Ask the Doctor: Why do I get diarrhoea every morning?

I would always suffer from diarrhoea after eating peanut paste so I stopped. However, I still get diarrhoea every morning. Is it because I have diabetes? Annet 

Dear Annet,

Diarrhoea, much as we may dislike it, is one way the body tries to protect itself from invading germs and detected toxic substances by flushing them out. 

However, when it is severe or takes long to subside, it can lead to complications, including dehydration, electrolyte imbalance, malnutrition and death, among many others.

Peanuts may cause diarrhoea if a person is allergic to them, does not digest them well (intolerance) or eats those which are infected with a fungus (aspergillus flavus). The best prevention of diarrhoea caused by peanuts, therefore, is to avoid eating them or their products.

Much as diabetes can cause diarrhoea due to other problems including amoebic, fungal, viral or bacterial infections, irritable bowel syndrome, or chemical food poisoning, your kind of diarrhoea is likely a result of diabetic effect on nerves that supply the intestines (autonomic nerves). 

Diabetes may damage the intestinal nerves resulting in among others, diarrhoea. Also, diarrhoea could be a side effect of the diabetes drugs, including one called metformin or some sugar-free sweeteners taken while avoiding use of sugar or if the cause of diabetes involves the part of the pancreas that helps digest food.  Diabetic diarrhoea usually occurs at night, may alternate with constipation, is watery, painless and can embarrassingly escape without notice. 

Treatment for diabetic diarrhoea may depend on an individual but proper diabetic control is very important.

Is it normal to have urinary incontinence at a young age?

Does drinking water make a student want to pass urine immediately? When I do not pass urine immediately, I always end up wetting my pants. Darlington

Dear Darlington

After the kidneys form urine, it is stored in a sac called the urinary bladder, which when it is about halfway full with urine, sends a message to the brain resulting in getting an urge to pass urine. Then, one will hold urine until the next convenient place to pass it.

The kidney being a regulator of water in the body may form more urine if one takes in more fluids, one reason why you may feel like passing urine immediately after taking water.

That said, one may not have taken lots of fluids but then may feel like passing urine. This is likely due to what is called polyuria, usually associated with disease conditions including diabetes mellitus (sukaali) and diabetes insipidus (the brains inability to help concentrate urine).

Since you pass urine on yourself if you do not answer your urge to pass urine, it is likely that you may also have a medical problem such as a urinary tract or prostate infection, an overactive bladder, stress and anxiety, among others.  

You need to be checked for those medical conditions and others depending on the doctor’s decision. 

If all tests are found to be okay, you do not need to do anything but only manage stress of course with the doctor’s help.