It is often not an emergency, but without sufficient hydration, diarrhoea can cause serious complications.

It can happen during nervy moments – sitting for an examination, before a job interview or going on stage. But performance-anxiety diarrhoea, as it is known in these cases, is gone once the anxious moment passes.

Causes of diarrhoea

Barring psychosomatic links – bodily symptoms caused by mental or emotional disturbances – diarrhoea is a sign of a number of conditions, including infections of the gut, said Dr Tan Yew Sang, Family Physician at SingHealth Polyclinics​Bukit Merah​.

“It can also be a reaction to antibio​​​tics, an overuse of laxatives to treat constipation, a sign of lactose intolerance or a sensitive gut,” said Dr Tan. ​Much like a fever,​​​​​ diarrhoea is believed to act as one of the body’s defence mechanisms to help rid it of toxins and other harmful substances.

“In Singapore, diarrhoea is often the result of eating raw or poorly cooked food, or cooked food that has been left in the open for many hours. In babies, unsterilised milk bottles is a common factor,” said Dr Tan. In most cases, diarrhoea – defined as having three or more loose or liquid stools a day – clears up after a few days as the body fights off the infection. But for infants or those with low immunity, it can be life-threatening.

In Singapore, about 5 per cent of total paediatric admissions to government hospitals are due to gastric flu. Less commonly, diarrhoea can be a symptom of more serious illnesses such as cancer of the gut, inflammatory bowel disease (where antibodies attack the gut), ischaemic bowel disease (where the gut lacks blood flow) and diabetes.

Dehydration can cause complications like kidney failure

Regardless of the cause, if fluids and salts are not replaced regularly during an episode of diarrhoea, patients can face complications unrelated to the illness that triggered the symptom. Dr Tan said: “If severely dehydrated, one can suffer from complications like kidney failure. Dehydration can lead to other illnesses and in extreme cases, even death. So it must be treated early. Hydration is really the cornerstone for treating diarrhoea.”

In developing countries with poor sanitation, improper disposal of sewage or rubbish, and limited access to clean drinking water, severe dehydration caused by diarrhoea is common. Patients brought to hospital with serious diarrhoea are usually hydrated intravenously with fluids and salts. Once the primary cause is identified, they are given medication such as anti-diarrhoeal drugs, charcoal, bacteria-containing supplements or antibiotics to treat the diarrhoea. A stool sample to check for infection, a scope of the gut and other investigations may follow if stools are bloody or weight loss is seen.

Managing diarrhoea at home

Besides drinking water, doctors recommend:

  1. ​In babies with diarrhoea, mothers should continue breastfeeding.
  2. In older children, give oral rehydration formul​ations and rehydration salts.
  3. In adults, give oral rehydration salts containing carbohydrates and electrolytes (e.g. sodium or potassium salts) with fluids.
  4. Avoid soft drinks, ice cream, fatty and spicy food, dairy products, caffeine and alcohol.
  5. Observe good personal hygiene, especially during food preparation.

Did you know?

  • Taking anti-diarrhoea medication is not a cure as it does not treat the underlying illness causing the diarrhoea.
  • Anti-diarrhoea medication for adults may not be safe for children. Check the instructions on the packaging or speak to your pharmacist or doctor.

Ref: V10​