First, let me apologize to the editor of the Islands’ Weekly who, day in and day out, strives to produce a respectable newspaper. However, as long as they continue to publish writers like me and articles like this, there is no chance. Which brings us to our topic: diarrhea. The definition of diarrhea is “An abnormally frequent or liquid fecal discharge.” Well, gee, that really doesn’t sound all that bad, does it? Yet diarrhea can be uncontrolled, messy, painful, embarrassing, debilitating, and dangerous if it goes on too long. I can also be a sign of something very bad.
Second let me apologize to the readers of the Weekly. In place of this column could be a tasteful, artsy piece about post-modern sculpture or an interview with some hot, new, avant -arde architect. Instead you are reading an article about a big pile of…
Having said that, you are continuing to read, so from here on, you have only yourself to blame. Diarrhea results from really just two things. Either it is a failure of the large bowel to adequately absorb the water present in food, or the bowel is actually leaking water into itself, the commonality being too much water. After all, the main purpose of your large intestine is to absorb water. If it didn’t do that job, we would die of dehydration pretty quickly.
The causes of diarrhea are many. Some viruses and bacteria have the ability to infect the gut and cause a watery stool by making toxins that bind to and disable the cells that line the large intestine. The archetype is the disease cholera, which kills many people world-wide, by means of massive dehydration. Infections can also destroy the microvilli, which are not tiny, little towns that some hot, new, avant-garde architect has constructed inside your intestine, but microscopic finger-like projections that line the bowel to increase surface area and thus absorption. When these are lost, once again water is allowed to run through the bowel. Autoimmune diseases such as ulcerative colitis or Crohn’s can also cause diarrhea and often bleeding.
Diarrhea can also be the result of increased motility, the proverbial poop-through-a-goose disease. The faster food moves through the bowel, the less time there is to absorb water. Infections can cause this, but so can anything that stimulates the gut to contract faster, including some foods, herbals, medications, and even emotional stress. Some people have guts that are very sensitive to stress. Personally my gut is extremely sensitive to criticism. Please remember this when visiting Lopez Clinic. Speak to me in soft, soothing, complimentary tones or, I’m warning you, things could get messy very quickly.
Diarrhea is common, very common, possibly to the point of being a national pass time. Consequently it isn’t something that always calls for medical attention. When should one seek help? Is it when you have run out of clothing? When the toilet stops up? When you are just plain lonely? No, no, and no, but diarrhea does need to be evaluated in the setting of high fever, severe abdominal pain, inability to keep hydrated (this is a frequent complication in children), bloody diarrhea, if it has become chronic, or any time one feels very ill. At the clinic we treat the dehydration, nausea, cramping, pain, and yes even the loneliness. Further testing and treatment for infection, parasites, autoimmune disease, and even cancer may be indicated.
My final apology is to those of you with, shall we say, more tender sensibilities? Roget’s Thesaurus offered no more aesthetic synonym, alternative definition, or euphemism for diarrhea. I can only hope that reading this did not trigger a severe case of diarrhea.