Diarrhoea

Diarrhoea is defined as the passage of abnormally liquid or unformed stools associated with increased frequency (three or more bowel movement a day) of defecation (1).

• this definition may not correspond to the patient's understanding of diarrhoea. Majority of patients complain of diarrhoea based on the consistency of the stool rather than the frequency of bowel movements
• however quantification of consistency is difficult in clinical practice, hence diarrhoea is often defined based on stool frequency or the stool weight alone
  • stool weight >200 g/day is considered diarrhoea (consumption of excess fibre may result in stool weights of 300 g/day or more with normal consistency which does not necessarily mean diarrhoea)
• a combination of frequency, stool consistency and stool weight should be considered when defining diarrhoea (1)

World Health Organization (WHO) and UNICEF have estimated that there are about two billion cases of diarrheal disease worldwide every year (2).

Each year around 1.9 million children younger than 5 years of age die from diarrhoea (more than 5000 deaths every day), mostly in developing countries

• this is equivalent to 18% of all the deaths of children under the age of five
• 78% occur in the African and South-East Asian regions (2).

References:

1. Guandalini S, Vaziri H 2011. Diarrhea. Diagnostic and therapeutic advantages. 1st edition
2. Farthing M et al. Acute diarrhea in adults and children: a global perspective. J Clin Gastroenterol. 2013;47(1):12-20