For Your Patients: I've Had Diarrhea That Won't Go Away -- What Should I Do?

Persistent diarrhea can occur for any number of reasons. One of them is ulcerative colitis (UC), a chronic disease affecting the large intestine.

Fortunately, it is also treatable -- most people respond quickly to medications and simple lifestyle changes. But first you have to see a doctor to get a proper diagnosis.

What Are the Symptoms?

Typical symptoms include the following:

• Frequent, urgent, loose bowel movements

• Blood in the stool

• Abdominal cramping and pain

• Feeling like you need to defecate, even when there's nothing there

If you've been experiencing these symptoms for more than 2 days, you should seek treatment. (It's not safe to take over-the-counter remedies such as Imodium for longer than that without guidance from a doctor.) You may be referred to a gastroenterologist, a specialist in disorders of the stomach and intestines.

Left untreated, UC and similar disorders can lead to weight loss, anemia, fatigue, and other complications. These complications could even result in colon cancer or need for surgery to remove your entire colon.

What Are Potential Causes of Diarrhea?

• Inflammatory bowel disease (IBD) -- a family of conditions that includes UC, Crohn's disease, and a few others

• Irritable bowel syndrome (IBS) -- which is easily confused with IBD; IBS does not typically have visible inflammation on colonoscopy

• Infections

• Diverticulitis -- in which pouches develop in the colon wall and become infected

• Malabsorption -- food that is not entirely digested can also cause diarrhea

How Will My Doctor Tell What I Have?

You can expect a series of tests, beginning with a hands-on exam in which the doctor will feel for abnormalities and areas of tenderness. Infections can usually be identified quickly from stool samples and blood tests.

If infections are ruled out, the doctor will likely want more blood and stool tests, along with imaging studies and a colonoscopy and/or an upper endoscopy.

During a colonoscopy, the doctor inserts a device consisting of a video camera at the end of a flexible tube through the rectum to examine the inside of your large intestine. An upper endoscopy is a different camera that is shorter and inserted through the mouth to examine the stomach and first part of the small intestine.

Read Part 1 of this series: What Is Ulcerative Colitis?

MedPage Today's "Medical Journeys" is a set of clinical resources reviewed by doctors, meant for physicians and other healthcare professionals as well as the patients they serve. Each episode of this 12-part journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.