Diarrhea can also be accompanied by other symptoms, such as nausea or loss of appetite, that also make it hard to keep food and liquids down. This reduces your calorie intake, which can also contribute to weight loss.
Diarrhea is a common health complaint. Even healthy adults and children may experience a few bouts of diarrhea each year. In the majority of cases, the symptoms are acute (short-term) and will clear up in a few days.
Diarrhea that continues longer than three days is a reason to consult your healthcare provider as it may be a symptom of a more serious health condition, such as a gastrointestinal infection (like from a bacteria called Clostridioides difficile or C. diff.), celiac disease, irritable bowel syndrome (IBS), or inflammatory bowel disease (IBD).
Persistent diarrhea lasting more than four days or chronic diarrhea lasting more than four weeks may lead to other complications, including dehydration and unintended weight loss. It's important to get a diagnosis so that the underlying cause of diarrhea can be addressed.
This article discusses the potential causes of chronic diarrhea and how it can lead to unintended weight loss. It also explains how the condition is diagnosed and treated.
Diarrhea and Weight Loss
Diarrhea refers to stools that are loose and watery. Loose stools may be accompanied by changes in bowel movements, including increased frequency and/or urgency or fecal incontinence. Over time, increased frequency of stool may cause weight loss.
Diarrhea can be either acute, persistent, or chronic. Acute diarrhea lasts less than two weeks and is one of the most common illnesses in the United States.
Diarrhea that lasts between two to four weeks is considered persistent. Diarrhea that continues for longer than four weeks is characterized as chronic. Chronic diarrhea affects an estimated 5% of the population at any given time.
How Digestive Problems Cause Weight Loss
When you have chronic diarrhea over days or weeks, you can lose a lot of body fluid. This loss of body fluid may show up on the scale as weight loss.
Diarrhea can also be accompanied by other symptoms, such as nausea or loss of appetite, that also make it hard to keep food and liquids down. This reduces your calorie intake, which can also contribute to weight loss.
Depending on how long diarrhea lasts and the severity of symptoms, the weight loss can be significant. However, any weight lost during a bout of diarrhea is mostly water weight and will likely return once your bowel movements and appetite are back to normal.
Related Symptoms
Chronic diarrhea may be accompanied by other symptoms that can indicate an underlying health condition. Associated symptoms may include:
Vomiting
Nausea
Fever
Fatigue
Malnutrition
Abdominal pain
Blood in the stool
Causes of Persistent or Chronic Diarrhea
Diarrhea can have many causes. Most cases of acute diarrhea are caused by an infection. The infection may be bacterial, viral, or parasitic. Often, this type of diarrhea will resolve on its own within a few days.
In some cases, acute diarrhea can result from changes in diet, such as consuming too much artificial sweetener or alcohol, or from other lifestyle factors, including stress.
Persistent or chronic diarrhea may be caused by a number of underlying health conditions or other factors. These include:
Medications: Diarrhea is a side effect of certain drugs, including antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), and chemotherapy.
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C. diff. infection: This type of infection often develops during or after a course of antibiotics, or it may be caught in a hospital or nursing home.
Inflammatory bowel disease: IBD includes Crohn's and ulcerative colitis, chronic conditions that cause inflammation of the gut and present with diarrhea.
Irritable bowel syndrome: IBS is a condition where the muscles that move waste through the intestines are highly sensitive to certain triggers.
Celiac disease: This is an autoimmune condition in which the immune system overreacts to the wheat protein gluten and attacks the lining of the small intestine.
Food allergy or intolerance: Food intolerance is caused by a lack of the enzymes needed to digest a specific food. Lactose intolerance, the inability to digest the sugars in milk, is the most common, but it's possible to be intolerant of other foods as well.
Diverticulitis : This condition causes inflammation of the diverticula (pockets of tissue in the large intestine), leading to diarrhea that is often accompanied by abdominal pain.
Diagnosing the Issue
If you have diarrhea that continues longer than a couple of weeks and you're losing weight unintentionally, it's important to make an appointment with your healthcare provider. To make a diagnosis, your healthcare provider will take a health history, do a physical exam, and more.
Health History
In taking a complete health history, your doctor will ask you a number of questions. These may include:
Details about how long you have been experiencing diarrhea
How frequently you have diarrhea
How much stool you pass
If you have other symptoms that accompany the diarrhea
Details about what the stool looks like
What foods you eat and what beverages you consume
If you are taking any medications or have in the past
If you have traveled to a developing country
If you have interacted with a sick person
Your healthcare provider may also ask about your family history and whether anyone in your immediate family has conditions such as:
Ulcerative colitis
Crohn's disease
Irritable bowel syndrome
Celiac disease
Lactose intolerance
Diet and Lifestyle
If your healthcare provider believes you may have a food intolerance or an allergy, they may ask you to make some changes to your diet to see if it helps improve your symptoms.
Changes may include spending about two weeks avoiding foods that contain common food allergens, such as wheat, dairy, eggs, nuts, corn, and soy.
You'll be asked to keep a food diary, noting your symptoms as you slowly re-introduce certain food. This can help doctors determine which foods might be triggering your symptoms.
Laboratory tests
A number of tests may be used to determine the cause of diarrhea. These include:
Stool tests: This usually involves testing a sample of stool for the presence of an infection.
Colonoscopy : During this procedure, a long, thin tube with a camera attached is inserted through the anus and threaded up the intestine. It is used to take images and a tissue sample. This test can show whether tissue is inflamed, if there are sores or ulcers, if there are abnormal growths, or if there is evidence of bleeding.
: During this procedure, a long, thin tube with a camera attached is inserted through the anus and threaded up the intestine. It is used to take images and a tissue sample. This test can show whether tissue is inflamed, if there are sores or ulcers, if there are abnormal growths, or if there is evidence of bleeding. Sigmoidoscopy : Similar to a colonoscopy, this test only sees the inside part of the lower part of the large intestine. Tissue samples can also be taken.
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: Similar to a colonoscopy, this test only sees the inside part of the lower part of the large intestine. Tissue samples can also be taken. Imaging studies: An ultrasound, X-rays, or other imaging tests may be used to look at organs and see if there are abnormalities.
Blood tests: Bloodwork may be used to test for the presence of an infection, evidence of bleeding, thyroid disease, celiac disease, and low levels of vitamins, which could indicate poor nutrient absorption in the gut.
Treating Diarrhea and Weight Loss
Treating diarrhea and associated weight loss will depend upon the underlying cause. If diarrhea is found to be due to a virus, bacteria, or parasite, your healthcare provider may prescribe a medication to treat the infection.
If the cause of diarrhea is celiac disease or a food allergy or intolerance, you may be advised to start a special diet. Diet changes are also often recommended to manage IBS and IBD.
Prescription medications may also be required to treat the underlying causes of chronic diarrhea. This includes medications for conditions like:
Crohn's disease
IBS
Ulcerative colitis
In some cases, your healthcare provider may also recommend taking probiotics or eating more probiotic-rich foods and drinks, like yogurt, kefir, and kombucha. These foods and supplements contain good bacteria that can help bolster the population of similar healthy bacteria naturally found in the digestive tract.
Summary
Chronic diarrhea is diarrhea that persists longer than four weeks. This can result in weight loss and be accompanied by a variety of other symptoms, including fatigue, nausea, and abdominal pain.
Chronic diarrhea can be caused by an infection, stress, some medications, or underlying health conditions like IBS, IBD, or celiac disease. Identifying the cause of diarrhea will help determine the best treatment for diarrhea and associated weight loss.
A Word From Verywell
Experiencing diarrhea that continues for weeks can be painful, embarrassing, and disruptive to your everyday life. It can also lead to additional complications, like fatigue, nutrient deficiencies, and unintended weight loss.
If you have diarrhea that hasn't resolved on its own, or you are losing weight without trying to, consider making an appointment with your healthcare provider. They will be able to help you identify the cause of your diarrhea and weight loss, and offer options to treat it.
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