What I Need to Know About Diarrhea

Diarrhea is frequent, loose and watery bowel movements. Stool contains what is left after your digestive system absorbs nutrients and fluids from what you eat and drink. If your body does not absorb the fluids, or if your digestive system produces extra fluids, stools will be loose and watery. Loose stools contain more water, salts and minerals and weigh more than solid stools. Diarrhea that last a short time is called acute diarrhea.  Acute diarrhea is a common problem and usually lasts only 1-2 days.  Diarrhea that lasts for at least 4 weeks is called chronic diarrhea.  In addition to loose stools, other possible symptoms include cramps, an urgent need to use the bathroom and loss of bowel control.

Causes of Diarrhea include:  Bacteria from contaminated food or water; viruses that cause illnesses, such as the flu; parasites, which are tiny organisms found in contaminated food or water; medicine such as antibiotics; problems digesting certain foods; diseases that affect the stomach, small intestine or colon, such as Crohn’s disease and problems with how the colon functions, caused by disorders such as irritable bowel syndrome. 

In order to diagnosis the cause of your diarrhea, your gastroenterologist will perform a physical exam, ask you about the medicines you are taking, test your stool or blood for bacteria, parasites or other signs of disease or infection. Your doctor may ask you to stop eating certain foods to see whether your diarrhea goes away.  If you have chronic diarrhea, your doctor may perform other tests to look for signs of disease.

Diarrhea is treated by replacing lost fluids, salts and minerals to prevent dehydration.  Taking medicine to stop diarrhea can be helpful in some cases. Medicines you can buy over the counter without a prescription include Imodium, Pepto-Bismol and Kaopectate. Stop taking these medicines if symptoms get worse or if the diarrhea lasts more than 2 days.  If you have bloody diarrhea, you should not use over-the –counter medicines.  These medicines may make the diarrhea last longer. Your Gastroenterologist will usually prescribe antibiotics instead.

 If you have diarrhea, you should eat soft, bland foods such as bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, baked chicken without the skin or fat.  In order to prevent dehydration, it is important to drink plenty of water, fruit juices, sports drinks, soda without caffeine and salty broths. Sometimes eating yogurt with active live bacterial cultures may help you feel better faster.

Traveler’s diarrhea is preventable.  It is caused by eating food or drinking water that contains harmful bacteria, viruses or parasites. You can prevent traveler’s diarrhea by being careful.  Do not drink tap water or use it to brush your teeth. Do not eat or drink unpasteurized milk or milk products. Do not eat raw fruits or vegetables, unless they can be peeled and you peel them yourself. Do not eat raw or rare meat or fish. Do not eat meat or shellfish that is not hot when served to you; and lastly do not eat food sold by street vendors.  In some cases taking antibiotics before traveling can prevent traveler’s diarrhea. 

March is National Colorectal Cancer Awareness Month

 Early detection is vital, over 90% of all cases of colon cancer can be prevented with recommended screening. Despite its high incidence, colon cancer is one of the most detectable and, if found early enough, most treatable forms of cancer.

If you’re 50 or older, getting a screening test for colon cancer could save your life. Here’s how:  Colon cancer usually starts from polyps in the colon or rectum. A polyp is a growth that shouldn't be there. Over time, some polyps can turn into cancer. A screening colonoscopy can find polyps, so they can be removed before they turn into cancer. A screening colonoscopy can also find colon cancer early. When it is found early, the chance of being cured is good.

You should begin screening for colorectal cancer soon after turning 50 and then keep getting screened regularly, we recommend every 5 years.  Some people are at a higher risk than others for developing colorectal cancer. Having any of these things may increase your risk—

  • Inflammatory bowel disease.
  • A personal or family history of colorectal polyps or colorectal cancer.
  • Genetic syndromes, like familial adenomatous polyposis or hereditary non-polyposis colorectal cancer (also known as Lynch syndrome).

If you think you may be at high risk for colorectal cancer, talk to your doctor about when and how often to get tested.

ACG: What Patients Need to Know Re: New Study Linking PPIs to Dementia

A recent study plublished  by a German Health Plan suggested an association between Proton Pump Inhibitor use and dementia in the elderly.  The following statement was released by Anerican College of Gastroenterology President Kenneth R DeVault MD FACG,  "We appreciate and respect the data in the study, but believe more research is needed to understand the impact of PPIs on cognitive function, especially since studies of this type do not control for diet or lifestyle factors, nor do they establish causation. The study authors noted that this analysis of administrative data from the health plan in Germany can only provide a statistical association between PPI prescription and occurence of dementia and does not prove that PPIs caused dementia.  They further recognized that in order to evaluate the cause and effect relationship in the elderly more research in the form of randomized prospective clinical trials are needed."

In light of this study, along with other recent studies suggesting complications with long-term PPI use, The ACG urges patients to discuss the use of PPIs and any other medications with their healthcare provider.  Dr. Elliot Heller on behalf of the physician staff at Digistive Disease Associates of Rockland noted that any patients who have any concerns about continue use of PPIs should contact us and/or set up a follow-up appointment.  He further commented that any patient with serious esophageal disorders should consult with us before stopping their medication or changing the dose.  

Understanding Your Risk of Esophageal Cancer

Esophageal Cancer is one of the fastest growing cancers in the United States. Clinical Studies have shown that several factors can make a person more likely to develop cancer of the esophagus.  The most recognized factor is whether a person has Barrett’s Esophagus which can increase one’s risk of cancer of the esophagus by 50 times or more.  The following are the other factors that add to the risk of developing cancer of the esophagus.

Gender: Males are approximately 7 times more likely to develop cancer of the esophagus than females

Race: Caucasians are at higher risk of developing Barrett’s Esophagus and Cancer of the esophagus than many other racial groups.

Weight: Obesity (Body mass Index >30) increases a person’s risk of developing cancer of the esophagus by more than 2 ½ times

Smoking: If a person smokes, the risk of developing cancer of the esophagus more than doubles compared to non-smokers.

Hiatal Hernia: Having a hiatal hernia (where a part of the stomach pushes up into the chest through an opening in the diaphragm) has also been suggested to increase a person’s risk of developing cancer of the esophagus.

Who should be screened for Barrett’s Esophagus or Cancer of the Esophagus?

When determining your risk of developing cancer of the esophagus, one can look to guidelines published by the American College of Physicians, American College of Gastroenterology, and the American Society for Gastrointestinal Endoscopy regarding who might be appropriate for screening for Barrett’s Esophagus and cancer of the esophagus by performing an endoscopy exam. They include:

Age & Gender: Men older than 50 years with chronic gastroesophageal reflux disease (GERD) symptoms for more than 5 years with the additional risk factors such as: night-time reflux symptoms, hiatal hernia, overweight, particular around the belly, tobacco use and family history of Barrett’s esophagus or cancer of the esophagus.

Heartburn Along With Alarm Symptoms: A person who has heartburn along with alarm symptoms: difficulty swallowing, bleeding, anemia, weight loss, recurrent vomiting

Heartburn Symptoms Continuing Even With Medications:  A person whose GERD symptoms continue even while taking proton pump inhibitor (PPI) medications at high doses for 4-8 weeks.



  We are pleased to announce that Dr Janice Jang will be joining our professional staff in July 2021. Dr Jang will be completing her fellowship in Gastroenterology at NYU Langone Health in June...

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