Aww, guys!!!
(wipes tear)
Geez.
brossa and spingears, thanks.
You’ve been reading my Christmas list again, haven’t you?
A doctor once told me, “if you’re vomiting or have diarrhea, don’t take anything to stop it–something has a reason to get out of you, and you should let it.” Barring dehydration, of course, is this true?
Amoebiasis! Been there, done that. Never want to again.
Curious, why does alcohol give you the runs, or at least a loose stool? Is it killing organisms that would otherwise be doing their “dry out the shit” job?
Is it possible for stress to induce diarrhea?
Yes and no. It depends on the cause, the duration, and the severity long before dehydration would set in. And it depends on the sensitivity of the colon to spasms.
With lactose intolerance, for example, milk can set off a long bout of diarrhea. As you say correctly, the usual advice is to let it go because that will remove the undigested lactose as fast as possible. But there comes a point at which the experienced can tell that the spasms are coming from the irritation of the colon rather than the original cause, and that’s a good time to take the antidiarrheal and shut the system down to give oneself a break from the misery.
And many people have IBS and that used to be called spasmic colon for obvious reasons. If you have IBS then the effect can last much longer than the originating cause would seem to warrant.
The body doesn’t always shut down like a fine car, but sometimes more like a lawnmower sputtering to a stop. That’s where I would draw the line.
Yes. In an otherwise healthy person, acute stress, like a job interview or public speaking engagement, can cause ‘situational’ diarrhea. Chronic stress can also lead to chronic diarrhea, but this sort of overlaps with irritable bowel syndrome.
There are nerve connections between the central nervous system and the enteric nervous system. The sight and smell of food can lead to increased gastric secretion and motility - this is an example of the CNS having an immediate effect on the enteric nervous system. More complex stimuli, like emotional state or increased stress level, can also alter the activity of the gut, although the effects are not always so clean-cut. For example, a vigorous fight-or-flight stimulus, like encountering a bear in your kitchen, will tend to ramp up the activity of the sympathetic autonomic nervous system. This will generally have the effect of shutting off gut motility and secretion and decreasing gut bloodflow while you try to escape the bear - no use wasting the energy on digestion at the moment. Sphincters also tend to tighten up, literally. And yet, another well-described effect of sudden fear is spontaneous voiding of the bowel and bladder. Thus, an individual’s GI response to stress is liable to be unpredictable - nausea/vomiting, heartburn, diarrhea, or constipation are all possible.
As for levdrakon’s question about alcohol and diarrhea - to some extent it depends upon how much alcohol we’re talking about, and over how long a period of time. It may also be that something else in the drink, like the tannins in red wine, is causing the diarrhea. Ethanol is an irritant to mucous membranes, and increases the production of gastric acid and pancreatic juices. The lining of the small bowel can be damaged by large amounts of ethanol, and therefore not absorb as much as it normally would. Thus the colon can be exposed to an increased volume of poorly digested material which overwhelms its absorptive capacity (glossing over some details). Chronic alcoholics display permanent changes to the gut mucosa which impair their ability to properly absorb nutrients. In any event, I doubt that enough alcohol makes it to the colon to directly poison the colonic bacteria (barring enemas). Also, the bacteria are not trying to dry out the shit - they are just eating, excreting, dividing, and dying. It is the colonic lining that is working to absorb water, and in the case of SCFA, it is using the by-products of bacterial metabolism to help with the absorption.
Fascinating thread. Really validates the adage that no one over 50 should trust a fart…
It’s my speculation that while antibodies against enterotoxigenic bacteria may give you “tough guts,” it’s also the colonization of the gut by local strains of E. coli that (1) can protect your mucosa (the way that gabriela described) from the local pathogens better than your native flora can, and (2) your colon needs to accept before they can do that.
spingears, your cite doesn’t really address the issue of how much bacterial mass is in feces – the exact source and state of that 75% water has a lot to do with it.
Exapno Mapcase, I thought it was called “spastic colon.”
levdrakon, heavy alcohol use can inflame colonic tissues, even killing cells outright, which interferes with the shit-drying mission. It can also interfere with absorption in the small intestine, which will (1) force the feces to flow faster and (2) cause undigested nutrients to pass into the colon, where they’re eaten by bacteria, which gets the gut gassy.
guinastasia, the main purpose of mucus production in the colon is to lubricate the passage of stools. Excess mucus can indicate anything from hemorrhoids to colon cancer, and “colon cleansing” is a boneheaded scam that does no good, may do great harm, and at its worst may cover up a deadly disease state.
When I lived in Israel for a year, I phased in local food and water gradually over about two weeks and had no trouble after that, except when I ate something once in East Jerusalem.
However, when I went to Egypt, I was told that I couldn’t really acclimate, and that “even the people who live here have diarrhea if they drink the water.” Any truth to this? I assumed that in Israel the issue was acclimating, whereas in Egypt it was contamination (rather than local e. coli strains, etc.).
[QUOTE=Street Deep]
What’s the straight dope on diarrhea?QUOTE]
It’s the shits.
This is the first time someone has explained the digestive system to me and I understood it.
Drying the shit!
Bravo, gabriela!! You’ve provided an explanation in moderate depth of a vital bodily function that’s wunerfully free of the obscure jargon of the medical priesthood! Thank you and brossa and thank all of you who have contributed to our gut understanding of these issues.
Like others here, I have a question. I’m not asking for medical advice; I know that’s verboten here. But maybe someone can help me merely understand the issues.
For about 25 years, I’ve been diagnosed with ulcerative proctitis (for which I take 3 g of sulfasalazine daily). To me, it’s trivial in that it hasn’t produced the tiniest bit of pain or discomfort, except of course from above average incidence of diarrhea, which frankly isn’t that much of a bother. (I’d be interested to know just why this causes diarrhea, but that’s not my main question.)
My question is: How significant is the loss of nutrient absorption from what seems to be a relatively minor case of ulcerative proctitis? (My gastroenterologist doesn’t seem to want to answer such questions). If you choose, you can certainly put it in approximate terms (say 1 to 5, where 1 is trivial and 5 is major).
Oh, and by the way, to the best of my own personal knowledge (my gastroenterologist may know differently), I have no extra-intestinal symptoms, and I only observe blood (and only with hard stools) about once a year with no visible mucous ever (although I understand microscopic amounts of blood are common).
This has got to mean an especially mild case, doesn’t it? So that the loss of absorption has got to be pretty trivial, right?
I’m gonna need QtM or someone to weigh in on Ambushed’s question - I’ve never seen a fatal case of ulcerative proctitis.
In fact, it’s not a disease I know, unless it is a different term for ulcerative colitis restricted to the very distal colon. In which case, it wouldn’t affect nutrient absorption at all! But I will let people who take care of the living, do the answering.
But thanks for responding!
That’s it, exactly. 4-6 inches of the most distal part of the colon.
That would be my guess, too. That’s why I’m so curious about what my potential surgeon’s concerns are on that score regarding a malapsorbtive bariatric surgery. He tells me that would make the malabsorption worse, but I can’t help but think that’s only valid for people with a much worse case than mine.
Thanks again!
Your bariatric surgeon is concerned because s/he cannot predict how your colon will respond to the drastic environmental alteration of a malabsorptive procedure. It could be catastrophic if the increase in volume, osmolarity, carbohydrate content, changed pH, etc. etc., changed your proctitis to full-fledged colitis, or set off sclerosing cholangitis, or led to breakdown of the surgical connections, or, or, or… A person with exercise-induced asthma may be able to use an inhaler and jog a mile at sea level, but totally decompensate when doing an Ironman triathlon at Lake Titicaca.
Also, do not underestimate the ability of 6 inches of inflamed colon to dump a LOT of mucus, blood, and fluid. Try thinking of things this way: a un-surgerized person with uncontrolled ulcerative proctitis can have nutritional problems, not because the last couple inches of colon is not absorbing well, but because it is actively secreting so much blood, mucus, and fluid. It’s hard to keep a boat afloat if some of the sailors are bailing and some are drilling holes in the hull.
Probiotics offer a multitude of health benefits. They will help give you that “iron gut”.
*There is growing public and scientific interest in probiotics. Researchers are studying whether probiotics taken as foods or supplements can help treat or prevent illness, such as:
Vaginal yeast infections
Diarrhea following treatment with certain antibiotics
In addition, recent research suggests a number of new potential uses for probiotics. One study in Sweden found that a group of employees who were given probiotics missed less work due to illness than did employees who were not given probiotics. Other studies have found probiotics to be helpful in managing the signs and symptoms of irritable bowel syndrome (IBS).*
*There is no published evidence that probiotic supplements are able to replace the body’s natural flora when these have been killed off. There is evidence, however, that probiotics do form beneficial temporary colonies which may assist the body in the same functions as the natural flora, while allowing the natural flora time to recover from depletion. The probiotic strains are then progressively replaced by a naturally developed gut flora. If the conditions which originally caused damage to the natural gut flora persist, the benefits obtained from probiotic supplements will be short lived.
[edit]
Benefits
Scientists have found a range of potentially beneficial medicinal uses for probiotics. Briefly, they are described below.
Managing Lactose Intolerance: Because LAB convert lactose into lactic acid, their ingestion may help lactose intolerant individuals tolerate more lactose than what they would have otherwise.[1]
Prevention of Colon Cancer: In laboratory investigations, LAB have demonstrated anti-mutagenic effects thought to be due to their ability to bind with (and therefore detoxify) heterocylic amines; carcinogenic substances formed in cooked meat.[2] Animal studies have demonstrated that LAB can protect against colon cancer in rodents, though human data is limited and conflicting.[3] Most human trials have found that LAB may exert anti-carcinogenic effects by decreasing the activity of an enzyme called ß-glucuronidase [3] (which can regenerate carcinogens in the digestive system). Lower rates of colon cancer among higher consumers of fermented dairy products have been observed in some population studies;[1] the results of which are encouraging however more research is needed.
Cholesterol Lowering: Animal studies have demonstrated the efficacy of a range of LAB to be able to lower serum cholesterol levels, presumably by breaking down bile in the gut, thus inhibiting its reabsorption (which enters the blood as cholesterol).Some, but not all human trials have shown that dairy foods fermented with LAB can produce modest reductions in total and LDL cholesterol levels in those with normal levels to begin with, however trials in hyperlipidemic subjects are needed.[1]
Lowering Blood Pressure: Several small clinical trials have shown that consumption of milk fermented with various strains of LAB can result in modest reductions in blood pressure. It is thought that this is due to the ACE inhibitor like peptides produced during fermentation. [1]
Improving Immune Function and Preventing Infections: LAB are thought to have several presumably beneficial effects on immune function. They may protect against pathogens by means of competitive inhibition (i.e., by competing for growth) and there is evidence to suggest that they may improve immune function by increasing the number of IgA-producing plasma cells , increasing or improving phagocytosis as well as increasing the proportion of T lymphocytes and Natural Killer cells. [4,5] Clinical trials have demonstrated that probiotics may decrease the incidence of respiratory tract infections [6] and dental caries in children[7] as well as aid in the treatment of Helicobacter pylori infections (which cause peptic ulcers) in adults when used in combination with standard medical treatments.[8] LAB foods and supplements have been shown to be effective in the treatment and prevention of acute diarrhea; decreasing the severity and duration of rotavirus infections in children as well as antibiotic associated and travelers diarrhea in adults.[4,5,9]
Reducing Inflammation: LAB foods and supplements have been found to modulate inflammatory and hypersensitivity responses, an observation thought to be at least in part due to the regulation of cytokine function [4]. Clinical studies suggest that they can prevent reoccurrences of Inflammatory Bowel Disease in adults, [4] as well as improve milk allergies [10] and decrease the risk of atopic eczema in children.[11]
Improving Mineral Absorption: It is hypothesized that probiotic lactobacilli may help correct malabsorption of trace minerals, found particularly in those with diets high in phytate content from whole grains, nuts, and legumes.[12]
Prevents Harmful Bacterial Growth Under Stress: In a study done to see the effects of stress on intestinal flora, rats that were fed probiotics had no occurance of harmful bacteria latched onto their intestines compared to rats that were fed sterile water. [1]*
*Research has shown that probiotics may help reduce:1
The symptoms of bloating and diarrhea from lactose intolerance.
Diarrhea that is a side effect of antibiotics.
Flare-ups of inflammatory bowel disease (IBD), which causes diarrhea and abdominal pain.
Inflammation of the ileal pouch (pouchitis) that may occur in people who have had surgery to remove the colon. *
Er… define “hidden.”
Cervaise, I’d hide along with my crap under a very, very large rock with a very, very small opening!