Information for Patients
What is diarrhea?
Diarrhea is loose, watery stools (bowel movements). You have diarrhea if you have loose stools three or more times in one day. Acute diarrhea is diarrhea that lasts a short time. It is a common problem. It usually lasts about one or two days, but it may last longer. Then it goes away on its own.
Diarrhea lasting more than a few days may be a sign of a more serious problem. Chronic diarrhea -- diarrhea that lasts at least four weeks -- can be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual, or they may come and go.
What causes diarrhea?
The most common causes of diarrhea include:
- Bacteria from contaminated food or water
- Viruses such as the flu, norovirus, or rotavirus . Rotavirus is the most common cause of acute diarrhea in children.
- Parasites, which are tiny organisms found in contaminated food or water
- Medicines such as antibiotics, cancer drugs, and antacids that contain magnesium
- Food intolerances and sensitivities, which are problems digesting certain ingredients or foods. An example is lactose intolerance.
- Diseases that affect the stomach, small intestine, or colon, such as Crohn's disease
- Problems with how the colon functions, such as irritable bowel syndrome
Some people also get diarrhea after stomach surgery, because sometimes the surgeries can cause food to move through your digestive system more quickly.
Sometimes no cause can be found. If your diarrhea goes away within a few days, finding the cause is usually not necessary.
Who is at risk for diarrhea?
People of all ages can get diarrhea. On average, adults In the United States have acute diarrhea once a year. Young children have it an average of twice a year.
People who visit developing countries are at risk for traveler's diarrhea. It is caused by consuming contaminated food or water.
What other symptoms might I have with diarrhea?
Other possible symptoms of diarrhea include:
- Cramps or pain in the abdomen
- An urgent need to use the bathroom
- Loss of bowel control
If a virus or bacteria is the cause of your diarrhea, you may also have a fever, chills, and bloody stools.
Diarrhea can cause dehydration, which means that your body does not have enough fluid to work properly. Dehydration can be serious, especially for children, older adults, and people with weakened immune systems.
When do I need to see a health care provider for diarrhea?
Although it is usually not harmful, diarrhea can become dangerous or signal a more serious problem. Contact your health care provider if you have:
- Signs of dehydration
- Diarrhea for more than 2 days, if you are an adult. For children, contact the provider if it lasts more than 24 hours.
- Severe pain in your abdomen or rectum (for adults)
- A fever of 102 degrees or higher
- Stools containing blood or pus
- Stools that are black and tarry
If children have diarrhea, parents or caregivers should not hesitate to call a health care provider. Diarrhea can be especially dangerous in newborns and infants.
How is the cause of diarrhea diagnosed?
To find the cause of diarrhea, your health care provider may:
- Do a physical exam
- Ask about any medicines you are taking
- Test your stool or blood to look for bacteria, parasites, or other signs of disease or infection
- Ask you to stop eating certain foods to see whether your diarrhea goes away
If you have chronic diarrhea, your health care provider may perform other tests to look for signs of disease.
What are the treatments for diarrhea?
Diarrhea is treated by replacing lost fluids and electrolytes to prevent dehydration. Depending on the cause of the problem, you may need medicines to stop the diarrhea or treat an infection.
Adults with diarrhea should drink water, fruit juices, sports drinks, sodas without caffeine, and salty broths. As your symptoms improve, you can eat soft, bland food.
Children with diarrhea should be given oral rehydration solutions to replace lost fluids and electrolytes.
Can diarrhea be prevented?
Two types of diarrhea can be prevented - rotavirus diarrhea and traveler's diarrhea. There are vaccines for rotavirus. They are given to babies in two or three doses.
You can help prevent traveler's diarrhea by being careful about what you eat and drink when you are in developing countries:
- Use only bottled or purified water for drinking, making ice cubes, and brushing your teeth
- If you do use tap water, boil it or use iodine tablets
- Make sure that the cooked food you eat is fully cooked and served hot
- Avoid unwashed or unpeeled raw fruits and vegetables
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.
Index of Diseases and Injuries Definitions
- And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
- Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
- Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
- Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
- NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
- See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
- See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
- 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.