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Gut Check: What Causes Diarrhea

By Alex Barkan, MD FACS


For the most part, everyone suffers from diarrhea at some point. This can be a distressing problem for anyone and with all the things we tend to put in our stomachs, we should expect a little tummy trouble sometimes. Because diarrhea is one of nature’s ways of cleansing the body, it isn’t always a cause for alarm. But, it’s important to understand when you may have a serious problem.


For the record, diarrhea is defined as loose bowel movements that often have a watery consistency. It has many causes, but the presence of loose stools does not always mean that you are sick. Sometimes this can be caused by a gastrointestinal bug, which is often accompanied by stomach cramping, or nausea and vomiting. These are the true gastroenteritis bugs that can leave you dehydrated and depleted of vital electrolytes like potassium and sodium. One of the ways that some people try to stave off the loss of electrolytes is to drink large amounts of fluids that are electrolyte enhanced, but sugar free. Natural sugar substitutes are often used in many of the calorie free electrolyte replacement drinks. Unfortunately, this is counterproductive since the sugar replacement chemicals actually worsen the diarrhea and increase the electrolyte loss. When diarrhea strikes, water is the best remedy to keep dehydration at bay. 


Another cause of diarrhea can be chemicals. Specifically, chemicals added to sugar-free foods are sugar alcohols which are found in sugar free chewing gum, protein bars for weight loss and to sugar free candies. In order to avoid the side effects of these sugar alcohols, the key is to consume them in moderation. Some patients have even reported difficulty with sugar alcohols in their vitamins if they take too many at the same time. In that case it is recommended that the vitamin doses be spread apart by a few hours.


Diarrhea can also be linked to nervousness and anxiety. Butterflies in the stomach can sometimes lead to hyperactive bowel contractions which can worsen to become full-fledged diarrhea. The overstimulation of the flight or fight adrenaline response causes the nervous system to react and cause the body to produce loose watery stools in response to an anxiety producing event. But, always remember that if diarrhea persists, consult with your physician for advice on treatment to ensure that other testing or intervention is not necessary.