduce Diarrhea
With acute diarrhea, a bone broth fast or BRAT diet may be helpful. Bone broth is a nutrient-dense, easy to digest, healing tonic. It contains many beneficial compounds and nutrients. Fasting with bone broth fast can help to heal the gut and take stress off the digestive system. Bone broth helps to restore fluid and electrolytes and is a powerful reset for the gut.
Some people with diarrhea may do better on a BRAT diet. The BRAT diet includes bananas, rice, unsweetened applesauce, and gluten-free bread. These foods are gentle on the stomach and can help to soak up the water in the colon. You can try either or both of these two options to determine which is more helpful for you.
Strategies to Heal from Diarrhea
While the strategies I discussed above often work to reduce the diarrhea in the short term, they are not long-term answers. To heal diarrhea and restore normal bowel function and gut health you will need a comprehensive lifestyle plan to follow.
The list below may seem overwhelming at first, but making these lifestyle changes will help you truly get you off of the toilet and help you regain your life. You may also be interested in working with a trained health practitioner to customize these strategies to get you over the hump.
1. Anti-Inflammatory Diet
One of the best strategies for supporting gut health and healing from diarrhea is to consume an anti-inflammatory diet. This healing diet removes foods that cause inflammation and damage the gut lining.
The most important foods to avoid are refined sugars, processed foods, vegetables oils, meat and dairy from conventionally-raised animals, and farmed fish. These foods contain chemicals, trans-fats, and other toxic ingredients which are highly inflammatory, create extra acidity in the tissues, and damage the gut mucosa.
An anti-inflammatory, gut healing diet includes whole, unprocessed foods: clean protein, organic vegetables and fruits, and healthy fats. Healthy fats are found in coconut, olives, avocados, and their oils and in grass-fed butter and ghee. Clean protein sources are grass-fed meats, pasture-raised, organic chicken and eggs, and wild-caught fish. A variety of organic vegetables, fruits, and healing herbs should also be included.
2. Identify and Remove Food Sensitivities
Around 45% of individuals have food sensitivities. A food sensitivity is an immune-mediated response to certain foods. When you have food sensitivities, your immune system reacts to certain foods as a threat amplifying the immune response.
Food sensitivities inflame the gut lining and may lead to intestinal permeability, diarrhea, and other digestive problems. It is important to identify any food sensitivities and remove these foods from your diet for a period of time.
Identifying food sensitivities can be difficult due to the delay in symptoms for some people, so testing is a great option. For information about different methods of testing for food sensitivities, check out this article.
3. Consider a Low-FODMAP Diet
If you are having diarrhea, you may benefit from a low FODMAPS diet. FODMAPS is an acronym for Fermentable Oligo, Di- and Monosaccharides and Polyols. These fermentable sugar-based carbohydrates include fructose, glucose, galactans, polyols, and lactose.
FODMAPS are poorly absorbed in the small intestine. They pass along the gut to the large intestine and are fermented by bacteria. This fermentation results in many digestive symptoms like gas, pain, and bloating.
A diet high in FODMAPS can contribute to functional gut disorders like irritable bowel syndrome (IBS). Reducing FODMAPS may help relieve diarrhea and other digestive symptoms (7). This article has more information on how to beat digestive problems with a low FODMAPS diet.
4. Test for and Reduce Gut Infections To Eliminate Diarrhea
The GI tract is a major entry point for pathogens. As described above, gut infections result from a variety of pathogens (8). It is important to take steps to eliminate gut infections to heal from diarrhea, reestablish a healthy microbial balance, and strengthen the gut mucosa.
To test for gut infections, the GI-MAP™ Stool Analysis Test is the most thorough stool test on the market. It is the only FDA-approved DNA test for gastrointestinal microbes and pathogens available.
The GI Map tests for imbalances in the gut microbiome, candida and other fungi, viruses, and parasites, including both protozoa and worms. This comprehensive test reveals the integrity of your gastrointestinal system with digestion, immune response, and gliadin, and inflammation markers.
5. Reduce Stress and Improve Sleep
Managing stress and getting adequate sleep are important for healing from diarrhea. Stress causes bowel dysfunction through different pathways, including the HPA axis, the autonomic nervous system, or directly on the bowel itself (9).
Stress alters the gut flora and increases intestinal permeability, which may lead to diarrhea and other gastrointestinal symptoms. Chronic stress has been linked to numerous digestive disorders, including irritable bowel syndrome (IBS) (10).
Two of the most effective strategies to reduce stress and optimize sleep are implementing a healing diet and balancing your blood sugar levels. Additional stress relieving techniques are grounding, deep breathing exercises, sunlight exposure, Epsom salt baths, and dry brushing.
Poor sleep quality is linked to gastrointestinal disorders, including diarrhea (11). To improve sleep, it is important to keep a regular sleep schedule and practice healthy bedtime habits. You should also get sunlight during the day, avoid artificial light and EMFs, black out your room with blackout curtains or using a sleep mask, and be smart about caffeine intake.
Supplementing with adaptogenic herbs, such as those in Cortisol Defense, may help your body resist and recovery from everyday stress and support restful sleep. Brain Calm Magnesium may also be helpful as magnesium plays a critical role in stress and sleep.
6. Strengthen the Gut Mucosa To Reduce Diarrhea
Your gut mucosa is a protective barrier that lines your digestive tract. It houses the gut microbiome, aids in the absorption of nutrients, and protects us from pathogens, toxins, and dietary antigens. To heal from diarrhea, it is important to strengthen your gut mucosa.
Supplementing with MegaMucosa is a great way to strengthen the gut barrier and improve gut dysfunction. MegaMucosa contains dairy-free immunoglobulins to support a healthy immune response in the mucosa and increase SIgA levels. It also contains four key amino acids and citrus polyphenols which support microbial diversity and alleviate barrier dysfunction.
The amino acid glutamine plays an important role in gut and immune function. It is the primary source of amino acids for the gut mucosa.
Glutamine improves intestinal barrier function, while a lack of glutamine can increase permeability (12). Supplementing with L-Glutamine can help to heal diarrhea by regulating bowel motility, healing intestinal permeability, improving digestion, and nutrient absorption, and improving the balance of your gut microflora.
7. Support Stomach Acid and Digestive Enzymes
Stomach acid and digestive enzymes are necessary for proper digestion and nutrient absorption. Low stomach acid and digestive enzyme levels are two major factors in digestive problems. Symptoms of low stomach acid and/or insufficient digestive enzymes include diarrhea, indigestion, bloating, nutrient deficiencies, and multiple food sensitivities.
There are several strategies to improve stomach acid levels. Stimulating digestive juices with ginger, fermented foods (such as kimchi and sauerkraut), and fermented drinks (like coconut kefir) can be helpful. Squeezing fresh lemon juice or apple cider vinegar on meat and vegetables can help pre-metabolize the food.
Another helpful strategy for improving stomach acid is having liquid nutrition during the day with at least half of your meals in an easily digestible form. Drinking water with or right after a meal will dilute your digestive juices, so hydrate outside of meals. While eating, you should be relaxed, eat protein first, and chew each bite many times.
Supplementation can be essential for individuals with low stomach acid. A supplement with Betaine HCL such as Acid ProZyme can be taken during your meal for stomach acid support.
If you are not producing sufficient digestive enzymes, supplementing with SuperDZyme may be beneficial. Digestive enzymes have many benefits such as reducing stress on the digestive system, improving the digestion of food and assimilation of nutrients, reducing inflammation in the gut, and much more.
8. Support Liver Health and Bile Flow
Supporting liver health and good bile flow are important for healing from diarrhea. Fortunately, there are many natural strategies that can protect and heal the liver. One of the most important strategies is following an anti-inflammatory, healing diet using ketogenic guidelines. You should include foods and herbs that support liver health in this diet.
Other natural healing strategies for the liver are intermittent fasting, drinking plenty of water, reducing stress and improving sleep, dealing with your anger, using Epsom salt baths and castor oil packs, and adding liver supporting nutrients. Improving gut health, supporting stomach acid levels, and optimizing bile flow are all important for liver health.
A fantastic dietary supplement for improving liver function is Gut Healing Protein. This comprehensive protein powder strengthens the gut lining, supports GI function, and improves detoxification. Bile Flow Support is an amazing liver support formula that provides nutrients involved in bile flow and fat metabolism.
9. Rebuild Gut Flora To Reduce Diarrhea
The large and complex community of microorganisms in our GI tract is called the gut flora. Your gut flora has many important functions in the body and proper diversity and balance are essential to your overall health. After you have eliminated pathogens, you should work on rebuilding your gut flora with probiotics, prebiotics, and fermented foods.
Probiotics are beneficial microorganisms (bacteria and yeasts) that keep your gut and body healthy. They are similar to the microorganisms that naturally live in our bodies. Probiotics support digestive health in many ways (13).
There are 4 main categories of probiotics: food based, spore-forming soil based, probiotic yeast, and combination probiotics. If you are struggling with digestive issues, a good strategy is to try one probiotic from each category for a short time to determine which is most beneficial. You should also rotate probiotics to keep the microbiome adapting. For information on the benefits and categories of probiotics along with suggested protocols, read this article.
As long as you don’t have issues with higher FODMAP groups as explained above, then you should also include these prebiotics which feed good bacteria and help them to thrive. The top prebiotic foods include berries, sweet potatoes, carrots, cucumbers, and seeds such as flax, hemp, pumpkin, and chia seeds.
Fermented foods are functional foods with probiotic, prebiotic, and bioactive components. These functional ingredients act together in the gastrointestinal tract to modify the gut microbiota, remove toxins, activate the immune system, and promote the absorption of nutrients (14).
10. Consider a Health Coach to Personalize Your Health Plan
If you have diarrhea, you should consider working with a skilled health coach to support and guide you. Our health coaches are trained to help identify the underlying cause of your digestive symptoms and to develop a customized protocol to address the cause.
Our health coaches work with challenging cases from all around the world and understand how to create individualized programs based on your unique needs. You can learn more about our coaching program here.
Final Thoughts on Diarrhea
Diarrhea is a common condition that affects everyone. For acute diarrhea, try the quick fix protocol. If you have been experiencing diarrhea for a longer period, follow the strategies in this article to address the underlying cause.
A stool test to evaluate the health of your gut and to identify the possible cause of your digestive issues can aid your health coach in developing a customized protocol for you. You can also check out our digestive health restoration program to learn more on how you can rebuild your gut health.
Sources For This Diarrhea Article Include:
1. Diarrhea, Mayo Clinic. Link here
2. Salmonella, CDC. Link here
3. About Escherichia coli Infection, CDC. Link here
4. Shigella-Shigellosis, CDC. Link here
5. Campylobacter (Campylobacteriosis), CDC. Link here
6. Parasites – Cryptosporidium, CDC. Link here
7. Staudacher J, Lomer M, et al., A Diet Low in FODMAPs Reduces Symptoms in Patients with Irritable Bowel Syndrome and A Probiotic Restores Bifidobacterium Species: A Randomized Controlled Trial, 2017 Oct., Gastroenterology, Vol. 153, Issue 4, p936-947. Link here
8. Godkin A, Smith K, Chronic infections with viruses or parasites: breaking bad to make good. 2017 Apr., 150(4): 389-396. PMID: 5343343
9. Chang Y, El-Zaatari M, Kao J, Does stress induce bowel dysfunction? 2014 Aug; 8(6): 583-585. PMID: 24881644
10. Mayer E, Naliboff B, et al., V. Stress and irritable bowel syndrome. Amer Jnl Psy, 2001 Apr. Link here
11. Cremonini F, Camilleri M, et al, Sleep disturbances are linked to both upper and lower gastrointestinal symptoms in the general population, 2009 Feb; 21(2): 128-135. PMID: 18823289
12. De Santis S, Cavalcanti E, et al, Nutritional Keys for Intestinal Barrier Modulation, 2015 Dec; 6:612. PMID: 26697008
13. Fedorak R, Probiotics in the Management of Ulcerative Colitis, 2010 Nov; 6(11): 688-690. PMID: 21437015
14. Aslam J, Green J, et al, Fermented foods, the gut and mental health: a mechanistic overview with implications for depression and anxiety. 2018 Nov 11: 1-13. PMID: 30415609
