14772 Diarrhoea H: Lis Speight, Host
A: Dr Christian Jessen, Health Expert B: Jackie Bell, a patient with personal experience
of the problem
H: Itís one of those uncomfortable and embarrassing conditions but we all suffer from it at some
point. Advice on how to treat and prevent diarrhoea, coming up on Health and Wellbeing.
H: Hello and welcome to the show Iím Lis Speight.
H: Now itís a subject that most of us donít want to discuss, although 20 million Adults
in the UK will have suffered from diarrhoea in the past 6 months. The most surprising
thing is that nearly 2 thirds of suffers do not treat their symptoms.
H: Well Iím joined today by health expert Dr Christian Jessen. Welcome along Christian,
and also Jackie Bell, a patient with a personal experience of the problem. Thanks to both
of you for coming in, nice to see you today Jackie.
H: Now coming up on todayís show, confronting the problem; causes and who suffers, and the
treatment and prevention of diarrhoea. We will also be tackling some of those common
myths; is it better to treat diarrhoea or should you simply let it run its course?
H: Dr Jessen, before we start, I think it would help to explain what exactly happens
when you suffer from diarrhoea. Letís take a look at this short video, which shows what
happens to the digestive system during a bout of diarrhoea. Could you just talk us through
to what is actually happening to the gut here? A: What you can see here is an image of your
gut with poo passing through quite normally. The muscle in the wall will help the poo along
at a certain rate. The reason your gut is so long is because water is absorbed from
the stools. When things go wrong and not as much water is absorbed into the gut wall,
it remains in the stool, which of course you can imagine it makes it watery and loose,
and makes it pass out rather quickly. This gives you all the symptoms of diarrhoea. The
muscles are working overtime and starts squeezing and pushing things through too quickly; that
can give you the feeling of cramps that you get with diarrhoea as well.
H: Ok so thereís a lot going on in there isnít there?
A: Yes there is. H: what exactly causes diarrhoea in the first
place? Generally there are a lot of different causes arenít there?
A: There is a whole host of causes, but more commonly I think, everyone always seems to
think of infectious causes. The bacteria, the bugs you get on holiday, travellers diarrhoea,
parasites but actually also food intolerance is an allergies can give you diarrhoea. Stress
is probably one of the more important causes and when youíre nervous we all know when
you perform and get nervous about something. H: Yes, like just before your exams or something.
A: Yes, you can start to get loose stools. We all know about the dreaded curry, spicy
foods can do it, alcohol can do it. Interestingly, women just before there periods can also develop
diarrhoea because of the hormonal changes. Thereís a whole host of different causes.
H: Lots of different things going on there. Why do so many people believe that it should
be left to run it course, with out treating it?
A: I think there are a number of myths. First of all when you read about diarrhoea, you
tend to read about the more extreme cases and those awful bacterial causes salmonella,
Campylobacter and Cholera and usually they are probably best treated with Antibiotics
or to be left to run its cause. Generally stress diarrhoea you do need to treat. If
you like most people, working , running about, got things to so when actually, treating it
is going to be the best way to get on with your life.
H: What about children, if you donít treat a child when they have diarrhoea it could
be quite dangerous? A: The most important thing with children
is to make sure they are getting their fluids up. Itís important with everybody, particularly
with children as there not very good with making sure they are drinking enough. Make
sure your child is really well hydrated because remember you are losing a lot of fluid when
you have diarrhoea and it is key to keeping a child healthy.
H: Jackie, lets bring you in here. Thanks for coming along today, I know itís a bit
of an embarrassing topic to talk about, how long have you been suffering from diarrhoea?
B: For about the last 10years. As you said, itís very stress related; if anything upsets
me it goes straight to my stomach. I get terrible cramps, I feel like Iíve been punched from
the inside out. It can be very very embarrassing sometimes. At home I can manage it quite happily
but if Iím out I find it very very embarrassing, and I have to take a pill to stop it.
H: So do you think yours is an irritable bowl response?
B: Quite possibly yes, I actually went to my pharmacist and he recommended me some pills,
which I take and they seem to do the job. When I have a bout or Iím in company or in
somebodyís house and they calm it all the way down. It takes away the craps, it does
help a lot. H: do you find it difficult to talk about
with your family and friends? B: Not with my family and not with my very
close friends. In fact I have been known phone one up as I have been on route on the motorway
and asked them if I could use there toilet. But not so close friends, Iíd find it rather
embarrassing. H: What about your GP?
B: Itís not the sort of thing I would want to go and talk to him about. If Iíd had a
lady GP I might feel happier but I was quite happy speaking to the Pharmacist. He gave
me these pills and they seemed to do the job. H: Does it actually affect the way you live
your life? B: Yes and no, I canít find any food that
upsets me. I carry the pills around with me the whole time so that if it suddenly happens
and Iím out Iíve got pills to take but I try and keep my life going as it should go.
I donít want it to disrupt my life. H: No. So youíre obviously taking these pills.
Christian, what sort of treatments are there out there? Thereís quite are wide range of
things you can do. A: You can really divide them into two main
things. The most important thing probably, is rehydration. So if youíve got a lot of
diarrhoea you need to replace those fluids. Dehydration will make you more and more ill
make you feel worse and worse, so absolutely drinking really anything. People argue about
whether fruit juice or milk is the right thing. I say any fluid is important.
H: Particularly with children I suppose, just try and get as much as you can in.
A: And particularly with fluids. You can start getting fussy you can have things like oral
rehydration solution which is salt and sugar mixtures which you dissolve in water but really,
any fluids, get them in. And then you get over the counter medications like Loperamide
which really calms the gut down and helps slow things down and helps more water be absorbed
so that the stools are not so loose - and really as you say, can help relieve the symptoms
of diarrhoea and help you get on with your day. So treatments are available. If you have
bad cramps, high fevers, blood or mucus with the diarrhoea then itís probably more likely
that you have a nasty infectious cause and you must go see your GP because perhaps antibiotics
would be right for you. H: Ok so thatís sort of a worse case scenario
then, antibiotics? A: It is, but it is a rarer cause. You know
I think most of us, things like stress related diarrhoea which is probably more common so
an over the counter treatment would be absolutely suitable.
H: So how do you prevent yourself from getting diarrhoea in the first place? Can you prevent
yourself from picking up bugs and that sort of thing?
A: Well, obviously good hygiene, washing hands, being carful about the sources of your food
and where youíre water come from particularly on holiday is absolutely imperative. In Jackieís
case itís probably very difficult isnít it? I mean you donít know exactly what sets
it off. B: I canít say there is a certain food that
sets it off. If I do get stressed it will go to my stomach first of all but I canít
pin point an actual thing. A: So with you I think just being prepared,
having the medication with you when you need it. If you are a woman who maybe suffers diarrhoea
before her period then you know almost to the day what time what time you need to start
taking your medication to make sure that it disrupts your life as little as possible.
So there are various things you can do. Obviously spicy foods and alcohol if you know they upset
you, you need to avoid them. If you are intolerant to certain foods you need to avoid those as
well. H: Now some people thing that if you take
diarrhoea tablets it sort of bungs you up and stops any bugs that youíve got from coming
out of your system. Is that right? A: Well, it is a very common myth actually
that I hear a lot and I would say, as I said before, if you have high fevers, cramps, a
lot of mucus coming out then actually go and seek medical advice first before you take
anything yourself. But for that short lived, acute diarrhoea where it is just the diarrhoea
and maybe a bit of cramping, no itís not right at all and it will absolutely help you
to get on with your life, stop you living in the bathroom for 3 days and it will relieve
the symptoms, make you feel a lot more comfortable. So no, it is fine to take medication.
H: And how long should you wait before seeking advice. How long were you suffering before
you went to the pharmacist? B: Maybe 2 or 3 weeks because at that time
I was getting it the whole time but now I have it about every 10 days, 2 weeks and I
can more of less tell when itís going to happen.
H: So what sets it off? Stress, anxiety that sort of stuff?
B: If I get upset, if anything upsets me that will set it off. It can be for no reason at
all. Also, just something will go in my stomach and say ëright, Iím going to make you want
to sit on the toilet for a long timeí A: In Jackieís case I mean, she knows absolutely
what it is, where it comes from, whatís going to set it off and thatís fine, Iíd say she
doesnít really need to seek medical advice now.
H: Because she is managing it really well, arenít you, which is good.
B: Yes, yes. A: I think, if you have your first bout of
diarrhoea or a bout of diarrhoea after a long period of normal bowel movements anything
lasting longer than about 3 days I would always say, look just seek advice. Check if there
is nothing else going on that could be dealt with as well.
H: Ok. Well thatís just about all weíve got time for but before we go, a top tip from
both of you. Jackie, what would you say? B: Carry some pills along with you and always
have a bottle of water with you, which I always do and I also know if Iím going out I try
to know where the toilets are. H: Good tip, always look for the loo.
A: Gosh youíve done all the good ones, you havenít left me any! I was going to say actually
just be prepared, you know, just always have something at least at home and donít under
estimate how quickly diarrhoea can dehydrate you, particularly if you are in a warm country
or in summer in this country. Its simple just make sure youíre getting plenty of fluids
on board. H: And try and treat it, donít be afraid
to treat your symptoms. A: Absolutely.
H: OK, well thatís all we have time for today, my thanks to Dr Christian Jessen and Jackie
for joining me and for all your advice. A + H: Thank you.
H: Thanks for watching weíll see you next time. Bye bye.