What Qualifies As "diarrhea"?

[Carol the Dabbler]

I kept reading that one common celiac symptom is diarrhea, and I thought, well, I don't have diarrhea, just loose stools. Then I got to wondering what is the definition of diarrhea?

My dictionary says, "excessive frequency and looseness of bowel movements." It doesn't say anything about cramping or urgency, which is what I have always thought distinguished diarrhea from ordinary loose stools. And what do they mean by "excessive"?

Has anyone seen/heard an "official" definition? And/or what is your personal definition?

[Ursa Major]

Diarrhea doesn't have to involve any cramping at all. Loose stools is anything that isn't formed. It can just be mushy, or it can be like water. It can be like an explosion, making a real mess, or just be.... well....... loose.

And your dictionary is wrong when it talks about 'excessive frequency', as it can just be a one-time thing. That is my experience, anyway.

[Carol the Dabbler]

So as you understand it, diarrhea is just another way of saying loose stools (with or without other factors)?

[bluejeangirl]

Diarrhea doesn't have to involve any cramping at all. Loose stools is anything that isn't formed. It can just be mushy, or it can be like water. It can be like an explosion, making a real mess, or just be.... well....... loose.

And your dictionary is wrong when it talks about 'excessive frequency', as it can just be a one-time thing. That is my experience, anyway.

I always wondered about what was meant by diarrhea. I also thought it involved cramping and watery stools. According to this I did have diarrhea or unformed stools before I went G.F. Interesting.

[jerseyangel]

I read once that diarrhea was watery or loose bowel movements that occur more than twice in an 8 hour period. I don't know if that's exactly right, though.

I normally don't get cramping with D--just a feeling of urgency.

[Ursa Major]

Sometimes I get terrible cramping, and have to run to the bathroom many times a day. Other times I just feel great urgency, rush to the bathroom, have an explosion of watery D and that is it. I am fine after that.

The dictionaries are mostly looking at D from being sick with a virus or food poisoning or something like that. If you look at it from that perspective, what they say is true. But when dealing with celiac disease those 'rules' don't necessarily apply.

[jerseyangel]

The dictionaries are mostly looking at D from being sick with a virus or food poisoning or something like that. If you look at it from that perspective, what they say is true. But when dealing with celiac disease those 'rules' don't necessarily apply.

Yes--I think this is very true.

[Jestgar]

When I was in the Peace Corps diarrhea was classified as "more than 4 times in one day, more than 1 day in a row" Everyone has tummy problems sometimes. You just need to be aware of when it becomes dangerous.

[Carol the Dabbler]

It occurs to me that when diarrhea is listed as a common celiac symptom, it simply means that quite a few celiacs checked that box on a questionnaire. Therefore, "diarrhea" simply means whatever it meant to those celiacs -- pretty similar to any/all of the above, I suppose.

[Carol the Dabbler]

OK, I just checked out the ultimate "general consensus" reference site, Open Original Shared Link. They start out by defining diarrhea as "frequent watery, loose bowel movements," then proceed immediately to say, "Acute infectious diarrhea is a common cause of death in developing countries," thus supporting Ursa Major's claim in post #6.

They also have an interesting (and only slightly gross) chart of stool shapes, which states that diarrhea can occur in a smooth, soft "sausage" shape. That surprises me, but it's consistent with a later statement, "the formal medical definition of diarrhea involves defecation of more than 200 grams per day." That's only about 7 ounces, folks -- a scant cupful, less than half a pound!

Finally, they discuss various mechanisms that can produce diarrhea, including this: "Osmotic diarrhea occurs when there is a loss of water due to a heavy osmotic load. This can occur when there is maldigestion (e.g., pancreatic disease or Coeliac disease), where the nutrients are left in the lumen, which pulls water into the lumen." I read that as saying that a celiac's diarrhea can be something like what happens when there's more salt on one side of a membrane than there is on the other -- water from the less-salty side will migrate to the saltier side, thus evening out the concentration. In the case of a celiac's intestines, the result is more water in the stools (so they're softer and bulkier) and less water in the rest of the body (causing dehydration and thirst).

I suspect that other diarrhea mechanisms can also occur in celiac disease. Motility diarrhea means that food is moving too fast through the digestive tract. And I don't quite understand the definition of inflammatory diarrhea, but I'd be surprised if celiacs don't generally have some degree of intestinal inflammation.

[kbtoyssni]

I also think it's somewhat relative to a person's normal bowel movements (if you can even remember what those are like!!!) I have days where I'm more D-like and days when I'm more C-like, but I wouldn't say I ever truly get D or C compared to what some of you deal with or compared to any medical definition. But for me it's a change and enough for me to know that something's wrong.

[2kids4me]

okay, so this thread is right up my alley...having worked in a vet clinic, I have seen a variety of stool!

My job as a tech is to record the character and color of stool. Diarrhea is an adjective to define stool that is liquid consistency and no form.

Watery diarrhea = usually light colored and splats out onto newspaper, mostly water that soaks into paper .....dog can walk through it and not get too messy.

Diarrhea / without the "watery" in front.....splats on paper, can be light ot dark brown or have blood/mucous in it - looks like liquidy pudding (sorry for the food reference ) Usually passed with little warning, doggy never gets a chance to tell you "Let me out"....kitties may not make it to the litter box...

Loose stool - can be called semi formed stool / semi soft...like a "thick cow pattie"....wont hold its shape long once on the paper - ....doggie might have tried to get your attention, but since you were busy with the surgery...he has walked through it...very messy, stuck in between pads. Bath time.

Diarrhea is further catagorized by what's in it:

bloody diarrhea

mucous and bloody diarrhea

garbage diarrhea - cause of diarrhea is now apparent, bits of plastic baggie, bits of bone.

green diarrhea (bile coming through when patient has not eaten for a few days)

crayola diarrhea - dog ate kids crayons. Very colorful..I once refered to the color as poople when a dog ate a non toxic kids purple marker....

Ok so back to people ..Diarrhea occurs for a number of reasons - it can be from small bowel inflammation or upset, food poisoning, large bowel irritation...you name it...it's a symptom of GI upset. It can be from inability to resorb water in the colon to rapid transit through the gut seen in irritated / inflammed bowel. The most common cause is viral....but next to that would be food related upset.... too much of one kind of food, an allergy, an intolerance, celiac of course [because the small bowel is damaged] .... food is not digested normally / completely at times....

The evaluation of diarrhea is subjective....but IMHO...anything that squirts out quick and has no form in the toilet bowl = dairrhea. Pain and cramping do not always accompany it, but in general your intestines have very sensitive nerve endings and anytime it speeds up to pass stool quickly - there is at the very least discomfort. Spasms in the bowel are incredibly painful - the bowel usually moves in waves called persitalsis, when diarrhea occurs - the rhythmic contraction becomes irregular - like waves crashing back against each other...

Viral diarrhea or food poisoning diarrhea tend to have severe cramping because of the sudden onset....Chronic diarrhea in some individuals is more annoying than anything , urgency and cramping may not be experienced.

Diarrhea / semi formed stool is not the normal consistency of stool so it should be evaluated based on that alone - other signs (cramping/ urgency) are secondary.

once a day or 16 times day - its still diarrhea.

Sandy

[little d]

This is good to know, before all this I thought that I just had weird stool, the more I read about what stool should look like and I did see a "normal" looking stool certainly did not look like mine. Ok gross alert mine were alway pensil thin with ridges, sometimes looser thant other, yes watery, not so watery with a real urgantacy when I had to go I had betty find a bathroom before I messed something up. Then other times teny tiny pebble constipated stool. I never knew what it would look like ever. My husband sometime would have to hurry home or find a Resturant for me to go, that was emarrasing.

donna

[darlindeb25]

Very interesting. I read an article once about this subject and this person writing it said that most people who think they have diarrhea, really do not. He said true diarrhea is not just running to the bathroom with urgency. All I could think was--have you ever had it mister?

I wanted to ask him--Have you ever fell asleep sitting on the toilet in the middle of the night, afraid to leave the bathroom? Have you ever sat there so long that your legs went numb and then they felt like pins and needles? I had a friend who actually would fall asleep in the bathtub out of fear of having an accident in bed! Sometimes I would be afraid to leave home. I developed agoraphobia over all of this. There is more to celiac disease than just the physical issues and for some, diarrhea is just the beginning.

It's a nasty subject, but it's good to see the correct difinitions of the word--thanks!

[Carol the Dabbler]

I also think it's somewhat relative to a person's normal bowel movements (if you can even remember what those are like!!!)

OK, maybe this is the crux of the matter -- we have no idea what's normal, because we have no frame of reference. Once we graduate from diapers and the potty chair, NOBODY ever looks at our stools. And except when our kids are in diapers, we NEVER look at anyone else's stools. So if our stools are the same as they usually are, we tend to assume that they're normal, and we don't check any of the little boxes on the medical questionnaire.

I'm wondering how many more cases of celiac disease would be suspected and diagnosed if doctors routinely asked for stool samples in addition to urine samples. Other than little dabs on Hemoccult cards, I've only been asked once, by a self-styled holistic doctor who sent the sample to Great Smokies. (That was about ten years ago, and apparently nobody was thinking of celiac disease, so the test didn't end up doing me much good.) But mainstream doctors never ever seem to be interested in stools, even when the patient is complaining of digestive-tract problems.

Now that celiac disease and various food intolerances are known to be way more common than was previously thought, maybe it'll become more routine for physicals to include a stool test.

[2kids4me]

Now that celiac disease and various food intolerances are known to be way more common than was previously thought, maybe it'll become more routine for physicals to include a stool test.

In my line of work - the only thing we can tell from stool is:

worms or giradia infection

blood - indicates bleeding from bowel but not diagnostic as to cause of bleeding

mucousy = irritated bowel

If we have an animal with abnormal stool....bloodwork, and xrays are used. The character of the stool is a symptom, and does not point to a specific disease. Causes of diarrhea can include but are not limited to:

hormonal imbalance, hyperthyroidism, adrenal failure (addisons), food intolerance, viral or bacterial infection, stress, eating a novel food (change in diet), pyometra, prostate infection/tumour....that's only a a partial list. Stool itself is rarely helpful in diagnoisi. It is a symptom that is noted along with any other symptoms and how long it has been present.

If we have a patient with diarrhea for example - we determine its significance in light of other symptoms - age of animal / fever / appetitie / abdominal pain / blood count / vomiting / water consumption / acute or chronic / general appearance....

Celiac disease is the "great imitator" in terms of symtpoms - they can be so varied and point the doctor in many directions. It is not considered a condition to routinely rule out ...since not all patients have diarrhea as a symptom.......compared ot something like diabetes where classic symptoms are increased thirst and increased urination...and easily diagnosed by a blood glucose or urine dipstick.

If they include stool test as part of a routine physical - the number of tests required would not be feasible - from a money perspective.

I would suggest that they routinely add the celiac panel to every routine physical. At least once for every person - as a screening tool. It would catch a lot of "missed celiacs" who have vague symptoms. I also think that patients with neurologic symptoms should be screened. Migraines and joint pain were the primary symptoms for my daughter.

Sandy