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How to Treat Diarrhea in the Elderly

Friday, October 1, 2021

Diarrhea is common in the elderly and can become a severe condition if not managed properly.

This article will help CDPAP caregivers provide the best care for their elderly family members that are experiencing diarrhea.

We will discuss how to identify symptoms of diarrhea, common causes, how to treat diarrhea in the elderly, and more!

Understanding Diarrhea

Before we get into how to care for diarrhea in the elderly, let's first take a brief look into what happens in the body that results in diarrhea.

Diarrhea is not a disease, it's a symptom of another illness.

It is a condition in which you have frequent watery, loose, and runny bowel motions. Bowel movements, also known as stools, are the body's waste products transported through the rectum and anus.

Your stool is made of what is left after your digestive system absorbs nutrients and fluids from what you eat and drink. If the fluids are not absorbed by your body, or if your digestive system creates too many fluids, your stools will be loose and watery.

Loose stools are heavier than solid stools because they contain more water, salts, and minerals.

Diarrhea, while not always severe, may be quite uncomfortable and can occur at any age.

Acute diarrhea is a typical issue that lasts only a few days but might continue for longer. Chronic diarrhea is defined as diarrhea that persists for at least four weeks.

For older adults, diarrhea can become a significant problem if not treated promptly, because it can also lead to other issues like dehydration or malabsorption of nutrients. All of which can then cause further damage to their health.

So, it is vital to catch the early signs of diarrhea and get the right treatment as quickly as possible.

Next, let's take a look at some of the symptoms of diarrhea in the elderly.

Symptoms of Diarrhea in the Elderly

The symptoms of diarrhea in the elderly are similar to what younger people experience.

  • watery diarrhea with abdominal cramps
  • nausea
  • loss of appetite
  • bloating
  • urgent need to use the bathroom

How to Recognize Diarrhea in the Elderly

For caregivers, diarrhea in their elderly loved ones can be challenging because it may not always cause discomfort until it is too late.

Older adults are less likely than younger people to recognize that they have diarrhea and therefore might not do anything about it until their symptoms become severe or go unnoticed.

Therefore, you might want to look for subtle clues that could suggest that your family member is experiencing GI discomfort.

For example, if they're eating less frequently, or they show decreased interest in the foods they usually love.

While these signs may not automatically mean they're experiencing diarrhea, you could still recognize them and talk to your family member about if there's any digestive trouble.

Now let's discuss some of the most common causes of diarrhea in the elderly.

Common Causes of Diarrhea

Here is a list of the most common culprits that may cause GI conditions in your loved ones,

Diarrhea Caused by Bacteria/Viruses

The most common causes of diarrhea in the elderly are bacteria or viruses, just like the rest of us.

But because the immune system is often weaker in older adults, they might be more susceptible to a stomach upset because they can't fight off the pathogens as effectively.

Antibiotics and antiviral medications can treat diarrhea, but because they also kill "good" bacteria along with the bad ones it's important to make sure you aren't giving them to someone who doesn't need them.

Diarrhea From Food Intolerance

Diarrhea can be triggered by food intolerance. If your loved one experiences diarrhea after eating certain foods, it could indicate a diagnosed allergy to the food being eaten.

Symptoms of food allergies can also include vomiting and hives, as well as diarrhea.

These are all signs that you should immediately consult with a doctor about what is causing them to have these allergic reactions so they can prescribe medications, if needed, before the symptoms get worse.

Clostridium Difficile Bacteria and Diarrhea

Older adults, particularly those older than 65, are particularly susceptible to diarrhea caused by clostridium difficile bacteria, also known as C. difficile. Typical symptoms include the following.

  • Watery diarrhea
  • Nausea
  • Loss of appetite
  • Fever,
  • Abdominal pain
  • Bloating

Your loved one could be at a higher risk of C. difficile in the following cases.

  • Stayed (or was discharged from) a healthcare facility within the last 12 weeks
  • Either currently on antibiotics or finished a course recently
  • Recent treatment with proton pump inhibitors, such as esomeprazole (Nexium), lansoprazole (Prevacid), and omeprazole (Prilosec), which are known to cause serious complications including nausea, heartburn, or stomach cramps.

Diverticulitis

Diverticulitis is another potential cause of diarrhea in the elderly.

This occurs when small bulging sacs of the bowel (diverticula) become infected and inflamed.

These diverticula can develop as a complication of chronic diarrhea, so your loved one's doctor might treat both conditions at once if they suspect this cause of symptoms.

Ischemic Colitis

Ischemic colitis is a type of colon damage caused by a lack, or interruption, of blood flow.

It can also cause diarrhea in the elderly.

Signs to look out for can be the following:

  • Sudden abdominal pain
  • Bloody and loose stool
  • Nausea
  • Vomiting
  • Bloating

Bowel Obstruction/Fecal Impaction

Obstruction of the small or large intestine is more likely to affect older persons, owing to age-related risk factors such as previous abdominal or pelvic surgery and digestive system tumors.

Diarrhea is more common in individuals with a small bowel obstruction. Abdominal discomfort, nausea, vomiting, and bloating are all signs of bowel blockage.

A large bowel obstruction caused by fecal impaction frequently leads to watery diarrhea as bowel fluid seeps around the blockage.

This condition is most common among older adults who have suffered from frequent and severe constipation for a long time.

Other Bowel Disorders

If your loved one or family member is diagnosed with another bowel disorder, then they are more likely to also experience more frequent bouts of diarrhea.

Here are some of the other possible conditions that can cause diarrhea.

  • Crohn disease
  • Lactose intolerance
  • Gastric bypass surgery
  • Celiac disease
  • Ulcerative colitis

Now that we know some of the potential causes of diarrhea in the elderly, let's take a look at what you can do as a CDPAP caregiver to help your family when they're experiencing GI issues.

Helping an Elderly Person with Diarrhea 

The first thing you should do is speak to your family member's doctor and to see if you need a prescription or OTC medicines.

But here are some wellness tips to help replenish lost fluids and to help your loved one feel better when experiencing a bout of diarrhea.

Keep Them Well Hydrated

Keeping them hydrated with electrolyte drinks like Gatorade or Pedialyte is important. If they are unable to keep liquids down, you can use an IV drip for this purpose.

Monitor Blood Sugar

Monitor their blood sugar levels and call the doctor if it gets very low (hypoglycemia). Some diabetics who cannot hold food or liquid down may need a special diabetic drink instead of water after vomiting several times in one day.

Foods to Avoid

Avoid greasy, fatty foods. Limit dairy intake - it may make symptoms worse for some people.

Foods to Eat

  • Bananas and applesauce can provide much-needed nutrients and electrolytes without upsetting the stomach too much (be sure there is no added sugar).
  • Rice and rice cereal are bland and easy on an upset tummy; toast or crackers will also be okay if your loved one needs something simple that's easier to keep down than solid food.

If you're not sure what they'll tolerate, offer several options as different things might stay down better with each person who has diarrhea

Clean the Rectal Area

It is vital that the rectal area is kept clean.

This can be done by wiping after each bowel movement with wet wipes or warm water and soap, and by washing the genital area to remove any feces that may have got stuck there.

Change undergarments as needed, and clean the surfaces where the fecal matter may have been present (such as toilet seats).

Leaving the rectal area unwashed may cause further health conditions through bacterial infections, so you must make sure to not skip this step as a caregiver.

You must know how to care for your elderly loved one if they experience diarrhea. But as they say, prevention is the best cure of all.

So, let's take a look at a few tips on how you can help your loved one or caregiving client maintain optimal digestive health and avoid diarrhea.

How to Prevent Diarrhea

Here are a few tips to help prevent diarrhea in your elderly family member.

Avoid Certain Foods

As we mentioned before, When caring for an elderly person with diarrhea, you'll want to avoid certain foods and drinks. These include:

  • Fatty foods
  • Foods with too much fiber
  • Excessive spice
  • Foods fried in processed oil
  • Too much caffeine

Maintain a Sanitary Environment to Prevent Viruses/Bacteria

It is important to keep the environment as clean as possible so that your loved one does not pick up any viruses or bacteria from surfaces.

Wipe down counters and bathrooms after washing hands thoroughly, wipe all door knobs, and keep the house well ventilated.

As we explained before, viruses and bacteria are one of the most common causes of diarrhea in the elderly, partly due to their weakened immune function that can't fight off the pathogens.

By keeping the area spotlessly clean, you'll be providing them additional protection against viruses and bacteria that thrive in unsanitary environments.

Adjust Medications/Supplements

Remember to check with your loved one's doctor before giving them any medications or supplements that may cause diarrhea as a side effect.

If you notice that diarrhea is more frequent after starting a certain medication, be sure to mention it to the doctor to see if they switch the prescription.

Diarrhea is already an uncomfortable enough symptom without having to worry about it being caused by another medication!

The same goes for any supplements. Sometimes, supplements that might be healthy for someone else can create adverse reactions in others. So, be sure to consult your loved one's doctor or nutritionist before starting a new supplement.

Stay Hydrated

Hydration is not only important for treating diarrhea, but it can also help prevent it.

Dehydration can lead to an electrolyte imbalance in the body, which can be a contributing factor for diarrhea in the elderly.

Make sure your family member drinks plenty of fluids, especially ones with minerals and electrolytes to always stay adequately hydrated. This is especially important if they are having problems keeping food down.

Use over-the-counter electrolyte solutions like Pedialyte, Gatorade or Coconut Water to replace lost minerals and salts in their body that cause diarrhea; this will help keep them hydrated and prevent diarrhea.

Probiotics Supplements

Adding a daily probiotic can help promote optimal balance in the gut microbiome which not only improves digestion, but is also good for energy levels, mood, and several other quality of life factors.

Fiber Supplements

A fiber supplement can prevent diarrhea by supporting optimal gut health.

But it can be tricky to know the right dosage of fiber, because as we explained before, too much fiber on the other can be a cause of diarrhea.

Fiber binds to water in the gut and helps keep stool full of moisture, which slows it all down making for easier passage through your system. Studies show that fiber also acts as a prebiotic fermentable substrate which supports good bacteria growth needed to maintain optimal digestive function!

But make sure to consult with your loved one's doctor before starting a fiber supplement to avoid any unintended digestive issues.

But sometimes prevention isn’t enough, and your family member can still end up with diarrhea. In the next section, we’ll discuss signs to look for to know when you should seek medical help.

When to Get Professional Help for Diarrhea

If diarrhea lasts for more than a couple of days, or it is not getting better with the treatments mentioned above, you should consider making an appointment with your doctor.

The longer it continues, the riskier it is to not treat the condition properly.

Untreated diarrhea can cause other complications like dehydration, or malabsorption of nutrients.

Even if there are no other symptoms and/or concerns about dehydration, take all necessary precautions and help your loved one get medical treatment.

Here are some of the signs to look for when trying to decide if you should get professional help.

If the Diarrhea is Severe

No diarrhea should be ignored, but if it is severe then you should seek medical attention immediately.

Severe diarrhea would be anything more than 2-3 loose bowel movements a day, ranging to the point where one can't keep water down.

If it's this serious, then there's a real chance of dehydration, which can be dangerous.

Dehydration Caused by Diarrhea

If diarrhea is severe, or it is moderate but persists for more than a day or two, there’s a significant risk of dehydration. 


Dehydration is a very serious matter for seniors and it can cause significant damage to their health. 


So, it is absolutely vital that you seek medical attention if you suspect that there is a chance of dehydration because of diarrhea.


Diarrhea for More Than One Day

Because of the increased risk of dehydration, you should call your loved one’s doctor in any case if their diarrhea persists for more than a day. 


Blood in the Diarrhea Stool

Blood in diarrhea does not always indicate something extremely serious like cancer. 


It could be something far less concerning like hemorrhoids, or it could also indicate inflammatory bowel disease (IBD), among other conditions. 


But it should definitely not be ignored, and you need to get it checked by a medical professional ASAP.


Diarrhea During or Following a Course of Antibiotics

As we explained before, diarrhea in the elderly is sometimes caused by medications like antibiotics. 


If you notice increased bowel movements or watery stool after starting a course of antibiotics, be sure to seek medical attention to evaluate the situation. 


Final Thoughts on Diarrhea in the Elderly

Diarrhea is a common symptom of many gastrointestinal disorders, and can be particularly problematic for seniors.

Seniors have weakened immunity, and often have a hard time fighting off bacterias and viruses that cause upset stomachs.

Consider taking steps to implement some of the prevention tips mentioned in the article like keeping your home clean with good hygiene practices or using natural probiotics to help prevent diarrhea before it starts!

If you’ve already found yourself dealing with an episode, try some of the treatment tips to help your loved one feel better.

And be sure to look out for the signs to see if you need to consult with your family member's doctor to treat diarrhea.