Diarrhea: Not only EHEC is dangerous!

About one in three people suffer from diarrhoea at least once a year. However, the mortality rate is very low. Only one in every thousand patients who suffer from diarrhoea dies from it.

About one in three people suffer from diarrhoea at least once a year. However, the mortality rate is very low. Only one in every thousand patients who suffer from diarrhoea dies from it. However, due to the high number of cases of diarrhoea, 3000 patients die from diarrhoea every year - even before EHEC.

The most common causes of diarrhea are infections, complications after taking medication (especially antibiotics), intestinal diseases such as ulcerative colitis, Crohn's disease or irritable bowel syndrome and food intolerances such as lactose or fructose intolerance.

The most common bacterial pathogens include salmonella, which is usually caused by food poisoning. Minced meat or food preparations made with raw eggs are particularly likely sources of infection. In the case of a salmonella infection, symptoms can appear a few hours or up to three days after infection. These include watery diarrhea, which may also be bloody, abdominal pain, possibly fever, nausea, vomiting and headaches. Disease usually only lasts a few days, but the germs can be excreted for up to six weeks, and even several months in infants. Antibiotics are only useful in special cases when treating diarrhea caused by salmonella.

Escheria (E.coli) has become very popular due to the EHEC epidemic. The coli bacteria also occur in a non-pathogenic form. In this case, these coli bacteria are part of the healthy intestinal flora. The enteropathogenic E.coli (EPEC), on the other hand, often cause intestinal infections in newborns and infants. Adults are less often affected. Infections with an enterotoxin-producing strain (ETEC) lead to watery diarrhea. This is a common cause of so-called traveler's diarrhea.

Enterohemorrhagic E. coli (EHEC), which has become popular due to the recent epidemic, is a pathogen that causes bloody diarrhea in humans. The incubation period is about 11 - 12 days. The hemolytic uremic syndrome is particularly feared and can lead to kidney failure.

Viruses are also common causes of diarrheal diseases. Rotaviruses, for example, cause acute diarrheal diseases in children and infants. Noroviruses can also cause epidemics in kindergartens and nursing homes. Noroviruses are not only transmitted through contact infection like the other pathogens mentioned above, but also through droplet infection when vomiting. The incubation period for viruses is usually very short, often only one to three days.

When to go to the doctor for diarrhea Doctor should go

If you develop a fever, if the diarrhea lasts longer than one or two days, if you have bloody diarrhea, if you experience abdominal pain, chills or vomiting. If you have pre-existing illnesses such as heart or kidney disease, you should definitely consult a doctor. Even if you are over 65, diarrhea can very quickly lead to dangerous fluid loss.

If possible, you should not take anti-diarrhea medication such as Imodium (loperamide) without medical advice. Imodium delays bowel emptying, which prevents the pathogens from being excreted quickly. This can lead to a delayed progression of the disease. In each individual case, however, it must always be considered whether medication such as Imodium is necessary to combat the risk of excessive fluid loss or whether it would be better to excrete the pathogens quickly.

The lost fluids and minerals can be replaced with rehydration solutions from the pharmacy (e.g. Elotrans). Lightly sweetened tea is also useful. Cola, like other sweet lemonades, is no longer recommended as these drinks have too high a sugar content, which can actually increase dehydration of the body.

If you suffer from constantly recurring diarrhea, you should definitely see a doctor to determine the cause.

Another drug is the so-called nicotinic acid. With doses of about 1 to 2 grams daily, triglycerides and cholesterol by about 30%. Nicotinic acid is the most effective drug for increasing HDL cholesterol (good cholesterol). Nicotinic acid is also the only drug that can lead to a reduction in the so-called lipoprotein A. In Germany, nicotinic acid is used relatively rarely because it is not very well tolerated. A common side effect is a so-called flush (reddening of the skin, feeling of heat and itching).

In exceptional cases, cholesterol elevations that prove to be refractory to therapy can also be treated with a so-called LDL apharesis (plasma exchange).

There are currently other drugs being developed that are intended to lead to a sufficient reduction in LDL. Antibody therapies in particular promise significant progress in the drug therapy of elevated cholesterol levels.