Chronic diarrhea means having loose stools regularly for more than four weeks. Diarrhea can be watery, fatty or inflammatory. A wide range of diseases can cause it. Sometimes, it turns out to be something you’re eating or a medication you’re taking.
Diarrhea is loose, runny poop. We’ve all probably had it at one time or another. It tends to come out fast, suddenly and urgently, and you may have cramping or spasms in your colon when you go.
If you have food poisoning or the flu, you might have diarrhea for a day or so. It goes away when the original infection does. Chronic diarrhea is persistent diarrhea that continues for more than four weeks.
An estimated 1% to 3% of the population has chronic diarrhea. But these estimates may be low, as many people don’t seek treatment unless they have other symptoms, such as pain or bleeding.
Chronic and frequent diarrhea is an everyday experience for some people, but under normal circumstances, it shouldn’t be. Your colon, where poop is formed, is reacting to something abnormal.
Some people have chronic bowel diseases that cause chronic diarrhea. These diseases may not be curable, but you can treat the symptoms. Other causes are often curable with the right treatment.
Normally, your colon receives liquefied food waste from your small intestine and gradually condenses it into solid poop. But with diarrhea, something impairs this process, leaving you with liquefied poop.
Something is making it hard for your colon to absorb water as it normally would, or making it excrete extra water, or both. It may be a problem with your colon itself or something abnormal inside it.
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Many diseases can cause chronic diarrhea. But before looking for diseases, a healthcare provider will ask you about your diet and medications. These are some of the most common causes of self-induced chronic diarrhea, and also some of the easiest causes to fix. Possible causes include:
Certain foods and drinks can cause diarrhea. If you eat or drink excessive amounts of them on a regular basis, or if you’re particularly sensitive to any of them, they might cause chronic diarrhea. Isolating the offending food or drink and reducing it or eliminating it from your diet may solve the problem. Consider:
Many medications can cause chronic diarrhea as a side effect. They can cause it by several different means. Whether they have that effect on you may depend on a variety of other factors, including dosage, diet and other conditions. Your healthcare provider will look at your complete medical profile to determine whether medications are a factor. Some that can cause chronic diarrhea include:
Healthcare providers sometimes classify diarrhea into three or four types as a way of narrowing down the cause. These types produce diarrhea with distinct qualities that doctors can recognize in your poop. They represent broad categories of causes. The three main types are inflammatory, fatty and watery. Some divide watery diarrhea into two sub-types (secretory and osmotic) to make four main types.
Watery diarrhea happens when your colon is unable to absorb enough water and electrolytes from your poop and/or when it’s secreting more than it’s absorbing. The osmotic type is caused by poorly absorbed nutrients that draw extra water into your colon. (This is how osmotic laxatives work.) Meanwhile, secretory diarrhea represents a wide variety of diseases that can cause watery diarrhea.
Some of these causes include:
Sometimes, excess fat in your poop changes the consistency to diarrhea. This can happen when your body has trouble breaking down and absorbing fats, or when bacteria in your gut produce excessive fatty acids. Fatty diarrhea may be less frequent but with greater volume. It may be smellier than normal and may leave a visible oil residue in the toilet. It may come with nausea, indigestion and weight loss.
Inflammatory diarrhea is caused by inflammation in your colon (colitis). Inflammation affects the mucous lining of your colon (mucosa). It causes swelling and impairs the colon’s ability to absorb. Inflammatory diarrhea tends to come out more frequently and in smaller amounts. It may be accompanied by stomach pain, fever or bleeding. Inflammatory conditions that can cause chronic diarrhea include:
Diarrhea that comes on suddenly and urgently or that’s difficult to hold in can have a dominating effect on your day-to-day life. It requires you to always have your eye on the nearest bathroom.
This habit can be difficult to hide on a regular, long-term basis. It can affect your confidence, as well as your overall quality of life. It may affect your ability to hold a job, especially a public-facing one.
You might need a medical diagnosis and medical treatment to stop it. However, there are some things you can try first:
If it doesn’t go away with simple diet and medication changes, you need to see a healthcare provider. The provider will thoroughly examine the possible causes of your chronic diarrhea in order to identify the right treatment. Treating the underlying condition may solve your chronic diarrhea, or the condition may not be directly treatable. You may need treatment that targets your chronic diarrhea separately.
Treatment may include:
It’s never a bad idea to see a doctor about chronic diarrhea. Unless you think you can solve it by quitting something in your diet, you’ll probably need treatment. If it’s been going on for a long time, you might be more at risk of additional complications that may also need treatment. You should seek care right away if you have other symptoms of illness, such as:
A note from Cleveland Clinic
Diarrhea is common, but usually, it goes away quickly and without treatment. Diarrhea that persists for a month or longer needs to be addressed by a healthcare professional. Sometimes, the cause turns out to be simple and relatively easy to fix. In other cases, you might discover an underlying condition needing complex treatment. In either case, don’t ignore this symptom. Your healthcare provider can help.
Last reviewed by a Cleveland Clinic medical professional on 10/19/2022.
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