The list of chronic diarrhea causes is very long. Some estimate that there are about 100 different reasons why people suffer from persistent diarrhea. This article is concentrating on the 8 of the most common culprits as it is most likely that your problem is caused by one of these.
Having chronic diarrhea is not fun at all and the amount of suffering it can bring is often underestimated by people who are not having their lives limited and disrupted in this way.
A first step to having a better life is to try and discover what is causing the problem which normally means talking to a doctor and having tests but the information here hopes to point you along the right path.
I recently came across someone who said "suffered my whole life from diarrhea". That is so sad to hear and I do not want people to have to live their lives like that.
There are things that if you have a little too much of them can result in diarrhea. If you are overdoing something in your diet which is causing your diarrhea then you will not feel ill. Your diarrhea will be painless, you will not see any blood or mucus and you will not be suffering from weight loss or fatigue. Overdoing one of these things can lead to painless persistent diarrhea:
Think about your diet and maybe keep a diary for a few days. If you think that you are having one of these chronic diarrhea causes as a regular or frequent part of your diet try cutting it out for a period to see if your diarrhea stops. When cutting out caffeine do this gradually to avoid getting withdrawal headaches. If you are successful then you can often reintroduce the problem dietary item in smaller amounts.
Alcohol and diarrhea often go together. If you just have a one off episode then do not worry but if you have a regular problem with alcohol and diarrhea then seek help from one of the organizations that can help with alcohol problems.
Prescription or over the counter medications both have the potential to cause adverse reactions and diarrhea accounts for about 7% of these reactions. Hundreds of different drugs can be counted as one of the chronic diarrhea causes but there are some medications which are more likely to be at fault than others. If you take regular medication then think about whether it could be causing your problem.
Here is a list of drugs which often cause diarrhea:
These are the most common medications that are associated with diarrhea but many others can also be at the root of your problem. If you think that your medication could be causing your chronic diarrhea then report this to your doctor who should record it as a adverse reaction.
Do not stop taking your medication without speaking to your doctor first as this could be dangerous. If it seems likely that your medication is to blame then your doctor may be able to adjust your medication to try and resolve your diarrhea.
In developed countries up to 20% of the population suffer from irritable bowel syndrome. I was one of the 20% and so have experience of this difficult and life disrupting disorder. The exact cause is not known. The bowel itself is normal but the function is disrupted causing either diarrhea or constipation or both. In other words the bowel is either running too quickly (diarrhea) or too slowly (constipation).
If you are otherwise well but your bowel habit has changed, you do not have weight loss or blood loss and the diarrhea never wakes you up during the night but is only during the day when you are awake you may have IBS.
Although IBS is one of the commonest chronic diarrhea causes there is no definitive test and the only way it can be diagnosed is to eliminate other possible causes of your chronic diarrhea. If you suspect that your diarrhea is caused by IBS then please see your doctor for a diagnosis.
About one in 100 people have celiac disease but only 24% of them have been diagnosed. It is a life long autoimmune disease where the immune system mistakenly reacts to the protein gluten which is found in wheat, rye, and barley. The immune system attacks its own body damaging the lining of the small intestine.
A major symptom of celiac disease can be persistent diarrhea which is caused by the inability of the damaged small intestine to absorb nutrients from food. The diarrhea is often very smelly and as it often contains fat which has not been absorbed the stools will be large and will float (the medical term for fatty stools is steatorrhea).
Not everybody has gut symptoms, especially adults.
Other symptoms can include:
The only treatment is to follow a gluten free diet.
As this is one of the common chronic diarrhea causes that is often under-diagnosed, it is worth getting a test done to check that you do not have it.
It may sound wrong but sometimes what appears to be diarrhea is really constipation. This is called overflow diarrhea, bypass diarrhea or constipation with overflow.
This happens when chronic constipation causes a hard plug of feces to almost block the bowel and the only poop which can get around the blockage is the liquid kind which then makes you think you have diarrhea.
This type of diarrhea often causes fecal incontinence and is most commonly seen in elderly people or young children. If your elderly relative or young child often suffers with constipation but then starts to leak liquid poop they may have this type of diarrhea.
Medical advice is needed in this situation. In severe cases manual removal of the feces can be necessary. Unfortunately this problem often reoccurs and monitoring of the situation is necessary.
Special clinics have been established in some areas to assist parents with this difficult to manage problem with their children.
Of all the chronic diarrhea causes, this is the one that you are probably least likely to suspect.
For more information about this problem see Constipation Treatment for Overflow Diarrhea.
There are three main types of Inflammatory Bowel Disease; Crohn's Disease which can affect the whole intestinal tract, Ulcerative Colitis and Microscopic Colitis which affect only the large bowel (the colon and rectum).
Chronic diarrhea is a symptom of all of these diseases but there are differences. With Crohn's Disease and Ulcerative Colitis you may see blood, mucus or pus in your diarrhea.
The diarrhea associated with Microscopic Colitis is watery, does not contain blood or mucus and is often explosive, coming on very suddenly. It is more common in elderly people and can happen day or night. It is commonly associated with the previous use of certain medications especially non-steroidal anti-inflammatory drugs.
Clostridium Difficile Infection is something that most people think of as a hospital acquired infection and it is true that this is often the case but it is increasingly being seen in the community.
C. Diff diarrhea is foul smelling, watery and sometimes has blood in it. It is accompanied by abdominal cramps and fever.
It is often associated with recent antibiotic use.
This infection is one of the chronic diarrhea causes which is very worrying to the medical profession as it is difficult to treat and can be fatal but there is hope for the future as new treatments are being developed using natural friendly bacteria to fight the infection.
Giardiasis is caused by a parasite which can cause chronic diarrhea if left untreated. The diarrhea is usually watery and foul smelling and is often accompanied by bloating, abdominal cramps, foul smelling flatulence, belching, nausea, tiredness, loss of appetite, indigestion, weight loss and dehydration. Giardiasis can also cause green diarrhea.
This parasite is often picked up by swallowing contaminated water.
Have you swallowed water from an unsafe source or have you been traveling? If you have returned from traveling abroad then giardiasis is much more likely especially if you have been to one of these areas where it is a real problem.
However, even in developed countries like the USA 2% of adults and 6-8% of children will be infected. For government information about the risks from this parasite see here.
There are many chronic diarrhea causes and this article has only touched on some of the most common. If you are suffering from persistent diarrhea then you need to see a doctor and have some investigations done as there are so many different diagnoses.
For more causes of chronic diarrhea, red flag symptoms to look out for and investigations that may be needed, please see this article about chronic diarrhea with further help for this difficult and distressing problem.