Chronic Diarrhea: What It Means and What You Can Do
Been having loose stools for weeks? Chronic diarrhea means diarrhea that lasts 4 weeks or longer. It’s not fun, but understanding common causes and simple steps can help you feel better faster and get the right tests or treatment.
What commonly causes chronic diarrhea?
There are a few clear culprits. Functional problems like IBS-D (irritable bowel syndrome with diarrhea) cause long-term loose stools and cramping without dangerous damage. Inflammatory conditions such as Crohn’s disease or ulcerative colitis usually bring blood, weight loss, or fever. Chronic infections (think Giardia or persistent C. difficile) can stick around after travel or antibiotics. Medicines — metformin, some antibiotics, magnesium supplements, and laxatives — often cause ongoing diarrhea. Other causes include food intolerance (lactose, fructose), celiac disease (gluten), bile acid malabsorption, pancreatic insufficiency, and hormone issues like an overactive thyroid.
Spotting the pattern helps. Are symptoms worse after certain foods? Did it start after antibiotics or a trip? Is there weight loss or blood in the stool? Those clues point toward different causes and tests.
Practical steps you can take now
1) Track what you eat and your symptoms. Keep a simple diary for two weeks — meals, drinks, stool, and any meds. That often reveals triggers like dairy or artificial sweeteners.
2) Stay hydrated and replace electrolytes. For mild losses, use an oral rehydration solution: about 1 liter plain water, 6 level teaspoons sugar, and 1/2 teaspoon salt. Sports drinks help in a pinch but can be high in sugar. Sip regularly; avoid caffeine and alcohol which can make diarrhea worse.
3) Try short-term symptom control. Over-the-counter loperamide can reduce stool frequency — follow the package or ask a pharmacist. Probiotics such as Saccharomyces boulardii or Lactobacillus rhamnosus GG help some people, especially after antibiotic-associated diarrhea.
4) Adjust fiber carefully. Soluble fiber (oatmeal, psyllium) can bulk stools. Avoid large amounts of insoluble fiber (raw bran) until you’re more stable.
5) Review your medicines. Talk to your pharmacist or doctor about drugs that can cause diarrhea and whether alternatives exist.
6) See a doctor for tests when needed. If diarrhea lasts more than a few weeks, or you have weight loss, night symptoms, blood, severe pain, or high fever, get medical care. Useful tests include stool studies (culture, ova/parasites, C. difficile), fecal calprotectin (to screen for inflammation), blood tests (CBC, thyroid, celiac serology), breath tests for SIBO or lactose, and colonoscopy when needed.
Some conditions need specific treatment — antibiotics for certain infections, anti-inflammatory drugs for IBD, bile acid binders for bile acid malabsorption, or pancreatic enzyme replacement if the pancreas isn’t working well. Your doctor will match the treatment to the cause.
If chronic diarrhea is disrupting life, don’t wait. A few records (food diary, stool pattern) plus the right tests will usually point toward a fix. For urgent signs like heavy bleeding, fainting, high fever, or severe dehydration, seek emergency care right away.
