Diarrhea: Online Diagnosis and Treatment

Diarrhea may seem like a nuisance disease, but it can severely compromise your quality of life and even be life-threatening. While most cases of diarrhea are infectious in origin and resolve with symptomatic care after a day or two, adults can get chronic diarrhea from a variety of causes.

Infectious causes of diarrhea are common, even in developed countries such as the U.S., where an estimated 211-375 million episodes of diarrheal illnesses occur each year. This results in about 73 million physician consultations, 1.8 million hospitalizations, and 3,100 deaths. Foodborne illnesses account for 76 million illnesses, 325,000 hospitalizations, and 5,000 yearly deaths.²

Scheduling a consultation with a virtual doctor on the Telegra MD telehealth platform to evaluate your diarrheal symptoms is simple and convenient. You will receive a diagnosis, a treatment protocol, and an appropriate online prescription to treat your diarrhea. Telehealth for diarrhea treatment makes it easy to consult with a virtual doctor and receive prescription medication to treat your diarrhea quickly and easily, even if you don’t have insurance.

What Is Diarrhea?

Diarrhea is defined as an alteration in a normal bowel movement. This can be an increase in water content, volume, or frequency of stools. A common definition of diarrhea is a change in stool consistency, with more than three bowel movements in a day. Diarrhea due to infection is usually accompanied by nausea, vomiting, or abdominal cramping.²

Diarrhea is considered acute if it lasts 14 days or less, persistent if it lasts 14 to 30 days, and chronic if it lasts longer than 30 days. Most commonly, diarrhea is viral in origin. Noninfectious causes of diarrhea are more common as diarrhea duration increases.³

Can Diarrhea Be Treated Through Telehealth?

Consulting a medical professional via telehealth makes evaluating and treating diarrhea much more convenient. You can schedule an online medical consultation appointment with a virtual doctor using the Telegra MD platform and receive a personalized treatment plan. Your virtual doctor can give you tips on how to combat the challenges associated with stomach upset and diarrhea and call in your online prescription to a local pharmacy. Online doctors who prescribe anti-diarrheal medications provide 24-hour appointment access, which means you can expect doctor access whenever you need it, leading to an earlier diagnosis and treatment.

Why Do You Get Diarrhea?

Diarrhea occurs when processed food and drinks in the intestines pass through the intestines quickly, and water cannot be reabsorbed. There are many potential causes of diarrhea, including the following:

Infectious diarrhea

Viruses, bacteria, and parasites can all cause diarrhea. They are a common cause of “traveler’s diarrhea” when consuming contaminated food and water.

• Viruses: rotavirus, norovirus, adenovirus, astrovirus
• Bacteria: Escherichia coli (E. coli), Clostridioides, Salmonella, Shigella, Campylobacter
• Parasites: Cryptosporidium enteritis, Entamoeba histolytica, Giardia lamblia

Medication-induced diarrhea

Some medications increase bowel motility or change the proportions of bacteria in the gut (normal gut flora) and can cause diarrhea, including the following:

• Antibiotics
• Magnesium
• Antacids
• Chemotherapy

Other causes of diarrhea

Other potential causes of diarrhea include:

• Food allergies or intolerances
• Celiac disease
• Crohn’s disease
• Irritable bowel syndrome
• Ulcerative colitis
• Small intestinal bacterial overgrowth
• Abdominal surgery

What Are the Common Symptoms of Diarrhea?

Diarrhea can originate in the large or small intestine. If it originates in the large intestine, it usually causes frequent, regular, small-volume, and sometimes painful bowel movements. The stool may contain mucus or blood. Diarrhea coming from the small intestine is usually large, volume, watery diarrhea that causes cramping, bloating, and gas.

Other symptoms associated with diarrhea include:

• Abdominal cramping
• Bloating
• Gas
• Vomiting
• Nausea
• Dizziness
• Blood or mucus in stools
• Fever
• Chills
• Weight loss
• Appetite changes
• Foul-smelling stools

When Should You See a Doctor for Diarrhea?

See a doctor for diarrhea if it lasts more than two days, you have a fever of 102 degrees or higher, severe or worsening abdominal or rectal pain, or frequent vomiting. Signs of dehydration or stool that is dark or tarry colored or is bloody should prompt a medical consultation.

Signs of dehydration include:

• Increased thirst
• Dry mouth
• Decreased urine
• Dark, concentrated urine
• Light-headedness
• Fatigue
• Dizziness
• Decreased tears
• Sunken eyes or cheeks

Telehealth for diarrhea is the ideal diagnosis and treatment option because it is easy to gather a complete history, order relevant tests and start treatment all from the comfort of your home. You can schedule an online appointment with a virtual doctor using the Telegra MD platform and receive a diagnosis. Your virtual doctor can give you tips on preventing and treating your diarrheal symptoms and call in a prescription to a local pharmacy. Online doctors who treat diarrhea provide 24-hour appointment access, which means you can expect doctor access whenever you need it, leading to an earlier diagnosis and treatment.

Are Some People at Increased Risk for Diarrhea?

A careful medical history will frequently identify risk factors for diarrhea. Some of these risk factors include the following:

• Restaurants: food poisoning or contaminated foods
• Healthcare facilities: hospital-acquired infections
• Schools and daycares: close contact, food poisoning or contaminated foods
• Military installations: close contact, food poisoning or contaminated foods
• Cruise ships: food poisoning or contaminated foods
• Antibiotic use: antibiotic-associated diarrhea
• Recent hospitalization: antibiotic-associated diarrhea, hospital-acquired infection
• Cancer chemotherapy: medication use
• Using antacids: medication use
• Travel: exposure to contaminated food or water
• Swimming pools and marine environments: parasitic infections, Shigella
• Animal exposure: young dogs, cats, turtles

Unpasteurized dairy products or juices and raw or undercooked meat or fish are common sources of foodborne diarrhea.

How Do You Diagnose Diarrhea?

Diarrhea can be diagnosed based on the symptoms. However, determining the cause of diarrhea takes more work. If your diarrhea lasts a day or two and you stay hydrated, you can usually continue with symptomatic care. However, if your diarrhea persists or worsens, you may need lab work or imaging tests to determine its cause.

• Stool cultures: Stool is collected and examined in a lab to look for bacterial causes of diarrhea, such as Salmonella, Shigella, and Campylobacter.
• Ova and Parasites: In this test, a lab technician looks for parasites and their eggs under a microscope.  
• Sigmoidoscopy: In this test, a short, flexible tube with a light, camera, and instruments is used to examine the rectum and the adjacent part of the large intestine and take biopsies if needed.
• Colonoscopy: In this test, a short, flexible tube with a light, camera, and instruments is used to examine the large intestine and take biopsies, if needed.
• Computed tomography (CT) scan: This test is not typically ordered to investigate the cause of acute diarrhea, but can be used to identify potential complications, such as intestinal obstruction or bowel perforation.
• Hydrogen breath test: This test measures the amount of hydrogen in your breath and is used to diagnose lactose intolerance.
• Elimination diet: In this test, you eliminate foods that are associated with intolerance and may cause your diarrhea.

How Do You Treat Diarrhea?

The first step in managing and treating diarrhea is rehydration. Oral rehydration solutions are available to treat more severe cases of diarrhea.

Antibiotics, such as azithromycin or fluoroquinolones, are prescribed to treat infectious diarrhea caused by bacteria. According to the American College of Gastroenterology, antibiotics may be prescribed if you have a high fever, blood or pus in stool, rectal pain or pressure, or moderate-to-severe traveler’s diarrhea.

Loperamide (Imodium) is an antimotility drug that slows the movement of stool through the bowel. It is used cautiously and only if fever is absent or low-grade and stools are not bloody. Loperamide can cause abdominal pain, drowsiness, dry mouth, and dizziness.

Diphenoxylate (Lomotil) is also an antimotility drug that may be used cautiously to treat diarrhea. It may cause mood disorders, sedation, and other side effects.

Antibiotics such as metronidazole or tinidazole, antiparasitics such as nitazoxanide, or antihelminthic medications such as albendazole are used to treat parasites such as Giardia. Metronidazole is also used to treat Clostridioides infections.

Many prescription medications in several classes are used to treat chronic diarrhea. Treatment depends on the cause of the diarrhea.

In addition to medications, treat your diarrhea by:

• Using the BRAT diet: bananas, rice, applesauce, and toast is a low-fiber, starchy diet that is used to treat short-term diarrhea.
• Rehydration: Replace water lost in stool by drinking plenty of fluids, especially oral rehydration solution (ORS).
• Avoid foods that worsen diarrhea: Avoid artificial sweeteners, caffeinated beverages, fatty foods, high-fiber fruits and vegetables, fried foods, milk, and spicy foods.

It is important to identify the cause of your diarrhea before treating it. A virtual doctor on the Telegra MD platform can help with this. The steps for seeing a doctor online through telemedicine are similar to seeing your local doctor. In both cases, you would:

• Make an appointment: Typically, appointments to see virtual doctors through telehealth are much easier to make and are more convenient than in-person appointments, as many telemedicine companies provide online telehealth services for diarrhea treatment at any time, day or night.
• Provide a medical history: Whether completing forms in your local doctor’s office or online before consulting with your virtual doctor, you will need to provide a medical history.
• Consult with your doctor: After reviewing your medical history forms, your virtual doctor will discuss your diarrhea diagnosis and treatment options.
• Treatment: After deciding on an optimal and personalized treatment plan for diarrhea, your virtual doctor will transmit your prescriptions to your local pharmacy.

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References

1. Guerrant RL, Van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV, Hennessy T, Griffin PM, DuPont H, Sack RB, Tarr P, Neill M, Nachamkin I, Reller LB, Osterholm MT, Bennish ML, Pickering LK; Infectious Diseases Society of America. Practice guidelines for the management of infectious diarrhea. Clin Infect Dis. 2001 Feb 1;32(3):331-51. doi: 10.1086/318514. Epub 2001 Jan 30. PMID: 11170940.

2. Richard L. Guerrant and others, Practice Guidelines for the Management of Infectious Diarrhea, Clinical Infectious Diseases, Volume 32, Issue 3, 1 February 2001, Pages 331–351, https://doi.org/10.1086/318514

3. LaRocque R, Harris J.B. Approach to the adult with acute diarrhea in resource-rich settings. UptoDate. Approach to the adult with acute diarrhea in resource-rich settings – UpToDate

4. Sadowski DC, Camilleri M, Chey WD, Leontiadis GI, Marshall JK, Shaffer EA, Tse F, Walters JRF. Canadian Association of Gastroenterology Clinical Practice Guideline on the Management of Bile Acid Diarrhea. Clin Gastroenterol Hepatol. 2020 Jan;18(1):24-41.e1. doi: 10.1016/j.cgh.2019.08.062. Epub 2019 Sep 14. PMID: 31526844.