Diarrhoea

Diarrhoea is defined by an increased frequency of bowel motions or increased fluid content, or both. It is often multifactorial. It often has a significant impact on quality of life due to frequency of toilet visits, embarrassment and soreness which can develop due to increased wiping and irritation from the liquid stool.

Causes

• Impacted faeces with overflow
• Bacterial and viral infections
• Medication side effects - especially chemotherapy and immunotherapy 
• Radiotherapy side effect
• Bacterial overgrowth
• Pancreatic insufficiency
• Bowel diseases - including bowel cancer, diverticulosis, inflammatory bowel disease and carcinoid
• Autonomic neuropathy

Management should generally be targeted at the specific cause (Creon for pancreatic insufficiency or octreotide for carcinoid) and supportive measures such as rehydration and electrolyte monitoring/replacement. Available symptomatic drug treatments include loperamide and codeine phosphate.