Diarrhoea

• Diarrhoea symptoms

  • Increased frequency of bowel movements
  • Soft/ watery stools
  • Abdominal cramps, flatulence, nauses
  • Urgent need to have bowel movement
• Causes of diarrhoea

  • Bacterial/ Viral Infection
  • Laxative overuse
  • Poor diet
  • Long-term conditions: Ulcerative colitis, Crohn's disease, IBS, Lactose intolerance, Coeliac disease
  • Recent travel abroad
• Refer if there is bloody, black or mucus in the stools
• Refer if there is diarrhoea with severe vomiting and fever
• Refer if there are signs of dehydration: (dry mouth, drowsiness/ confusion, passing little urine, sunken fontanello & eyes)
• Refer if there is severe abdominal or rectal pain
• Refer if there is suspected drug induced diarrhoea e.g. antibiotics
• Refer adults & children > 3 days without any treatment
• Refer adults & children > 24 hrs with anti-diarrhoea treatment
• Refer children under 3 yrs & Elderly > 2 days
• Refer babies under 1 yr > 24 hrs
• 1st Line Treatment: Oral Rehydration Therapy (ORT)


  1. Dioralyte is suitable for all ages, replaces lost fluids & salts to help correct dehydration

  2. Clean drinking water/ or boiled & cooled water, mixture should be consumed within 1 hour of preparation

  3. Can be stored in a fridge for 24 hours

  4. Dioralyte relief contains rice starch which bulks up the stool
• 2nd Line Treatment: Loperamide, (Imodium), antidiarrheal treatment

  1. High affinity for opiate receptors in the gut wall leading to reduced motility, therefore allowing more water to be absorbed

  2. Advise use in combination with step 1 ORT (oral rehydration therapy)

  3. Age 12 and over only, not for pregnant or breastfeeding women
• 3rd Line Treatment: Kaolin


  Absorbs toxins/ bacteria and removes it from the gut
• 3rd Line Treatment: Morphine/ Codeine

  Slows the action of the GI tract (old school remedy)
• 3rd Line Treatment: Bismuth subsalicylate. Pepto Bismol liquid

  Avoid if pt allergic to aspirin and <16yrs