There are different causes of diarrhea, that varies
form country to country.
I advanced countries it is usually caused by non
infectious diseases (Chrohn’s disease or irritable
bowel), or Viruses ( Nora virus) or milder form of
bacteria like(Giardia or Campylobactor). Occasional
Salmonella (different species from the one that causes
typhoid) out break happen, usually due to egg. Diarrhea
in these countries is usually self limiting and treated
with clear liquid diet only. Agents like Imodium and
Pepto-Bismol can be used to reduce motility of
intestine, but antibiotic is not needed in majority of
Diarrhea in developing countries like India is usually
caused by protozoan , parasites or aggressive bacteria.
It can be severe, causing bloody stools, also called
Protozoan are microscopic one cell organisms ( much
lager than bacteria or virus), that live in human
intestine. They go out of patient’s body in the stool,
get in food and water and enter another person, through
mouth. The so called “ Feco Oral contamination”.
Basically one ends up eating minute amount of feces from
The commonest of these is called Amoeba ( Entamoeba
Histolica). This is the most common cause of the
diarrhea in India. Nearly all Indians have suffered from
it one time or other in their lives. 90% times the
infection is asymptomatic (patient harbors the germ
without symptoms) . It manifests in 4-5% only. Others
may be chronic carriers and shed its eggs in stool.
Diarrhea is only second to Malaria in mortality by
protozoan. Most common age is young children. It is the
leading cause of Malnutrition under the age of 5. These
malnourished children are more prone to all diseases.
They also have stunted brain development.. This disease
must be treated by antibiotics. Just liquid diet and
Imodium is not enough.
Parasites are larger agents. Visible by naked eyes. They
are the common “Worms”, noted in stool. They are also
asymptomatic in most cases. Thread worms causes anal
itching. Hook worm causes silent intestinal bleeding and
anemia. They are also acquired by feco-oral
contamination. All of them cause malnutrition. They are
treated by special deworming medicines.
Bacteria cause Cholera (Vibrio Cholerae) and Typhoid (
Salmonella Typhae). Both these are serious diseases with
high mortality rate. Both are caused by feco-oral
Diarrhea can be severe to cause rapid dehydration and
death. Cholera stools are called “Rice water “ stool, as
it is just fluid. Typhoid infection makes intestinal
wall friable, resulting in its breakdown and spread of
feces in the whole belly. A very serious condition.
Tuberculosis is another cause of diarrhea in India. It
happens when the disease attacks intestines.
Tuberculosis mostly starts in lung and spreads to the
rest of the body. All these conditions need specialized
treatment in a hospital setting.
Prevention: Protozoan , bacteria and the eggs of
parasites are readily killed by boiling the water. This
will make most water safe to drink in India. Iodine
tablets also kill these agents. They should be used to
soak fruits before eating.