Diarrhoea is a condition where you frequently pass watery or loose stools. Some people may also have other symptoms, depending on the cause. It affects most people from time to time and is usually nothing to worry about. However, it can be distressing and unpleasant until it passes, which normally takes a few days to a week [1].
The excessive loss of water in your stool can also sometimes lead to dehydration, which can be serious if it’s not recognised and treated quickly [1].
Research shows that diarrhoea regularly occurs just before or during menstruation- for approximately a quarter of menstruating people [2]. Up t0 50% of women with with IBS (Irritable Bowel Syndrome)- find that their symptoms are more severe in the luteal phase of the menstrual cycle i.e. the 14 days before menstruation, and during menstruation [3]. Diarrhoea is also a known side-effect of many hormonal (and other) medications [1].
Symptoms: Watery, loose stools; stomach ache; bloating.
Medical conditions to rule out first [1];
Short-term diarrhoea is usually a symptom of a bowel infection (gastroenteritis), which can be caused by:
- a virus – such as norovirus or rotavirus
- bacteria – such as campylobacter, Clostridium difficile (C. difficile), Escherichia coli (E. coli), salmonella or shigella; these can all cause food poisoning
- parasites – such as the Giardia intestinalis parasite that causes giardiasis
Other possible causes of short-term diarrhoea include:
- anxiety
- drinking too much alcohol
- a food allergy
- appendicitis
- damage to the lining of the intestines as a result of radiotherapy
Diarrhoea can also sometimes be a side effect of a medication, including:
- antibiotics
- antacid medicines that contain magnesium
- some chemotherapy medicines
- non-steroidal anti-inflammatory drugs (NSAIDs)
- selective serotonin reuptake inhibitors (SSRIs)
- statins – cholesterol-lowering medicines
- laxatives – medicine used to help empty your bowels
Conditions that can cause persistent diarrhoea include:
- irritable bowel syndrome (IBS) – a poorly understood condition that affects the normal functions of the bowel
- inflammatory bowel disease – conditions that cause the gut to become inflamed, such as Crohn’s disease and ulcerative colitis
- coeliac disease – a digestive condition where you have an adverse reaction to gluten
- bile acid malabsorption – where bile produced by the liver builds up in the digestive system
- chronic pancreatitis – inflammation of the pancreas
- diverticular disease – where small bulges or pockets develop in the lining of the intestine
- bowel cancer – this can cause diarrhoea and blood in your stools
Persistent diarrhoea can also sometimes occur after surgery on the stomach, such as a gastrectomy.
Note: If your symptoms are caused by your hormonal medication, we suggest that you discuss your options with a doctor. These steps may reduce symptom severity, but are unlikely to be able to stop them completely whilst you remain on the same medication.
Managing hormone-related diarrhoea:
The good news is that hormone-related diarrhoea responds particularly well to the steps outlined on our ‘all symptoms‘ page!
Try a hormone-balancing diet– As outlined in this blog, a vegetable-based ‘anti-inflammatory’ diet can significantly improve all hormone-related symptoms. We highlight a few of the key steps that are especially relevant for those suffering from diarrhoea, below;
Eat lots of fresh fruit and vegetables– Eat small, light meals and avoid fatty or spicy foods. Good examples are potatoes, rice, bananas, soup, and boiled vegetables [1].
Avoid caffeine and alcohol– binge drinking is known to result in diarrhoea, especially in those with IBS (Irritable Bowel Syndrome) [4], and caffeine, especially in the form of coffee, can act as a laxative [5].
Take nutritional supplements, if needed- Magnesium (100-300 mg daily) can help to regulate the menstrual cycle (reducing cycle-related diarrhoea), but too much magnesium can also cause diarrhoea [6]… So, if you are experiencing this symptom on a regular basis and have ruled out other causes, you may wish to reduce your supplement amount, to see if this improves things?
Reduce stress hormones– Most of us know that stress can trigger diarrhoea e.g. before a job interview, or after a shock. When you get nervous your body produces adrenaline and other chemicals. These chemicals speed up the normal function of your nervous system and can make some of your muscles work faster than usual. If the muscles in your intestines start to speed up, the natural rhythm of your digestion will speed up too.
Faster digestion means you absorb less fluid than usual, making your stools more frequent and watery. This is what we know as diarrhoea. Just a small reduction in the fluid absorbed by your intestines can be enough to bring on an attack of diarrhoea [7].
By tracking symptoms over time, and getting to know when you feel more anxious, or sensitive to stress, you can feel more in control, and ‘resist’ those first fluttery feelings in the pit of your stomach. Take note of any triggering experiences- this will help you to identify the cause(s) of your stress e.g. work, home, or finances etc. Relaxation techniques or mindfulness practice can help to calm your breathing, and body, to break out of a downward spiral of emotional distress.
If you have tried the suggested tips and tricks for at least 3 months, and your symptoms do not improve, please consult your doctor.
If you have any suggestions, or tips, for managing diarrhoea- please let us know- we can share them with others!
Further Information:
- NHS information on diarrhoea: http://www.nhs.uk/Conditions/Diarrhoea/Pages/Introduction.aspxw
Page last reviewed and updated: June 2018
References:
- NHS. (2016) Diarrhoea. [ONLINE] Available at: http://www.nhs.uk/Conditions/Diarrhoea/Pages/Introduction.aspx?WT.mc_id=organic_split. [Accessed 13 April 2017]
- Bernstein MT, Graff LA, Avery L, Palatnick C, Parnerowski K, Targownik LE. (2014) Gastrointestinal symptoms before and during menses in healthy women. BMC Womens Health Jan 22;14:14. doi: 10.1186/1472-6874-14-14. PubMed PMID: 24450290;
PubMed Central PMCID: PMC3901893 - Moore J, Barlow D, Jewell D, Kennedy S. (1998) Do gastrointestinal symptoms vary with the menstrual cycle? Br J Obstet Gynaecol. Dec;105(12):1322-5. Review. PubMed PMID: 9883927
- Reding KW, Cain KC, Jarrett ME, Eugenio MD, Heitkemper MM. (2013) Relationship between patterns of alcohol consumption and gastrointestinal symptoms among patients with irritable bowel syndrome. Am J Gastroenterol Feb;108(2):270-6. doi: 10.1038/ajg.2012.414. PubMed PMID: 23295280; PubMed Central PMCID: PMC3697482
- Scholten P, van Leerdam ME, Kuipers EJ. (2006) Chronic diarrhoea: the importance of an accurate medical history. Ned Tijdschr Geneeskd. 2006 Feb 25;150(8):405-8. Dutch. PubMed PMID: 16538836
- Fine KD, Santa Ana CA, Fordtran JS. (1991) Diagnosis of magnesium-induced diarrhea. N Engl J Med. Apr 11;324(15):1012-7. PubMed PMID: 2005938
- Singh RK, Pandey HP, Singh RH. (2003) Correlation of serotonin and monoamine oxidase levels with anxiety level in diarrhea-predominant irritable bowel syndrome. Indian J Gastroenterol May-Jun;22(3):88-90. PubMed PMID: 12839379