WHEN you’ve fallen victim to a nasty case of the runs it can be tricky to figure out what triggered them in the first place.
If you’re wracking your brain about the cause in-between frantic trips to the loo, there’s a formula you can use to help you get to the bottom of your misery.
Dr Will Bulsiewicz advised you count the number of trips you’ve taken to the loo
Dr Will Bulsiewicz – a doctor specialising in gut health – recently appeared on nutrition site Zoe’s podcast to discuss all things diarrhoea.
He shared why things get so liquid in the first place.
“When you have diarrhoea, it’s because your intestines have been flooded with and abnormal amount of water,” Dr Bulsiewicz said.
You might not adequately be absorbing the water from your intestines, or water might be being pulled in to your intestines.
Spicy meals can be especially dicey, as they contain a phytochemical called capsaicin – which makes things like chilli peppers spicy – that irritates pain receptors in your intestine.
Your body will basically want to get rid of this irritant as soon as possible – “and boom, there’s diarrhoea,” as Dr Bulsiewicz put it.
The doctor went on to describe how to 90 per cent of the water that we consume or that’s secreted into our intestines to aid digestion is absorbed in our small intestine.
If you’ve fallen victim to a tummy bug, all this water gets shunted from your small intestine into your large intestine, ‘completely’ overwhelming it.
“We’re not anatomically to stop water from coming out, we’re anatomically designed to stop solid stool from coming out,” Dr Bulsiewicz said.
The GP mentioned other ‘classics’ that can trigger runny a tummy:
dairy products – specifically non-fermented ones caffeine sugars- including artificial sweeteners
“Drinking a large amount of diet coke could definitely trigger diarrhoea for a lot of people,” the gut specialist said.
When it comes to the run, Dr Bulsiewicz said it’s important to track how many times you’re having to run to the loo – and this is where the maths comes in.
“The thing about diarrhoea is that if you have one or two lose bowel movements, that honestly is probably something that you ate.”
In you’re feeling much better after one or two messy trips to the loo, he advised you think about what you had in the couple of meals leading up to the incident.
“If you have three bouts or more of diarrhoea within a 24 hour period, that’s when I start to consider the possibility this could be an infection,” Dr Bulsiewicz noted.
What he calls an infection – or gastroenteritis – you’ll know as stomach flu or a tummy bug.
These additional symptoms can indicate an infection – and not something you ate – is causing your tummy upset:
nausea vomiting loss of appetiteweight loss dehydration abdominal pain blood in your stool fever
And if you’re waking up in the middle of the night with an urgent need to poo, then that’s another surefire sign of an bug.
“There are many digestive conditions that exist and the majority of them will not wake you up in the middle of the night to have a bowel movement,” Dr Bulsiewicz noted.
Inflammatory conditions such as ulcerative colitis or Crohns disease could also be the cause of your midnight loo trips.
According to the doctor, “if it’s an inflammatory cause, it’s something that slowly starts to pick up steam” over weeks or months, building speed gradually ‘like a freight train’ rather than the ‘rocket taking off’ effect of a stomach bug.
Risks of diarrhoea if not treated
In most cases, explosive, urgent diarrhoea won’t be life threatening to us.
But Dr Bulsiewicz said there are litres of water coming out of you that you need to replace – easier said then done if you can’t keep anything in your stomach and you’re also throwing up.
In some cases, dehydration might land you in the hospital.
Dr Bulsiewicz said you should seek medical help if you notice these signs:
an increase in heart rate dry mouth and cracked lips light-headedness when you move
It’s also worth bearing in mind that you also lose electrolytes – sodium, potassium, magnesium – when you’ve got a case of the runs and it’s important to replace them.
Dr Bulsiewicz suggested having Dioralyte – a broth or a soup could work too.
Bananas can also help replenish the potassium you’ve lost if your stomach can tolerate them.
And if you want to put a stop to your diarrhoea misery, the doctor said taking Imodium can ‘slow the explosiveness’ of your poos.
But there are concerns that taking the Imodium can actually be dangerous if it’s a bacterial infection, Dr Bulsiewicz noted, as by slowing down your colon movement you’re trapping the bacteria in it.
He suggested you take Pepto-Bismol instead, which can simultaneously combat the infection and ease your diarrhoea
If you have blood in your stool, fever and severe abdominal pain or you’re over 65 and kidney heart or lung disease, you may need to take antibiotics – speak to a GP urgently if you experience these symptoms.
When you should seek help
Usually diarrhoea is something you have to ride out, as it will get better on its own.
You must stay off school or work if you have been unwell for at least two days, as this suggests you have a bug that could be spread.
A pharmacist can help with medicines to relieve diarrhoea and it’s associated symptoms, like dehydration.
But call a pharmacy or contact them online before going in person. You can get medicines delivered or ask someone to collect them.
The NHS says to call 111 if:
there is blood in diarrhoea, or you are bleeding from the bottom
diarrhoea has lasted more than seven days, or vomiting more than two days
you have signs of dehydration (fewer wet nappies in young children) despite using rehydration sachets
you can’t keep fluid down
you are worried about a baby under 12 months
your child has stopped feeding (breast or bottle)
Call 999 if you or your child:
vomit blood or have vomit that looks like ground coffee
have green or yellow-green vomit
might have swallowed something poisonous
have a stiff neck and pain when looking at bright lights
have a sudden, severe headache or stomach ache