Overview
Diarrhea is present when bowel movements occur more than three times a day and stool consistency is markedly reduced. In adults, the most common cause is an acute, uncomplicated gastrointestinal infection (gastroenteritis), usually triggered by viruses, which as a rule resolves on its own within a few days. The most important measure is replacing lost fluids and salts, as the body loses a great deal of water and electrolytes during diarrhea. In the OpenClinic24 video consultation, doctors take a structured history of your symptoms: duration, frequency and consistency of bowel movements, accompanying symptoms, recent travel, medicines taken, and pre-existing conditions. They then specifically check for warning signs that speak against an uncomplicated course. If, following a medical assessment, an uncomplicated gastroenteritis is present, you receive concrete recommendations for symptomatic treatment; where medically appropriate, a private prescription according to the German medical fee schedule (GOÄ) may be issued. If there is doubt about an uncomplicated course, you will be referred to a local practice or clinic.
Common causes
Most acute diarrheal illnesses are caused by viruses, in particular norovirus and rotavirus, which spread easily from person to person. Bacterial pathogens such as Campylobacter, Salmonella, or certain E. coli strains often enter the body via contaminated food or drinking water; typical features here are more severe abdominal pain, fever, or bloody stools. After long-distance travel, so-called traveler's diarrhea is an additional possible cause. Medicines can also trigger diarrhea, above all antibiotics, as can food intolerances such as lactose intolerance. If diarrhea persists for several weeks, chronic causes come into consideration, such as irritable bowel syndrome or chronic inflammatory bowel diseases; these require further work-up with a physical examination and laboratory diagnostics. In the video consultation, a precise description of the onset, course, and possible triggers helps to narrow down the probable cause and determine the next steps.
When to see a doctor
Uncomplicated diarrhea usually improves within two to three days. You should seek medical advice if the symptoms last longer, worsen, or if warning signs appear. These include: blood or mucus in the stool, fever above 39 °C, severe or persistent abdominal pain, repeated vomiting with an inability to keep fluids down, and signs of dehydration such as intense thirst, dark urine, dizziness, or markedly reduced urine output. A lower threshold applies to infants, small children, pregnant women, elderly people, and persons with a weakened immune system – here an in-person examination is advisable at an early stage. In the case of emergency signs such as drowsiness, confusion, almost no urine output, cold pale skin, or circulatory weakness, call the emergency number 112 immediately.