Quick Answer
Diarrhea is the passage of three or more loose stools per day. It is acute when under 2 weeks, chronic beyond 4 weeks. Dr. Anando Sengupta evaluates diarrhea with stool studies, blood tests, and colonoscopy when needed, and treats the underlying cause — from infection to IBD to functional disease.
Acute vs chronic diarrhea
| Acute | Chronic | |
|---|---|---|
| Duration | Less than 2 weeks | More than 4 weeks |
| Common causes | Viruses, bacterial gastroenteritis, food poisoning, traveller's diarrhea | IBS, IBD, celiac disease, lactose intolerance, microscopic colitis, bile acid diarrhea |
| Treatment focus | Rehydration, anti-motility, targeted antibiotics | Identify and treat underlying cause |
Symptoms & warning signs
- Frequent loose or watery stools
- Cramping abdominal pain
- Urgency, sometimes incontinence
- Nausea, vomiting
- Fever, body aches
- Signs of dehydration: thirst, dry mouth, reduced urine, dizziness
Get urgent care if you have: blood in the stool, high fever, severe abdominal pain, persistent vomiting, signs of dehydration, weight loss, or diarrhea after recent antibiotic use (suspected C. difficile).
How chronic diarrhea is investigated
| Test | Purpose |
|---|---|
| CBC, ESR, CRP, electrolytes, TSH | Inflammation, anaemia, dehydration, thyroid |
| Stool routine, culture, ova/cyst, C. difficile | Infection, parasites |
| Stool calprotectin | Distinguishes IBS vs IBD |
| Celiac serology (anti-tTG) | Coeliac disease |
| Lactose / SIBO breath test | Carbohydrate malabsorption, bacterial overgrowth |
| Colonoscopy + biopsy | IBD, microscopic colitis, malignancy |
| MR enterography / capsule endoscopy | Small bowel disease |
Treatment
Acute diarrhea
- Hydration — oral rehydration salts (ORS), light fluids, soft food
- Anti-motility — loperamide for non-bloody, non-feverish cases
- Antibiotics — only when bacterial cause is suspected (azithromycin, rifaximin, ciprofloxacin)
- Probiotics — help shorten duration in some patients
- Zinc supplementation — especially in children
Chronic diarrhea
Treatment depends on the cause:
- IBS-D: low-FODMAP diet, antispasmodics, rifaximin, low-dose tricyclic
- IBD: 5-ASA, immunomodulators, biologics — see IBD page
- Coeliac disease: strict gluten-free diet
- Lactose intolerance: avoid milk, use lactase enzyme
- Microscopic colitis: budesonide
- Bile acid diarrhea: cholestyramine
Frequently Asked Questions
Diarrhea is acute if it lasts under 2 weeks, persistent if 2–4 weeks, and chronic if it continues beyond 4 weeks. Chronic diarrhea always needs specialist evaluation to identify the underlying cause.
See a doctor if there is blood in the stool, high fever, severe dehydration (dry mouth, dizziness, reduced urine), more than 6 stools/day, weight loss, or symptoms lasting more than 5 days.
Stool routine, stool culture, ova/cyst, C. difficile, calprotectin, blood tests (CBC, ESR, CRP, TSH, celiac panel), colonoscopy with biopsy, and sometimes capsule endoscopy or breath tests for SIBO/lactose intolerance.
Loperamide is safe for non-bloody, non-feverish acute diarrhea in adults. Avoid it if there is high fever, blood in the stool or in suspected C. difficile infection.
Most cases settle with hydration alone. A short course of azithromycin or rifaximin shortens the illness if diarrhea is severe or has not improved within 24–48 hours.
Yes — IBS-D is a common cause, but the diagnosis is made only after ruling out IBD, celiac, microscopic colitis, infection and bile acid diarrhea. See our IBS treatment page.
Yes. Dr. Anando Sengupta consults at North Delhi Nursing Home, Ashok Vihar Phase II (Mon–Sat, 5:30–7:30 PM) — within easy reach of Model Town (3 km), GTB Nagar, Mukherjee Nagar, Wazirpur and Shastri Nagar. Morning slots and procedures (endoscopy, colonoscopy, ERCP, EUS) are at Fortis Hospital, Shalimar Bagh (~3 km from Pitampura, with cashless insurance on all major panels). Both clinics serve patients from across North Delhi.
