Chronic Diarrhoea: Finding the Cause and Keeping Notes
Understand persistent diarrhoea, reasons for investigation, and how One Food Forward helps record urgency, meals and medicines for a clearer clinical history.
The most demanding part of diarrhoea is not always the time spent in the bathroom. It may be the cancelled outing, the interrupted sleep, or the constant calculation of where the next toilet will be.
When loose stools keep returning, you deserve a considered explanation. A diary can help tell the story while your clinician investigates it.
Start your food and symptom diary
Understanding Chronic Diarrhea
Chronic diarrhoea generally means loose or watery stools lasting at least four weeks. It has many possible causes, including infection, medication effects, inflammatory disease, malabsorption and disorders of gut–brain interaction. Urgency and the effect on daily life matter too. A recurring symptom after eating does not prove a food intolerance. [1]
Treatment and everyday food decisions
Assessment is guided by your history and may include blood or stool tests and sometimes further investigations. Treatment follows the cause. Ask for advice about hydration and whether anti-diarrhoeal medicine is suitable. Repeatedly cutting out foods can obscure the picture and make nutrition harder, particularly if you are also losing weight. [2]
How One Food Forward can help you keep the useful details
In One Food Forward, note stool frequency and consistency, urgency, night-time episodes and pain. Keep meal times, medication changes, recent illness or travel in the same history. A record that includes diarrhoea before breakfast or during the night can challenge the assumption that the last thing you ate must explain everything.
Choose a level of detail you can sustain. You might record the day’s number of episodes and one note about its impact rather than every anxious trip to the toilet. One Food Forward can help you prepare questions and describe change after treatment. It cannot identify infection, inflammation or nutrient loss, and a reassuring-looking record should not postpone medical assessment.
Two causes worth understanding are bile acid diarrhoea and microscopic colitis. These links explain possibilities to discuss, rather than diagnoses to make from a diary.
Is all chronic diarrhoea IBS-D?
No. IBS-D is one possible diagnosis, generally involving recurrent abdominal pain as well as altered stools. Other causes, including coeliac disease and bile acid diarrhoea, may require different tests or treatment. Your clinician decides which possibilities need checking.
Keep the details somewhere you can find them
There is no need to tell the whole story at once. Start with today’s meal, a symptom or a few words about how you felt. Those small entries give you something to return to when it is time to talk about your care.
Sources and further reading
Your healthcare team should guide diagnosis, treatment and changes to your diet or medicines.
Spotted something that needs correcting? Contact One Food Forward support and include this page’s address.