Diarrhea is a common symptom for a whole bunch of diseases, ranging from foodborne illness to colorectal cancer.
But does diarrhea itself cause any long-term health problems for otherwise-healthy adults? Example, suppose I am lactose-intolerant, but I just loves me some milk and ice cream and cheese, so I keep eating it - and suffer regular bouts of diarrhea. Am I setting myself up for problems later in life, like cancer or IBS or something? Or does my digestive tract go completely back to normal once I eliminate whatever is causing my diarrhea?
Now, now, don’t understate things: Diarrhea is one of the major killers worldwide. In fact, an informal definition of “Rich country” is one where everyone laughs at diarrhea, and nobody takes it seriously.
It’d depend on the type of diarrhea; inflammatory, osmotic, secretory, infectious, etc.
If one is having diarrhea due to lactose intolerance, the symptoms are due more to the production of hydrogen and short chain fatty acids. Much gas, noise, stink, and the possibility of inadequate nutrition due to non-absorption of the lactose. But not a secretory diarrhea, so unlikely to cause significant electrolyte imbalances chronically. One could live fairly healthily with this condition, if one didn’t mind the symptoms and social isolation. Choose friends with anosmia.
Other chronic diarrheas can be more deadly but that depends on their individual pathophysiologies, which is a subspecialty unto itself.
Taking this as a hypothetical: If you’ve had long-term diarrhea, high thee to a doctor!!
In the long term, it would definitely leave you with a dysfunctional intestinal microbiome. More and more is being uncovered about just how many systems can be messed up as a result.
Here’s a great starter for you: The gut microbiome in health and in disease - PMC
Individual severe instances can result in dehydration. Short of death, this can shorten the lifespan of any organ, cause kidney stones, brain cell death, and even changes in the structure of the brain:
Actually pretty short-term, compared to what I was thinking of. I’m aware that diarrhea can cause fatal dehydration and electrolyte imbalance, but that’s a matter of days. I’m thinking here of diarrhea every few days over the course of years.
As it happens, I am not lactose-intolerant, AFAIK; cheese, milk, ice cream, no problem. But certain foods seem to cause diarrhea. And not reliably, not by themselves. Seems like I have to eat a couple of meals in a row before an episode is triggered. After a single incident of diarrhea, all is well, life goes on. So I don’t think I’m in danger of dehydration or malnutrition. Spoke to a doctor about it many years ago, and he suggested keeping a diary (a diarrhy?) to try to find patterns. And as noted, it doesn’t seem like there’s much of a pattern; a greasy lunch at one restaurant might not cause anything, but a greasy breakfast at home might do it. Or it might not.
Basically I’m wondering how hard I should try to sort this out. Is it just an inconvenience, or is it threatening my longevity and/or long-term health?
When I wrote my first book on lactose intolerance, three decades ago, most people had never heard of the condition. That didn’t come until the huge 1990s marketing campaigns of Lactaid and Dairy Ease that turned LI into a staple of sitcom jokes. One of the first letters I received in response was from a Florida mother who told me that her teen-aged son had suffered from enormous amounts of diarrhea for years, with weight loss and weakness and general ill health. But after reading the book she took him off milk and he started doing amazingly better.
I’ve gotten probably 3000 letters and emails since and I’ve learned to take personal anecdotes with a great deal of salt. I’d like to believe this one was true, because it was the most heart-warming affirmation of my work I ever got.
As far as I can tell, and I’ve read most of the literature, there are no long-term effects from occasional or even frequent attacks of lactose intolerance symptoms. If the mother’s story was true, there may be exceptions for very long-term and continual diarrhea. Infants can get temporary LI from numerous gastrointestinal ailments and you have one super-unhappy kid until they figure out that milk needs to be stopped. But that also doesn’t seem to lead to future issues.
If certain foods seem to trigger diarrhea, see a gastroenterologist. I also have Irritable Bowel Syndrome which has food triggers. Including, sometimes, milk. That in some ways was worse than the LI. I finally after many years found a drug that worked on me. It’s not perfect, but the difference is enormous and wonderful.
We’ll never know what used to happen before anybody realized that LI was a thing. It didn’t enter the medical literature as a known problem for adults until the early 1970s, believe it or not. In those days you were told to drink milk to sooth your system, which, let me tell you, exacerbates the symptoms. I’m one of the least healthy people around, true; I’ve got 99 problems but LI-induced diarrhetic degeneracy isn’t one of them.
Doctors advice, avoid milk’s lactose if you are suffering diarrhea.
Buy lactose free milk , for example.
You might have diarrhea from a virus, ok ?
diarrhea changes your gut flora…
Now with the wrong gut flora, you might then be lactose intolerant.
That will keep the diarrhea happening and make it worse than food poisoning diarrhea.
Suppose you have diarrhea with the “urgency”… which often happens with any first cause… (The cause that keeps it going longer may be different to what first induced it.) You might do injury to your colon, rectum specifically, anus, by the spasms … overexerting during the attempt to produce.
An injury can lead to a diverticules… ballooning of sections of the membranes, as injury causes reduction of elasticity. When diverticules get infected or cause symptoms, its called diverticulitis. If an infection eats through , the infection can affect nearby organs… its easily fatal to have this. A diverticule could interrupt blood flow to a section of the intestines… these days they can remove the damaged section. But its not a good thing to get.
Somewhere in there colon cancer may be triggerred…
Suppose you start avoiding lactone and sufficient high fibre foods (eg bran ). The wrong gut flora can then come become constipation. If you strain too hard with constipation, you might suffer diverticules … so diarrhea could be called diverticules.
Fear of lactose might be said to be a disease.
fear of feeling a full … (“I am bloated, I need to detox !” ) might be said to be a disease.
I second this. I would also talk to a doctor again. You may have IBS-D. I had it for years and didn’t get diagnosed until a severe episode landed me in the emergency room. My symptoms sound a lot like yours.
I manage it by paying attention to what I eat (see the FODMAPs info) and by taking probiotics. IBS can be linked to all kinds of other things, so it’s a good thing to get diagnosed.
I have had symptoms very much like the OP for decades. Probably 20 years ago I was given the diagnosis of IBS (there was no -C or -D at the time, but my symptoms are clearly IBS-D). At the time IBS was a diagnosis of exclusion - after many tests they couldn’t find anything more serious wrong, so I got the IBS diagnosis. I don’t know if there are stricter diagnostic criteria nowadays.
I have tried many times to keep a food diary, restrict my diet, eliminate lactose (I am part Asian so I have always strongly suspected LI) but never got any consistent results. I could eat a Blizzard at Dairy Queen and have absolutely no adverse reaction one day, then do the same thing a week later and be off to the races.
The one thing that I could get a repeatable result from was the French onion soup at Longhorn Steakhouse. I would have some at lunch, and within 45 minutes I would be running to the bathroom. Maybe the combination of mass quantities of onions and soft cheese does it.
I am starting with a new internist next month (Mayo Clinic in Scottsdale), I am planning on trying to convince her to look more closely at my problem. My biggest concern has not been a long-term health risk from the IBS-D, but rather what more serious condition could arise that is masked by the IBS-D symptoms.
True, anything might be said about anything. Think of all the things I could say about this post! Really nasty things! And they would be true!
However, these two sentences have null content. Neither “fear of lactose” nor “fear of feeling full” are diseases under any meaningful sense of the word. Ignore them. Better, wipe them from your memories. Fear of remembering pure nonsense might be said to be a anti-disease!
Onions (and garlic and artichokes) are very high in fructans, the “F” in FODMAPs. Lactose is a dissacaride, which is the “D”
Your onion soup is a good case study. Now, I don’t mean to sound like an expert, because I’m not, but I’ll give my very basic understanding of where the trouble comes from.
Starting with the lactose… tolerance to it is more like a spectrum, it’s not really binary where you either are or you aren’t tolerant, AND that tolerance can change. With someone who is tolerant and is able to eat dairy with no problems, they produce lactase which allows them to break down the lactose in their small intestines. Someone who is lactose intolerant produces little to no lactase, and that lactose then passes through whole to the large intestine where it gets broken down the hard (and stinky/painful/gut-wrenching/bloated) way by the type of bacteria there that thrive on the stuff.
With the fructans in the onions, the interesting bit is that nobody is really able to break down fructans very well in their small intestines. They pass on whole to the large intestine, where presumably those with more optimal gut microbiomes don’t have the same kind of problems as those who aren’t so lucky.
All the foods that are FODMAPs act in the same way. As you can see, it’s easy to eat the wrong things in the wrong combinations/amounts and inadvertantly end up feeding a nasty fermentation factory in your colon.
What about any physical damage – like, would there be any long term scarring of your rectum or anything like that? (Like frequent vomiting can destroy your esophagus and your teeth)
I mean, obviously our rectums are built for pooping, but since it’s diarrhea, would that factor in?
you can get scarring and irritation if your poops acidic …but its like what youd get from not cleaning right… I know from helping my baby brother who had problems and his dr showe the family the cream they used to ease it …
