When Montezuma's revenge strikes

What is meant by diarrhoea?

Diarrhoea is not a disease but a symptom. 

Diarrhoea is defined as bowel movements that occur more than three times a day, when the stool has a pasty or liquid consistency or when there is an increased stool volume of over 250 grams per day.

What types of diarrhoea are there?

Not all diarrhoea is the same. Clinicians distinguish 5 types depending on the mechanism that makes the stool liquid. 

Osmotic diarrhoea occurs when the body cannot absorb certain foods or medications and fluid is drawn through the intestinal mucosa into the bowel lumen. This makes the intestinal contents thin to watery. 

There is also secretory diarrhoea, which usually occurs with chronic inflammatory bowel diseases, food poisoning and due to toxins from certain bacteria. 

An exudative diarrhoea is caused by severe inflammation of the intestinal mucosa due to bacteria and parasites and is manifested, among other things, by mucus and blood in the stool. 

Hypermotile diarrhoea involves increased peristalsis, where insufficient fluid is absorbed from the food bolus. 

And with fatty stools (steatorrhoea) the stool consistency becomes pasty due to a lack of bile acids. 

What are the most common causes of diarrhoea?

The most common causes of diarrhoea are viruses, bacteria and inflammation. 

Bacteria can come from contaminated food, which is often the case with traveller's diarrhoea. Fruit on the beach may look tempting but can cause acute diarrhoea and spoil a few days of a long‑awaited holiday. 

Why is the loss of fluid and electrolytes dangerous in diarrhoea?

Regardless of the cause, besides stopping the diarrhoea it is particularly important to prevent severe dehydration. With diarrhoea the body loses not only a lot of fluid but also important minerals, known as electrolytes. These include potassium, magnesium, sodium, calcium, phosphorus and chloride. 

Our body cannot produce them itself, yet they are crucial for the proper functioning of cells. Diarrhoea often leads to significant electrolyte loss and these important minerals should be replenished as soon as possible. 

Gut in distress? These tips help restore balance

• Above all, ensure adequate fluid intake. Avoid already opened drinks and tap water, as they may be hygienically unsafe. Good options are commercially bottled water, soft drinks in cans or alcohol‑free beer, which has a favourable electrolyte composition. Cola is not a good idea, even though it is considered a home remedy: it contains sugar, caffeine and carbonation and can worsen fluid loss. Green tea has antibacterial properties, soothes the gastrointestinal tract and its tannins help against diarrhoea.
• Avoid ice cubes in water and drinks, as they can be bacterial hotspots: bacteria can easily multiply in ice machines.
• For traveller's diarrhoea, chew a few papaya seeds. Their enzyme papain is thought to have antibacterial and digestive benefits. You can dry these seeds and take them with you when travelling for emergencies.
• Because the body loses a lot of energy during diarrhoea, it needs light foods that quickly provide energy. Short‑chain carbohydrates such as pasta and rice are suitable because they are quickly processed by the body and cause a rapid rise in blood sugar.
• Easily digestible foods include potatoes cut into small pieces and cooked in plenty of water (they supply potassium), salted rice and oats cooked in water, which provide minerals and vitamins.
• A classic remedy for diarrhoea is rice porridge. Cook one cup of hulled rice with five cups of water for 45 minutes, puree it and eat small portions of this porridge several times a day to soothe the irritated intestinal lining and firm up the stool.
• Crushed and pureed bananas provide not only magnesium and potassium but also pectin, making them particularly effective against diarrhoea. Pectin is also abundant in apples. You can drink apple spritzer or simply chew an apple well to release pectin. It absorbs fluid, swells in the intestine and thereby thickens the stool.
• To bind toxins, stir one to two teaspoons of finely ground medicinal clay into half a glass of water or tea and sip the mixture slowly.
• Dry yeast products containing the yeast Saccharomyces boulardii help rebuild defenses and inhibit the growth of pathogens.
• A hot water bottle or a warm grain cushion soothes the gut by releasing a pleasant warmth for a long time. Place it on the affected area for as long as the warmth feels comfortable.
• Pay careful attention to hygiene. Clean toilets, sinks, floors and door handles with disinfectant wipes. Wear disposable gloves when doing so. Wash your hands with water and soap before every meal, after every toilet visit and repeatedly in between. This is good prevention against diarrhoea. Pocket hand sanitiser sprays are also important.
• If you have very severe, bloody or mucousy diarrhoea, see a doctor. The same applies if you have a fever.

These tips will calm your gastrointestinal tract so you don't spend your holiday time on the toilet!