Chronic Diarrhea: How Often Is Too Often?

Chronic diarrhea may be an unpleasant experience and topic of discussion, but the condition is fairly common. It affects 5 percent of the U.S. population at any given time, according to the American Gastroenterological Association (AGA). Diarrhea isn't always symptomatic of a serious condition, but diarrhea that lasts too long can be more harmful and may lead your doctor to diagnose other health problems.

When Is Diarrhea Considered Chronic?

When it comes to chronic diarrhea, you may ask yourself, "How much is too much?" While diarrhea is common and can happen for a multitude of acute or benign reasons, diarrhea that lasts more than four weeks is generally considered chronic, per the AGA. The diarrhea itself can also range in its symptoms, including loose stool consistency, increased frequency, urgency of bowel movements, or incontinence.

To identify whether you're suffering from chronic diarrhea, your doctor will likely conduct a medical history and physical examination. These evaluations may bring to light common causes of persistent diarrhea, such as diet, medications, and surgery or radiation therapy. But if there doesn't seem to be an obvious cause, your doctor can perform a range of tests as needed for your individual case. These can include blood and stool tests, an endoscopy, imaging studies, histology, and physiological testing.

Common Causes

According to American Family Physician, there are a variety of common causes of chronic diarrhea, including:

• Irritable bowel syndrome (IBS)
• Inflammatory bowel disease (IBD)
• Microscopic colitis (most common among older patients)
• Malabsorptive diarrhea, when nutrient absorption and digestive function are impaired
• Chronic gastrointestinal (GI) infections
• Medications, such as laxatives, antacids, proton pump inhibitors, and antineoplastic agents

Causes in Children

Children are especially at risk for chronic diarrhea as a symptom of many diseases and disorders, according to the National Institute of Diabetics and Digestive and Kidney Diseases (NIDDK). These often overlap with causes that are also common for adults, but they tend to include:

• Infections of the digestive tract
• Functional gastrointestinal (GI) disorders
• Food allergies and intolerances (such as celiac disease)
• Inflammatory bowel disease
• Small intestinal bacterial overgrowth
• Malabsorption, wherein the small intestine doesn't properly absorb nutrients from food

Because prolonged diarrhea can lead to dehydration, it's important to diagnose and then manage or resolve the diarrhea's cause. For children, diarrhea caused by malabsorption can also hinder normal growth and result in health complications later on, further emphasizing the importance of resolving this symptom.

Treatment Options

The specific treatment regimen for chronic diarrhea that your doctor will recommend can vary widely based on the root cause. Doctors can treat bacterial and parasitic infections with targeted medications, such as antibiotics. Functional GI disorders, such as IBS, can often be managed with medications and dietary changes. Dietary changes, particularly avoiding certain triggers, can also reduce or eliminate diarrhea caused by food allergies and intolerances.

The most important starting point for treating diarrhea is performing the evaluations and testing needed to confirm its root cause. Then you and your doctor can make the necessary changes to your diet, lifestyle, or medication regimen to ensure the diarrhea stops -- managing the root cause in the process.

Diarrhea that lasts only a few hours or even days is often normal and nothing to be concerned about. But if your diarrhea persists to the point of being chronic, schedule an appointment with your doctor for a thorough evaluation. The sooner you resolve your discomfort, the sooner you can return to a normal life with a healthy GI tract.