It's difficult to go about your daily activities when you have diarrhea. A broad array of medical conditions and disorders can lead to this common, troublesome symptom. The duration of the diarrhea helps narrow the list of possible causes. Diarrhea lasting 5 days is considered short term or acute, meaning it comes on suddenly and lasts less than 2 weeks. Intestinal infections caused by contamination of food, water or other beverages account for most cases of acute diarrhea. Noninfectious conditions can also lead to short-term diarrhea.
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Several bacterial infections can cause acute diarrhea lasting 5 or more days. Some common examples include:
Salmonella food poisoning most commonly occurs due to eating contaminated raw or undercooked eggs or poultry, contaminated water, or unpasteurized milk or juice. Typical symptoms include diarrhea (possibly bloody), vomiting, fever and abdominal cramps usually lasting 4 to 7 days.
Campylobacter intestinal infections most commonly come from the same types of contaminated foods as salmonella infections. Characteristic symptoms include bloody diarrhea, abdominal pain, fever, and possibly nausea and vomiting. Symptoms usually last 2 to 10 days.
An infection caused by shigella, known as shigellosis, is typically contracted by consuming food or water contaminated by fecal material containing the bacteria. As such, shigellosis can easily be passed from an infected person to others in the absence of careful handwashing after using the bathroom. Typical symptoms include diarrhea that might contain blood and/or mucus, abdominal cramps, fever, nausea and vomiting. These symptoms usually clear within a week, although they might persist for up to 4 weeks in some people.
Escherichia coli (E. coli)
There are hundreds of strains of E. coli. Most are harmless to humans and many normally inhabit the colon. There are, however, 6 types that can cause diarrhea when they contaminate food. These strains are called diarrheagenic E. coli. Symptoms vary somewhat depending on the type of diarrhea-causing E. coli causing the infection and may include fever, abdominal pain, nausea and vomiting. Diarrhea caused by E. coli usually clears within 5 to 10 days.
Clostridium difficile (C. difficile)
C. difficile infection most commonly occurs in older adults residing in skilled-nursing facilities or who have frequent or extended stays in healthcare facilities. Recent treatment with antibiotics is another major risk factor for C. difficile infection. Antibiotics reduce the numbers of normal bacteria in the colon, which allows C. difficile to flourish. Typical symptoms include 3 or more watery stools daily, low-grade fever, nausea, reduced appetite and abdominal pain. While the diarrhea associated with a C. difficile infection often persists for longer than 5 days, it is a consideration for anyone with risk factors.
Parasitic intestinal infections can also cause acute diarrhea lasting 5 days or longer. Two microscopic parasites predominate in the United States.
Giardia parasites inhabit the intestines of infected persons and animals and are shed in the stool. People usually contract giardia by ingesting contaminated food or water, especially untreated water from a lake, river, stream or well. The illness can also be passed from an infected person to others if not practicing handwashing after bowel movements. Symptoms of a giardia infection include diarrhea with greasy foul-smelling stools, increased intestinal gas and bloating, abdominal cramps, and possibly nausea and vomiting. The duration of these symptoms varies from 1 to 2 weeks or longer and can recur if the infection is not treated.
Crypto is shed in the stool of infected humans and animals. People contract this infection by ingesting contaminated water or foods, especially raw fruits or vegetables and unpasteurized milk. Symptoms include watery diarrhea and abdominal cramps, possibly accompanied by nausea, vomiting and/or fever. The diarrhea usually lasts 1 to 2 weeks but might persist up to 4 weeks or recur.
Medication Side Effect
If you develop diarrhea after starting a new medication, you might be experiencing a drug side effect. According to a May 2008 "Practical Gastroenterology" review article, more than 700 medications are known to potentially cause diarrhea. Common culprits include antibiotics, laxatives, magnesium-containing antacids, certain blood pressure medicines as well as the diabetes drug metformin. High-dose vitamin C and magnesium supplements can also cause diarrhea.
Recent dietary changes can potentially cause acute diarrhea. For example, a sudden increase in the amount of milk and other dairy products in your diet might trigger abdominal cramps, gas and diarrhea due to lactose intolerance, an enzyme deficiency that impairs the breakdown of milk sugar. If you're trying to lose weight and have added a number of sugar-free products to your diet, artificial sweeteners called sugar alcohols might be to blame for your diarrhea. On the flipside, you might develop diarrhea if the amount of fatty foods in your diet has recently increased due to a vacation or holiday celebrations.
Diarrhea lasting 5 days might herald a more long-term digestive disorder, especially if your diarrhea continues or recurs. A few of the more common conditions that might be considerations include:
- Irritable bowel syndrome
- Inflammatory bowel disease (Crohn disease or ulcerative colitis)
- Celiac disease
- Pancreatic or liver disease
- Ischemic colitis (colon damage caused by reduced blood flow)
- Colon or pancreatic cancer
Warnings and Precautions
Contact your doctor if you experience unexplained diarrhea that lasts longer than a week. Seek help sooner if you have a weakened immune system, are unable to keep down keep down fluids for more than 12 to 24 hours, or your diarrhea is accompanied by a fever. Seek urgent medical care if you experience any warning signs or symptoms, including:
- Dizziness, lightheadedness or fainting
- Severe or worsening abdominal pain
- Bleeding from your rectum
- Decreased urine production
- Confusion or other mental changes
Reviewed and revised by: Tina M. St. John, M.D.
REFERENCES & RESOURCES
- Differential Diagnosis of Common Complaints, 6th Edition; Robert H. Seller and Andrew B. Symons
- Symptom to Diagnosis: An Evidence-Based Guide, 2nd Edition; Scott Stern, Adam Cifu and Diane Altkorn
- American Family Physician: Acute Diarrhea in Adults
- Cleveland Clinic Center for Continuing Education: Acute Diarrhea
- Mayo Clinic Proceedings: Evaluating the Patient With Diarrhea: A Case-Based Approach
- Centers for Disease Control and Prevention: Foodborne Illnesses and Germs
- Clinics in Geriatric Medicine: Diarrheal Diseases in the Elderly
- Practical Gastroenterology: Medication Induced Constipation and Diarrhea
- NHS: Symptoms of Dehydration