Diarrhea is an unpleasant and often distressing problem. Occasional gastrointestinal complaints are normal, but what if the diarrhea becomes chronic and nothing seems to help? Many sufferers complain: “I have diarrhea all the time! Where does it come from? Nothing helps!”

Having constant diarrhea is not only a great strain on the intestines, but also on the entire body. The constant excretion of nutrients can lead to a micronutrient deficiency because the intestines can no longer optimally absorb the essential vitamins, minerals and trace elements.

In addition to the physical consequences, many sufferers also suffer psychologically from their situation. If you have constant diarrhea, you always have to make sure that there is a toilet nearby. Spontaneous activities are avoided, social contacts suffer and even in the work environment those affected often feel uncomfortable, as colleagues may react with irritation or make fun of them.

Patients often report:

• “I can hardly go out anymore because I don’t know how my stomach will react on the day.”
• “I have to plan every trip carefully so that I don’t end up in an unpleasant situation.”
• “Sometimes I prefer not to eat at all if I have an important appointment.”

All these restrictions often lead to frustration, resignation and the assumption that you have to accept the situation. But that doesn’t have to be the case!

Constant diarrhea can have many causes. In my practice, I first examine the basic functions of the digestive organs:

• Stomach: Does it produce enough stomach acid? Is gastritis possibly present?
• Pancreatic function: Are enough digestive enzymes being produced?
• Liver & gall bladder: Are there any congestion or problems with fat digestion?
• Intestinal flora: Is the microbiome in balance or are there any incorrect colonizations? Perhaps an increase in clostridia?

An imbalance in these areas can already lead to diarrhea. A detailed stool examination often provides information as to whether harmful bacteria or yeasts, for example, have become prevalent.

Nahrungsmittelunverträglichkeiten und -intoleranzen

• • Histaminintoleranz
  • Fruktoseintoleranz
  • Laktoseintoleranz
  • Sorbitintoleranz

Dysbiosis – incorrect colonization in the intestine

1. • Imbalance of the intestinal flora (e.g. increased clostridia levels)
   • Overgrowth with yeast fungi (e.g. Candida)
   • SIBO (small intestine overgrowth)

Hormonal disorders

1. • Thyroid dysfunction (e.g. hyperthyroidism)
   • Imbalance of stress hormones (e.g. cortisol)

Chronic inflammatory bowel disease (IBD)

1. • Crohn’s disease
   • Ulcerative colitis

Irritable bowel syndrome (IBS)

1. • Often stress-related
   • Combination of diarrhea, flatulence and abdominal cramps

Bile acid malabsorption syndrome (BAM)

1. • Occurs when bile acids are not properly reabsorbed from the small intestine and instead enter the large intestine, where they cause diarrhea
   • Common in patients after gallbladder removal or bowel surgery
   • Diagnosis by a SeHCAT test or empirically by administering bile acid-binding drugs
   • Therapy: use of bile acid binders (e.g. colestyramine), adjustment of fat intake, probiotic support

Imbalance of minerals

1. • A deficiency or imbalance of magnesium, calcium, sodium and potassium can cause diarrhea
   • These minerals are essential for intestinal motility and water absorption in the intestine
   • Therapy: A targeted analysis of the mineral values and appropriate supplementation can help to restore the balance

Environmental and toxic substance pollution

1. • Heavy metals
   • Pesticides
   • Drug residues
   • Additives in food

Stress und psychische Faktoren

• • Stresshormone beeinflussen den Darm stark
  • Angst und Nervosität können die Verdauung stören

Die Therapie richtet sich nach der jeweiligen Ursache. Ein pauschaler Ansatz mit Medikamenten hilft oft nicht dauerhaft. Vielmehr muss individuell untersucht werden, welche Faktoren den Durchfall auslösen. Mögliche Behandlungsstrategien umfassen:

• Darmsanierung: Probiotika, Behandlung sämtlicher Ungleichgewichte im Darm und eine gezielte Ernährung helfen, die Darmbakterien ins Gleichgewicht zu bringen.
• Enzymersatztherapie: Falls die Bauchspeicheldrüse zu wenig Enzyme produziert, können diese ersetzt werden.
• Anpassung der Ernährung: Eliminationsdiäten helfen, unverträgliche Lebensmittel zu identifizieren.
• Stressmanagement: Meditation, Yoga oder psychologische Betreuung können hilfreich sein.
• Sanfte Darmsanierung: Mit Heilerde, Flohsamenschalen und Bitterstoffen kann die Verdauung unterstützt werden.
• Gezielte Therapie des Gallensäurenverlustsyndroms: Falls BAM vorliegt, sollte eine entsprechende Behandlung mit Gallensäurebindern erfolgen.
• Mineralstoffausgleich: Falls ein Ungleichgewicht an Magnesium, Calcium, Natrium oder Kalium vorliegt, kann eine gezielte Supplementierung sinnvoll sein.

Chronic diarrhea can be very stressful, but there are solutions! Targeted research into the causes and individual therapy can improve quality of life enormously. I recommend carrying out a comprehensive stool examination and tackling the causes in a targeted manner instead of just treating symptoms with medication.

If you constantly have diarrhea, you should support your intestines in a targeted way to lead a life free of symptoms again!