“The trots” is an informal term for diarrhea, characterized by loose, watery bowel movements occurring more frequently than usual. This common digestive upset affects individuals of all ages globally. While often temporary and self-resolving, understanding its nature aids management.
What “The Trots” Are
Diarrhea involves the passage of loose, watery stools typically three or more times daily. The normal digestive process involves food and fluids moving through the small intestine, where nutrients and most water are absorbed, before waste passes to the large intestine for further water absorption. With diarrhea, this process is disrupted; digestion becomes too rapid, preventing the large intestine from adequately absorbing excess fluid. This imbalance leads to increased water content in stools, resulting in their characteristic loose consistency.
Common Causes and Accompanying Symptoms
Several factors can lead to diarrhea, often accompanied by distinct symptoms. Viral infections are a frequent cause, particularly norovirus in adults and rotavirus in young children. These inflame the intestines, leading to nausea, vomiting, abdominal cramps, and a mild fever. Highly contagious, they typically clear up within a few days.
Bacterial infections, often linked to food poisoning, commonly trigger diarrhea. Bacteria such as Salmonella, E. coli, and Campylobacter can contaminate food or water, leading to symptoms like severe abdominal pain, fever, and sometimes bloody stools.
Certain medications, including antibiotics, can cause diarrhea by disrupting the natural balance of beneficial gut bacteria, sometimes leading to conditions like Clostridioides difficile infection. Antacids containing magnesium, some antidepressants, and metformin are other examples that may induce this side effect.
Dietary factors also play a role. Lactose intolerance, where the body struggles to digest dairy sugar, can result in diarrhea after consuming milk or dairy. Artificial sweeteners (sorbitol, fructose), fatty, greasy, or spicy foods, and excessive caffeine or alcohol may also provoke loose stools. Accompanying symptoms include bloating, an urgent need to use the bathroom, nausea, vomiting, and abdominal pain. Prolonged or severe cases can lead to dehydration, manifesting as increased thirst, dry mouth, reduced urination, and fatigue.
Managing and Preventing “The Trots”
Managing diarrhea primarily involves preventing dehydration, which can occur rapidly due to fluid loss. Oral Rehydration Solutions (ORS), a mixture of water, salt, and sugar, effectively replace lost fluids and electrolytes. These solutions are absorbed in the small intestine, helping to restore the body’s balance. While the traditional BRAT (bananas, rice, applesauce, toast) diet is known for its bland, easy-to-digest components, current recommendations emphasize a broader intake of bland foods and prompt refeeding for adequate nutrition. Avoiding fatty, spicy, high-fiber foods, and dairy (if intolerant) can reduce digestive irritation. Over-the-counter medications like loperamide or bismuth subsalicylate provide symptomatic relief, but use with caution, especially in children or severe infections.
Knowing when to seek medical attention is important. Adults should consult a healthcare provider if diarrhea lasts over two days, or if they experience severe dehydration, a fever above 102°F (39°C), severe abdominal pain, or bloody/black stools. For children, medical advice is recommended if diarrhea persists over 24 hours, if they show dehydration signs (e.g., no wet diapers for several hours), or if they have a high fever or bloody stools.
Preventing diarrhea often centers on good hygiene and safe food practices. Frequent hand washing with soap and water, especially after using the bathroom and before preparing food, is effective. Proper food handling, including thoroughly cooking meats, avoiding cross-contamination, and promptly refrigerating perishable foods, helps prevent bacterial growth. When traveling, drinking bottled water and avoiding ice made from tap water can significantly reduce risk. Vaccination, such as the rotavirus vaccine for infants, also contributes to prevention.