Every year, millions of people worldwide experience a period of diarrhoea. Although acute diarrhoea is often caused by gastroenteritis, a viral infection, there are many other reasons why diarrhoea may develop.
In food poisoning, a bacterium is the culprit and the source is often chicken. With a bacterial infection and after eating contaminated food, symptoms develop within eight hours. They are often very severe: malaise, vomiting, headache, diarrhoea. The symptoms usually resolve on their own after a few days, but they should not be taken too lightly.
- Escherichia coli
- Salmonella spp.
- Shigella spp.
- Yersinia enterocolitica
- Campylobacter jejuni
The infections listed above can be contracted through direct contact with stool or contaminated food. Among children, Campylobacter was found in 6%, while E. coli and Yersinia enterocolitica were present in 2% and Salmonella spp. in 1%.
Chronic abdominal complaints after an infection
- The inflammation can become chronic because the bacteria do not disappear on their own. Proper stool testing can detect the presence of these bacteria.
- Even after the bacteria have disappeared, infections can cause a post-infectious syndrome that manifests as abdominal cramps, flatulence, a bloated abdomen or diarrhoea, complaints that may persist for years.
Chronic diarrhoea
In addition to a bacterial origin, chronic diarrhoea can have many causes: food allergies, excessively high histamine levels, parasites, ulcerative colitis, coeliac disease, bowel cancer and medication use.
Intestinal parasites
In many cases, chronic diarrhoea with a fluctuating pattern is caused by infection with intestinal parasites. With a parasitic infection, it can take several days before diarrhoea develops
a. Infection with Giardia lamblia and Cryptosporidium spp. can cause severe diarrhoea.
b. With Dientamoeba fragilis infection, the diarrhoea is less severe; mushy stools, flatulence, a bloated abdomen and increased urgency can persist for years.
c. After a visit to the tropics, tropical parasitic infections such as Strongyloides infection can develop. Malaria can also cause abdominal complaints.
d. Infections with worms such as tapeworms are uncommon.
Autoimmune diseases
Crohn’s disease and ulcerative colitis can be accompanied by prolonged severe diarrhoea, with watery stools as often as ten times a day or even more.
Gluten intolerance
Diarrhoea occurs when eating grains containing gluten if a person has gluten intolerance, coeliac disease. Diarrhoea, a distended abdomen and abdominal pain occur especially in children, because they develop more damage to the intestinal villi than adults.
Antibiotics
Diarrhoea often occurs during or after a course of antibiotics. A culture of the gut flora can show whether the numbers of bacteria in the intestine have decreased or whether there is an increase in yeasts such as candida albicans.
Milk sugar
An intolerance to milk sugar causes flatulence, a bloated abdomen and diarrhoea. In the Netherlands, 15% of people cannot break down milk sugar. They develop diarrhoea when they drink a glass of milk, but also from hidden lactose added to foods and medicines.
Histamine
High histamine levels in the intestine cause diarrhoea. An increase in histamine is caused by a deficiency of the enzyme (DAO) that breaks down histamine in the intestine.
High histamine levels occur especially after eating mature cheese or chocolate and drinking red wine.
Additives
Food additives such as aspartame, sorbitol and fructose can cause diarrhoea and a bloated abdomen.
Antidepressants and medicines for high blood pressure can cause diarrhoea.
