Diarrhoea

Sign/Symptoms
Drugs
Treatments
Attributes
Commonality is common
Further Tests

 

Diarrhea

 

            Diarrhea is a relatively common condition that involves the numerous passing of loose or watery stools. [1] It may be mild and go away in a couple of days or may be persistent and connote an underlying serious medical illness. [2]

           

Types

            The condition can be classified as either acute or chronic. In the acute type, symptoms show rapidly and last in about five up to ten days. This is frequently seen in developing countries and is a top cause of mortality in pediatric patients.

            Chronic diarrhea as the name implies is a diarrhea taking place for a long period such as those occurring in inflammatory bowel syndrome (IBS) and Crohn's disease. [1]

           

Causes

                Most commonly, diarrhea is viral which classically resolves spontaneously after a few days. Bacteria are the etiologic organism in most cases of food poisoning particularly E.coli.  Parasites such as Giardia lamblia may also cause the condition. Travel to endemic areas is a risk factor. [1]

            Some people may develop diarrhea due to intolerance to a type of sugar called lactose which is found in milk and ingredient in dairy products. Some individuals may have trouble digesting a different form of sugar called fructose which is found in fruits and certain beverages.

            Diarrhea can be present in some patients who underwent surgical procedures such as gallbladder removal operation.

            The chronic type can be seen in various diseases such as Crohn's disease, ulcerative colitis and celiac disease.

            Other infrequent causes are radiation therapy and nerve disorders. [2]

 

Signs and Symptoms                                                                                           

            Patients may have abdominal cramps, stomach pain, vomiting, appetite loss, fatigue, bloating, nausea and loose watery stools. Some may have blood in the stool, fever and headache. [1]

 

Diagnosis

            After obtaining the medical history of the patient, the physician performs a physical examination. When there is a need, the patient’s stool is examined (fecalysis). Depending on the case, certain procedure may be performed such as sigmoidoscopy. [1]

 

Treatment

            In the majority of cases, diarrhea resolves on its own without the need for medical intervention. Dehydration should be watched out for. The affected person must drink plenty of fluids and should avoid medications which are not prescribed. Specific drugs may be given which depends on the result of fecalysis. Diet and lifestyle changes may help for chronic type cases. [2][3]

 

References:

1.      http://www.medicalnewstoday.com/articles/158634.php

2.      http://www.mayoclinic.com/health/diarrhea/DS00292

3.      http://www.nlm.nih.gov/medlineplus/ency/article/003126.htm

 

 

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Vitamin A [1, 45, 46, 47, 48, 49, 50, 51]:

Please note, this management does NOT treat the condition itself. It may mildly help in preventing some of the symptoms, and even then has insufficient evidence to back up this claim at present. Please note, this acts as a PREVENTATIVE treatment, and not necessarily symptomatic relief.

Recommendation: Strong (Vitamin A may help to prevent diarrhoea due to its role in the body's immune function)

Grade of Evidence: high quality of evidence

Thuja (Eastern White Cedar, Thuja Occidentalis) [1, 42, 43, 44]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present. Little is known about the full effects of Thuja, so it is not recommended for medicinal use. Thuja can be poisonous if ingested in large amounts.

Recommendation: no recommendation (There is insufficient evidence to support claims that Thuja helps to treat diarrhoea)

Grade of Evidence: very low quality of evidence

Psyllium (Isphagula, Plantago Psyllium) [1, 36, 37, 38, 39, 40, 41]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: strongly in favor (Clinical trials have shown that Psyllium is effective in treating side effects of cancer therapy like diarrhoea )

Grade of Evidence: high quality of evidence

Peppermint Oil [1, 30, 31, 32, 33, 34, 35]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (There is insufficient evidence to support claims that peppermint helps to treat diarrhoea)

Grade of Evidence: very low of evidence

Mugwort (Artemisa Vulgaris) [1, 27, 28, 29]:

Please note, this management does NOT treat the condition itself. It has been proposed only as a weak supportive symptomatic support, and even then, has been discounted due life-threatening side effects

Recommendation: No recommendation (There is insufficient evidence to support claims that mugwart helps to treat diarrhoea. More research is needed.)

Grade of Evidence: very low quality of evidence

Kampo [1, 25, 26]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (Initial studies indicate a possible reduction of severity in diarrhoea when using Kampo. However, more studies are needed, and the side effects of the treatment are relatively unknown.)

Grade of Evidence: very low quality of evidence

Indian Snakeroot (Rauvolfia, Rawolfia Serpentina) [1, 23, 24]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (There is insufficient evidence to support claims that Indian Snakeroot helps to treat diarrhoea in any way)

Grade of Evidence: very low quality of evidence

Green Tea [1, 18, 19, 20, 21, 22]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly in favor (There is insufficient evidence to support claims that Green Tea helps to treat diarrhoea in any way. Although reports are positive, more studies are needed.)

Grade of Evidence: low quality of evidence

Gotu Kola (Centella Asiatica, Hydrocotyle Asiatica)[1, 12, 13, 14, 15, 16, 17]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (There is insufficient evidence to support claims that Gotu Kola helps in the treatment of diarrhoea in any way. More research is needed.)

Grade of Evidence: low quality of evidence

Goldenseal (Hydrastis Canadensis) [1, 5, 6, 7, 8, 9, 10, 11]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly against (Animal studies show that Goldenseal may help reduce certain types of diarrhoea. However, more studies on humans is needed. In addition, Goldenseal may produce toxic effects, including depression, constipation, rapid heartbeat, stomach pain, mouth ulcers and vomiting.)

Grade of Evidence: low quality of evidence

Comfrey (Blackwort, Symphytum Officinale)  [1, 2, 3, 4]:

Please note, this herb is TOXIC IF TAKEN ORALLY, OR IF APPLIED TO AN OPEN WOUND. Can cause severe liver or kidney damage and lead to death. May ONLY be used as a cream over intact skin, and does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Strongly Against  (ONLY TO BE USED AS A CREAM OVER HEALTHY SKIN. If taken orally to treat diarrhoea, Comfrey can lead to severe liver and kidney damage, and can even lead to death.)

Grade of Evidence: low quality of evidence

Red Pepper (Capsaicin):

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (There is insufficient evidence to support claims that red peppers help to treat or prevent diarrhoea)

Grade of Evidence: very low quality of evidence

Bromelain (Sulphydryl Proteolytic Enzyme, Ananas Comosus):

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (Available evidence does not support claims that Bromelain helps to treat diarrhoea)

Grade of Evidence: low quality of evidence

Black Cohosh (cimicifuga Racemosa):

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (Available evidence does not support claims that Black Cohosh helps to treat symptoms of diarrhoea in any way. Studies have yielded mixed results)

Grade of Evidence: moderate quality of evidence

Therapeutic Touch:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (There is insufficient evidence to support claims that Therapeutic Touch can help to treat diarrhoea in any way)

Grade of Evidence: very low quality of evidence

* www.gradeworkinggroup.org

 


Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. http://www.ncbi.nlm.nih.gov/pubmed/19460762

3. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/comfrey

4. http://www.ncbi.nlm.nih.gov/pubmed/2103401

5. http://nccam.nih.gov/health/goldenseal/

6. Tierra Michael (1998): The Way of Herbs. New York, Pocket Books

7. Grieve M. (1971): A Modern Herbal. New York, Dover Publications, Inc

8. Mills S. and Bone K. (2000): Principles and Practice of Phytotherapy. Philadelphia, Churchill Livingstone

9. Tice Raymond (1997): Goldenseal and Two of its constituent alkaloids: berberine and hydrastine Research Triangle Park, National Institute of Environmental Health Sciences, in Seiger E: Review of Toxilogical Literature

10. http://www.henriettesherbal.com/eclectic/ellingwood/hydrastis.html

11. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/goldenseal

12. Winston, D., Maimes, S., Adaptogens: Herbs For Strength, Stamina, and Stress Relief, 2007, pp. 226-7

13. "A Double-Blind, Placebo-Controlled Study on the Effects of Gotu Kola (Centella asiatica) on Acoustic Startle Response in Healthy Subjects". Journal of Clinical Psychopharmacology. 20(6):680-684, December 2000. Bradwejn, Jacques MD, FRCPC *; Zhou, Yueping MD, PhD ++; Koszycki, Diana PhD *; Shlik, Jakov MD, PhD

14.  B. M. Hausen (1993) "Centella asiatica (Indian pennywort), an effective therapeutic but a weak sensitizer." Contact Dermatitis 29 (4), 175–179 doi:10.1111/j.1600-0536.1993.tb03532.x

15. Cataldo, A., Gasbarro, V., et al., "Effectiveness of the Combination of Alpha Tocopherol, Rutin, Melilotus, and Centella asiatica in The Treatment of Patients With Chronic Venous Insufficiency", Minerva Cardioangiology, 2001, Apr; 49(2):159-63

16. http://en.wikipedia.org/wiki/Gotu_kola#Medicinal_effects

17. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/gotu-kola

18. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/green-tea

19. http://www.ncbi.nlm.nih.gov/pubmed/16968850

20.  http://www.denverpost.com/nationworld/ci_4326770

21. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-green_tea.html

22. http://nccam.nih.gov/health/greentea/index.htm

23. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/indian-snakeroot

24. http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/seven/000092149.htm

25. Shibata, Yoshiharu and Jean Wu. "Kampo Treatment for Climacteric Disorders: A Handbook for Practitioners." Paradigm Publications, 1997

26. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/kampo

27. Anliker MD, Borelli S, Wüthrich B. Occupational protein contact dermatitis from spices in a butcher: a new presentation of the mugwort-spice syndrome. Contact Dermatitis. 2002;46:72-74.

28. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/mugwort

29. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. Philadelphia, PA: Lippincott Williams & Wilkins; 2004.

30. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/peppermint

31. http://www.ncbi.nlm.nih.gov/pubmed/17420159

32. http://www.ncbi.nlm.nih.gov/pubmed/19507027

33. http://www.medicine.ox.ac.uk/bandolier/booth/alternat/AT022.html

34. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-peppermint.html

35. http://nccam.nih.gov/health/peppermintoil/index.htm

36. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-psyllium.html

37. http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601104.html

38. http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed&part=A17913

39. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/psyllium

40. http://www.mayoclinic.com/health/cholesterol-lowering-supplements/CL00013/METHOD=print

41. http://www.ageless.co.za/herb-psyllium.htm

42. http://www.nlm.nih.gov/medlineplus/ency/article/002769.htm

43. http://plants.usda.gov/plantguide/pdf/cs_thoc2.pdf

44. http://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3Aproject=medlineplus&query=thuja&x=0&y=0

45. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-vitamina.html

46. http://www.nlm.nih.gov/medlineplus/vitamina.html

47. http://ods.od.nih.gov/factsheets/vitamina.asp

48. http://www.who.int/nutrition/topics/vad/en/

49. Latham, Michael E. (1997). Human Nutrition in the Developing World (Fao Food and Nutrition Paper). Food & Agriculture Organization of the United. ISBN 92-5-103818-X.

50. Sommer, Alfred (1995). Vitamin a Deficiency and Its Consequences: A Field Guide to Detection and Control. Geneva: World Health Organization. ISBN 92-4-154478-3.

51. http://www.unicef.org/worldfitforchildren/files/A-RES-S27-2E.p


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