Diarrhea is passing loose, watery stools three or more times a day, or more often than what is normal for you. Diarrhea may be acute, persistent, or chronic.
Acute diarrhea is a common problem that typically lasts less than a week and goes away on its own.1
Persistent diarrhea lasts longer than 2 weeks and less than 4 weeks.1
Chronic diarrhea lasts at least 4 weeks.1 Chronic diarrhea symptoms may be ongoing or may come and go.
How common is diarrhea?
Diarrhea is a common problem. Acute diarrhea is more common than persistent or chronic diarrhea. Research suggests that people in the United States have acute diarrhea about once a year.1 However, the actual number may be higher since most people with diarrhea don’t seek medical care.
Research suggests that up to 5% of people in the United States have chronic diarrhea.2
take certain medicines, such as antibiotics or medicines commonly used to treat cancer
consume food or drinks with sugar alcohols, such as sorbitol, mannitol, or xylitol
What are the complications of diarrhea?
Diarrhea can lead to dehydration and malabsorption. These complications may cause serious symptoms and health problems. People who have diarrhea and are pregnant, are over age 65, are currently taking antibiotics, or have a weakened immune system are more likely to have complications from diarrhea and should keep in touch with their doctor.3
Dehydration
Dehydration means your body doesn’t have enough fluid and electrolytes. Diarrhea, especially acute diarrhea, may cause you to become dehydrated because loose stools remove more fluid and electrolytes from your body than solid stools. If you can’t drink enough liquids or oral rehydration solutions to rehydrate your body, becoming dehydrated can lead to serious health problems, such as organ damage, shock, coma, or even death. However, serious health problems from being dehydrated are rare.
Malabsorption
Malabsorption occurs when your body can’t absorb enough nutrients from the food you eat. Malabsorption may cause you to become malnourished. Chronic diarrhea can cause malabsorption. Certain conditions that cause chronic diarrhea—such as infections, food allergies and intolerances, and certain digestive tract problems—may also cause malabsorption.
stools that are black and tarry or contain red blood or pus
symptoms of dehydration
Additional symptoms for adults
You should also talk with a doctor right away if you or an adult in your care has symptoms such as5
diarrhea lasting more than 2 days
high fever
six or more loose stools per day
People who have diarrhea and are pregnant, are over age 65, are currently taking antibiotics, or have a weakened immune system are more likely to have health problems from diarrhea and should keep in touch with their doctor.5
Additional symptoms for infants and children
You should also talk with a doctor right away if an infant or child has symptoms such as
diarrhea lasting more than a day
any fever in infants or high fever in older children
refusing to eat or drink anything for longer than a few hours in infants
frequent loose stools
If an infant or child has diarrhea, don’t hesitate to call a doctor for advice. Diarrhea is especially dangerous in newborns and infants and can lead to severe dehydration in just a day or two. A child with symptoms of dehydration can die within a day if left untreated.
Seek a doctor’s help right away if the child has diarrhea and is younger than 12 months, was born prematurely, or has a history of other medical conditions. Also, seek a doctor’s help right away if the child can’t drink enough liquids or oral rehydration solutions to prevent dehydration.
What causes diarrhea?
Acute diarrhea often has different causes than persistent and chronic diarrhea.
Acute diarrhea
The most common causes of acute diarrhea are viral gastroenteritis, food poisoning, and medicine side effects.
Viral gastroenteritis
Viral gastroenteritis is an infection of your intestines and a common cause of acute diarrhea. Many different viruses can cause viral gastroenteritis. The most common viruses include
Diarrhea can be a symptom of food poisoning. Food poisoning is an infection or irritation of your digestive tract that spreads through foods or drinks. Microbes—viruses, bacteria, and parasites—cause most food poisoning. Food poisoning usually goes away within a week, but some infections can last longer.
The most common microbes that cause food poisoning include
Any food or drink can contain microbes that cause food poisoning. However, some foods are more likely to lead to food poisoning than others, including
undercooked meats, poultry, and seafood
fruits and vegetables
raw or untreated milk, eggs, and cheeses
Travelers’ diarrhea
Consuming contaminated food and water or other drinks while traveling may also cause diarrhea, a condition known as
travelers’ diarrhea. Travelers’ diarrhea can occur anywhere. However, it’s more likely to affect people traveling to areas where sanitation and access to clean water are limited.
Medicine side effects
Medicines, such as antibiotics, antacids containing magnesium, and medicines commonly used to treat cancer, may cause acute diarrhea. Some liquid medicines contain sugar alcohols—such as sorbitol, mannitol, and xylitol—which may also cause diarrhea in some people.
Persistent and chronic diarrhea
Some infections, food allergies and intolerances, digestive tract problems, abdominal surgery, and long-term use of medicines can cause persistent and chronic diarrhea.
Infections
Some infections may cause ongoing diarrhea. After the infection goes away, you may have problems digesting certain carbohydrates, which can make diarrhea last longer.
Food allergies and intolerances
Allergies to foods such as cow’s milk, soy, cereal grains, eggs, and seafood may cause chronic diarrhea.
Some people have problems digesting certain carbohydrates, which can also cause chronic diarrhea.
Lactose intolerance is a condition in which you may have diarrhea after you consume foods or drinks that contain lactose. Lactose is a sugar naturally found in milk and milk products.
Dietary fructose intolerance is a condition in which you may have diarrhea after you consume foods or drinks that contain fructose. Fructose is a sugar found in fruits, fruit juices, and honey. Fructose is also added to many foods and soft drinks.
Sucrose intolerance is a condition in which you may have diarrhea after you consume foods or drinks that contain sucrose. Sucrose is also known as table sugar or white sugar.
Sugar alcohols commonly found in sugar-free candies and gum may also cause diarrhea in some people.
Digestive tract problems
Digestive tract problems that may cause chronic diarrhea include
Disorders of gut-brain interaction, which used to be called functional gastrointestinal (GI) disorders, are related to problems with how the brain and gut work together. Disorders of gut-brain interaction aren’t diseases. They are groups of symptoms that occur together.
Two disorders of gut-brain interaction that cause chronic diarrhea are
irritable bowel syndrome, in which you have repeated pain in your abdomen and changes in your bowel movements
functional diarrhea, in which you have chronic diarrhea that isn’t due to another cause
If you had surgery on your stomach or esophagus, you may develop a condition called dumping syndrome. Chronic diarrhea is a possible symptom of dumping syndrome.
Long-term use of certain medicines
Certain medicines that must be taken for a long time may cause chronic diarrhea. For example, antibiotics can change your gut flora and increase your chances of developing a Clostridioides difficile (C. difficile) infection. A C. difficile infection can cause chronic diarrhea.
References
Diagnosis
How do doctors find the cause of diarrhea?
If your doctor thinks it’s important to find the cause of your diarrhea, they may use your medical and family history, a physical exam, or tests.
Medical and family history
Your doctor may ask about your
symptoms, including how long you’ve had diarrhea, what your stool looks like, and how often you have diarrhea
eating and drinking habits
prescription and over-the-counter medicines
current and past medical conditions
recent international travel
Your doctor may also ask whether anyone in your family has digestive tract problems, food allergies and intolerances, or conditions that cause chronic diarrhea. Some conditions that cause chronic diarrhea, include
If your doctor decides diagnostic tests would be helpful, they may use one or more of the following tests to help find the cause of diarrhea.
Stool test
Doctors may use stool tests to check for blood, bacteria, parasites, or signs of diseases. A health care professional will give you a container for catching and storing the stool. You will receive instructions on where to send or take the container for analysis.
Blood tests
Blood tests can show signs of certain causes of diarrhea or problems such as dehydration. For a blood test, a health care professional will take a sample of your blood and send it to a lab. Doctors may use blood tests to check for certain diseases or disorders that can cause diarrhea.
Normally, a small amount of hydrogen is found in your breath. If you have problems digesting carbohydrates like lactose, fructose, and sucrose, you may have high levels of hydrogen in your breath.
For this test, you will drink a liquid containing a specific carbohydrate. Over a few hours, you will breathe into a container that measures how much hydrogen is in your breath. During this time, a health care professional will ask you about your symptoms. If your hydrogen levels go up and your symptoms get worse during the test, your doctor may diagnose one of the above conditions.
Changes in diet
Your doctor may ask you to avoid foods with certain ingredients to see whether your diarrhea responds to a change in diet.
Endoscopy
Your doctor may use endoscopy to view the inside of your digestive tract and help find your cause of diarrhea. Endoscopy tests may include
In most cases, you can treat acute diarrhea at home, without medical treatment.
Hydrate and replace electrolytes
When you have diarrhea, you need to replace lost fluids and electrolytes to stay hydrated. Drink plenty of water and liquids that contain electrolytes, such as broths and sports drinks. You can also drink oral rehydration solutions, liquids that contain glucose and electrolytes. You can make rehydration solutions at home or buy them from a store that sells medicines or baby supplies.
Older adults; people with a weak immune system; and people who have diabetes, kidney disease, or other health conditions should talk with their doctor before drinking oral rehydration solutions. There may be specific solutions or amounts of liquid that would work best for you.
When you have diarrhea, you may lose your appetite for a short time. When your appetite returns, you can most often go back to eating your normal diet, even if you still have diarrhea.
Antidiarrheal medicine
In most cases, you can safely treat acute diarrhea with over-the-counter medicines such as loperamide and bismuth subsalicylate. Doctors typically recommend against over-the-counter medicines for infants, children, or people who have bloody stools or fever.
See a doctor if your diarrhea gets worse or lasts more than 2 days while taking over-the-counter medicine.
In most cases, you can treat acute diarrhea by staying hydrated.
How can I treat my child’s acute diarrhea at home?
If your child has diarrhea, talk with their doctor for advice.
It’s important for children to stay hydrated when they have diarrhea. They should drink plenty of water, as well as oral rehydration solutions, broths, and sports drinks. Infants should drink breast milk or formula as usual. Talk with a doctor before giving oral rehydration solutions to your infant.
Doctors typically recommend against giving infants, toddlers, and young children over-the-counter medicines to treat diarrhea.
How do doctors treat diarrhea?
Most cases of acute diarrhea go away on their own. However, doctors may use a combination of tools to treat diarrhea in some people.
Hydration
If you are severely dehydrated, your doctor may recommend you receive intravenous (IV) fluids. Doctors may need to treat people with severe dehydration in a hospital. If you aren’t severely dehydrated, your doctor may recommend staying hydrated and replacing electrolytes at home.
Medicines
Antibiotics or other medicines may help people with some digestive tract infections. Doctors may also prescribe medicines to treat conditions that cause chronic diarrhea, such as Crohn’s disease, irritable bowel syndrome, or ulcerative colitis.
Diet changes
Chronic diarrhea caused by a food allergy or intolerance can be treated by avoiding foods and drinks that trigger the reaction. Doctors may suggest tracking what you eat and drink, as well as your bowel habits, to find out what may be causing diarrhea.
Probiotic supplements
Probiotics are live microorganisms—most often bacteria—that are like the ones you have in your digestive tract. Researchers are still studying the use of probiotics to treat diarrhea. However, many doctors and professional societies don’t believe that the evidence supports their use in treating or preventing diarrhea.6
You can take steps to lower your risk of getting diarrhea, such as washing your hands, avoiding contaminated foods and drinks, and getting vaccinated against certain viruses.
Wash your hands
Washing your hands can lower your chances of getting or spreading infections that can cause diarrhea. Wash your hands thoroughly with soap and water for at least 20 seconds7
after using the bathroom
after changing diapers
before and after handling or preparing food
before and after caring for someone with diarrhea
after handling garbage
If you don’t have soap and water available, use a hand sanitizer that is at least 60% alcohol.7
Keep foods and drinks safe
Protect yourself against food poisoning by keeping foods and drinks safe. Properly storing, cooking, cleaning, and handling foods can help lower your chances of getting sick.
When traveling to areas with limited sanitation and water filtration systems, only
drink bottled water and use it to make ice, prepare foods, and brush your teeth
consume drinks that are in factory-sealed containers
eat meat, fish, or shellfish if they’ve been cooked to a safe temperature and are served hot
eat raw vegetables and raw fruits if they’ve been washed in clean water or are peeled
Vaccinate infants to prevent rotavirus infection
Two oral vaccines are approved to protect children from rotavirus, a virus that causes viral gastroenteritis. Doctors usually give infants the vaccines in either two or three doses.
For the rotavirus vaccine to be effective, infants should receive all doses by age 8 months. Infants age 15 weeks or older who have never received the rotavirus vaccine should not start the series.8
References
Eating, Diet, & Nutrition
What should I eat if I have diarrhea?
If you have acute diarrhea, you may not feel like eating. In most cases, when you feel like eating again, you can eat your normal diet. Children with acute diarrhea should have their usual age-appropriate diet, and infants should have breast milk or formula.
If you have chronic diarrhea, your doctor may recommend changing what you eat. People with food allergies or problems digesting certain carbohydrates or proteins should eat foods that improve symptoms and ensure good nutrition. Talk with your doctor about what foods are best for you.
Parents and caregivers should give children with diarrhea their usual age-appropriate diet and feed infants breast milk or formula.
What should I avoid eating if I have diarrhea?
If you have acute diarrhea, avoid foods and drinks that could make diarrhea worse, such as
alcoholic beverages.
drinks with caffeine, such as coffee, tea, and some soft drinks.
foods and drinks containing large amounts of simple sugars, such as fructose and lactose. Sweetened beverages, some fruit juices, candy, and packaged desserts often have these sweeteners.
foods and drinks containing sugar alcohols, such as sugarless gum and candies.
foods that are high in fat, such as fried foods, pizza, and fast food.
milk and milk products that contain lactose. Some people recovering from acute diarrhea have problems digesting lactose for up to a month or more afterward. Children and infants with acute diarrhea should continue their age-appropriate diet.
Most experts don’t recommend following a restricted diet, other than what is above, or fasting when you have acute diarrhea.
If you have chronic diarrhea, your doctor may suggest avoiding foods or drinks that make your symptoms worse.
Keeping a food journal could help you figure out which foods and drinks trigger your symptoms. Be sure to track
what foods and drinks you consume
what symptoms you have
when symptoms occur
which foods and drinks make symptoms worse
Take your notes to your doctor and talk about which foods and drinks seem to make your symptoms worse. You may need to avoid or limit these foods and drinks.
Clinical Trials
NIDDK conducts and supports clinical trials in many diseases and conditions, including digestive diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life.
What are clinical trials for diarrhea?
Clinical trials—and other types of
clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future.
Researchers are studying many aspects of diarrhea, such as new ways to treat and prevent the condition.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
What clinical studies for diarrhea are looking for participants?
You can view a filtered list of clinical studies on diarrhea that are federally funded, open, and recruiting at
ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe for you. Always talk with your health care provider before you participate in a clinical study.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.
NIDDK would like to thank: Phillip I. Tarr, M.D., Washington University School of Medicine
