What's the True Cause of Ongoing Diarrhea? | Persistent Diarrhea

Persistent Diarrhea

Hello, this is Baeknokdam Korean Medicine Clinic.

Is recurrent diarrhea truly a simple problem? Many people find themselves rushing to the bathroom every morning, or immediately after a meal. Sometimes, even just a cup of coffee or a bit of stress can cause stomach pain and diarrhea. However, at the hospital, most people are simply told, "There's nothing wrong with your bowels," or "You have irritable bowel syndrome (IBS)." But in reality, the individual feels like they are constantly "expelling something." This isn't just a simple bowel issue; it could be a disruption of the body's entire rhythm.

Diarrhea: Too Diverse to Be Grouped Under One Name

Not all diarrhea is the same. How many times a day does it occur? Is it immediately after a meal, or a few hours later? Does it only happen in the morning? Do you wake up at night to go to the bathroom? Do you feel relieved immediately after, or more exhausted?

Odor, mucus, oil, and even color—all of these pieces of information are clues revealing what's happening inside your body. Some types of diarrhea are a result of the body expending energy too quickly, while others are a result of improper absorption. Diarrhea that simply appears watery is not all the same.

Why Can't Diarrhea Be Stopped? – A Functional Medicine Interpretation of Mechanisms

In functional medicine, the mechanisms of diarrhea are categorized as follows:

• Osmotic Diarrhea: This occurs when undigested food increases osmotic pressure in the intestines, drawing water into the lumen. Examples include lactose intolerance, excessive fruit intake, and artificial sweeteners.
• Secretory Diarrhea: This is characterized by excessive secretion of water and electrolytes from the intestinal wall due to inflammation or toxins. Bacterial infections and chronic inflammation are typical causes.
• Motility-Related Diarrhea: This happens when intestinal motility speeds up due to autonomic nervous system dysregulation, preventing sufficient absorption of contents before expulsion. It is associated with stress-induced diarrhea and hyperthyroidism.
• Gut Microbiome Imbalance: When food is abnormally fermented by microorganisms, it can lead to increased gas and pressure in the intestines, thereby inducing diarrhea. Small Intestinal Bacterial Overgrowth (SIBO) is an example.

In essence, diarrhea may not merely be a digestive system issue but rather a signal of a systemic physiological rhythm disruption.

How Does Korean Medicine Interpret Diarrhea?

In Korean medicine, diarrhea is understood not merely as defecation but as the body's response to expel something. If the functions of the Spleen and Stomach become weak and cannot manage dampness, it's called 'Biheoseol' (Spleen Deficiency Diarrhea). Diarrhea that occurs early in the morning due to cold energy is termed 'Ogyeongseol' (Dawn Diarrhea). Diarrhea immediately after a meal is called 'Sikhujeukseol' (Postprandial Diarrhea). Stomach pain and diarrhea immediately following stress are interpreted as 'Gangi-beom-bi' (Liver Qi invading the Spleen/Stomach).

Furthermore, differentiating between cold and heat is crucial. Cold-natured diarrhea, for instance, watery and cold-feeling stool that pours out, may indicate Spleen Yang Deficiency (Bi-yang-heo) or Kidney Yang Deficiency (Sin-yang-heo). Conversely, sticky, foul-smelling diarrhea accompanied by mucus strongly suggests Damp-Heat (Seup-yeol). Regardless of the type of diarrhea, it's more important to understand *why* the body is expelling something so forcefully rather than just *what* it is expelling.

Key to Diarrhea Consultation: It's About Sensation, Not Frequency

In the clinic, the most crucial aspect of inquiring about diarrhea isn't "how many times a day," but rather *when*, *in what situation*, and *with what sensation* it occurs. Is it within 10 minutes after a meal, or 1-2 hours later? Do you feel refreshed after diarrhea, or exhausted? Do you experience cold sweats or heart palpitations during defecation? Does abdominal pain subside after diarrhea, or does discomfort persist?

This sensory information directly reflects the state of your autonomic nervous system, digestive enzymes, and gut microbiome. Therefore, simply stating "I have diarrhea" can cause us to miss truly important signals.

Diarrhea You Shouldn't Ignore: High-Risk Signs

While persistent diarrhea isn't always dangerous, a deeper differential diagnosis is absolutely necessary in the following cases:

• Repeated diarrhea in the early morning or nocturnal bowel movements.
• Diarrhea mixed with mucus or blood.
• Weight loss, accumulating fatigue, and loss of appetite.
• First onset of diarrhea after the age of 50.
• Frequent and severe flatulence, alternating with diarrhea.

Such cases may indicate possibilities like SIBO, inflammatory bowel disease (IBD), pancreatic enzyme issues, or intestinal tumors. These should not be dismissed as simple enteritis or stress.

The Goal Is Not to Stop Diarrhea, But to Restore the Body's Rhythm

Diarrhea is an "emptying act." However, recurrent diarrhea also implies that the body is continually trying to resolve something, but it's not being resolved. The gut is not merely an excretory organ; it is a mirror reflecting the nervous system, immune system, and emotions.

Instead of just stopping diarrhea, we must understand *why* the body has continuously needed to expel things. And through that understanding, we must restore the conditions for replenishment and the rhythm of absorption. This is not about "treating" diarrhea, but about interpreting the body *through* diarrhea.

#ChronicDiarrhea #PersistentDiarrhea