Is diarrhea necessarily a sign of disease, or can it be a normal reaction to stress?

P.O.

Diarrhea can stem from many things, including stress. To pinpoint the exact cause, patients need to work with their doctors to develop a complete medical history. For example, recent travel in a developing country might suggest diarrhea caused by a parasitic or bacterial infection. On the other hand, if the patient has just started taking an antibiotic or another drug, the diarrhea may be a side effect of the medication. Also, it is becoming much more common to see patients who have diarrhea related to certain diet foods. For example, many sugar-free foods contain sorbitol or fructose, compounds that are not easily absorbed by the digestive system and that lead to looser stools. The fat substitute, Olestra, can cause loose stools because it is not absorbed.

As you mention, diarrhea sometimes is linked to increased anxiety or stress. Such stressors may include relationship problems or changes in lifestyle such as a new job, a recent move or travel.

Extensive medical testing is usually reserved for cases of diarrhea that last longer than three to four weeks (chronic diarrhea). One of the most common causes of chronic diarrhea is irritable bowel syndrome (IBS). Patients with IBS typically complain of intermittent diarrhea and constipation, associated with abdominal cramps. Patients who have stress-related diarrhea often also experience IBS symptoms.

It is wise for anyone with severe or chronic diarrhea to be evaluated by a doctor. This is especially true if the diarrhea is associated with rectal bleeding, weight loss, fever or a family history of colitis or colon cancer.