Pseudomonas: Signs, Symptoms, and Complications

Is Diarrhea Contagious? Here's What To Know About Infectious Diarrhea, According To Gastroenterologists

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Unpleasant as it is, diarrhea—that loose, watery stool—is a common and normal part of life. Diarrhea is technically characterized as having a loose bowel movement three or more times in one day, according to the US National Library of Medicine (MedlinePlus), and it can be chronic or acute.

Generally speaking, diarrhea of any kind can be caused by a wide range of things. Certain medicines, food intolerance, chronic diseases are all things that can cause chronic, non-infectious diarrhea. But acute diarrhea specifically—the kind that comes on quickly and lasts up to a few days—is usually contagious, meaning you picked it up from contact with another person who also had diarrhea.

How that happens is unnerving, to say the least: Contagious diarrhea usually makes its way into your body through what's known as fecal-oral transmission, Carolyn Newberry, MD, a gastroenterologist at Weill Cornell Medicine, tells Health. That means, technically, the infectious agent is shed in the stool of another host or person, and somehow enters the mouth of the next host or person.

Here, gastroenterologists help explain when diarrhea is contagious, how you know if you have contagious diarrhea, and what you can do to prevent and treat it.

When is diarrhea contagious—and what causes it?

Let's dial it back a bit here: Infectious diarrhea specifically is caused by one of three things: bacteria, viruses, or parasites. Though the words "contagious" and "infectious" may often be used interchangeably, they're not exactly the same thing. Contagious diseases are spread by contact (usually person to person), while infectious diseases are spread by infectious agents. That means, while diseases that are contagious are also infectious, not all infectious agents are necessarily contagious.

Viruses specifically are the most common cause of diarrhea that can be passed between people (think: when someone neglects to wash their hands after using the bathroom and then touches a commonly-used surface). According to MedlinePlus and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the most common viruses that can cause diarrhea include:

Norovirus

Rotavirus (in children)

Influenza

Of course, that's not an exhaustive list of viral causes of diarrhea. According to the Mayo Clinic, adenoviruses, astrovirus, cytomegalovirus, and viral hepatitis are also known causes of diarrhea. Norovirus in particular is notorious for contagious diarrhea—specifically on cruise ships (or other situations in which people live in close quarters), says Lisa Ganjhu, DO, a gastroenterologist at NYU Langone.

Bacteria, too, can cause diarrhea. While many types of bacteria that cause infectious diarrhea stem from ingesting contaminated food, it is possible for people infected with the bacteria to spread it to others. According to the NIDDK, the most common types of bacteria that can cause diarrhea include:

Campylobacter

Escherichia coli (E. Coli)

Salmonella

Shigella

Parasitic infections can also be the root cause of some cases of contagious diarrhea. Though they're a less common that viral infections, the NIDDK says the following parasites that can cause contagious diarrhea include:

Cryptosporidium enteritis

Entamoeba histolytica 

Giardia lamblia

RELATED: What Is Chronic Diarrhea? Here's When You Should See a Doctor

How can you tell if you have contagious diarrhea? 

Obviously, not all instances of diarrhea are contagious. Most often, when diarrhea is chronic or lasts for an extended period of time, it's indicative of underlying issues or diseases like irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), food intolerances, or medications.

In that case, the biggest indicator that your diarrhea is contagious is that it comes on quickly, rather than being an expected part of your life. Acute diarrhea, as it's called, is almost always contagious. "So things like that can clue you in — it comes on all of a sudden, you've been around someone sick, recently traveled, or ate spoiled food," Dr. Newberry says. 

An acute case of diarrhea is something that "happens like once a year for most people," Dr. Ganjhu says. Because it's so infrequent, and most of us know how to deal with it, contagious diarrhea usually doesn't get diagnosed, she says. If you do want to see a doctor for your diarrhea, however, they'll be able to tell whether it's caused by parasites, bacteria, or a virus through a simple stool test. "There are a lot of different bugs we can actually test for," Dr. Ganjhu says.  

RELATED: What Causes Bloody Diarrhea? These 6 Medical Conditions Are Common Culprits

How can you treat (and prevent) contagious diarrhea? 

Although you might not have known it, you've almost certainly had contagious diarrhea before and already know how to treat it: with lots of fluids and rest. "If you have a healthy immune system, you'll be sick for a few days and it will clear up on its own," Dr. Newberry says. 

To help you get through a bout of acute diarrhea, stick to foods that are gentle on your stomach and drink lots of water and something with minerals (like sports drinks or enhanced waters) to replenish electrolytes. If you need it, you can also use an over-the-counter medicine like Pepto Bismol to calm your stomach. "Just let your body fight the infection off," Dr. Newberry says. 

As for avoiding contagious diarrhea (or avoiding giving it to someone else if you're already ill with it), keep in mind how easily is spreads from person to person. "Diarrhea is probably one of the most communicable disorders out there" says Dr. Ganjhu.

To protect yourself (or others), you'll want to keep your distance, avoid touching commonly-used surfaces, and wash or sanitize your hands when necessary. If you share a space with someone who has a bacterial form of diarrhea specifically, make sure you sanitize or disinfect surfaces as much as possible, Dr. Ganjhu says. "It's very important that if that person uses the toilet to make sure you bleach down all the surfaces to kill any potential cross contamination," she says. 

However, because diarrhea-causing bacteria and parasites are also often found in contaminated food and water, it's important to know how to avoid that contamination. That means making sure to cook poultry, meat, or shellfish all the way through before eating; and abiding by other food-safety practices, like keeping perishable items refrigerated, and properly washing all fruits and vegetables.

And while, most often, the water we consume in the US will be safe, there can still be danger in areas with sub-par sewer systems or after flooding or heavy storms, which can wash sewer into drinking water (in these situations your city will send out a water boil alert, Christine Lee, MD, a gastroenterologist at the Cleveland Clinic, tells Health).

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What Is Travelers' Diarrhea?

Vacation is supposed to be a time of rest, but a case of travelers' diarrhea can make your trip a nightmare.

Travelers' diarrhea causes loose, watery stools, usually brought about by bacteria, viruses, or fungi. Generally, mild cases of travelers' diarrhea resolve with hydration, rest, and a bland diet. Still, travelers' diarrhea may lead to complications, such as dehydration and malabsorption.

Travelers' diarrhea is one of the most common travel-related illnesses, affecting anywhere from 30% to 70% of travelers. Though travelers' diarrhea can occur anywhere in the world, it is more common when traveling to parts of Asia, the Middle East, Africa, Mexico, and Central and South America.

Here, gastroenterologists explain what causes travelers' diarrhea, the symptoms, and how best to treat it so you can enjoy your vacation as much as possible.

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Travelers' diarrhea is a form of acute diarrhea that comes on while traveling. Acute diarrhea is sudden loose and watery stools. 

There are different levels of travelers' diarrhea (i.E., mild, acute, and severe). At varying severities, those levels can include symptoms like:

Mild cramps

Urgent loose stools

Severe abdominal pain

Fever

Vomiting

Bloody diarrhea

Symptoms can occur within a few hours to as long as a few weeks depending on the cause of the travelers' diarrhea. Bacterial travelers' diarrhea can last up to seven days. In contrast, viral travelers' diarrhea lasts about three days.

Travelers' diarrhea spreads through fecal matter through contaminated food and water. Bacteria, viruses, and parasites cause travelers' diarrhea.

Bacteria account for about 80% to 90% of cases, while viruses make up about 5% to 15%. Less commonly, parasites, also known as protozoal pathogens, can cause travelers' diarrhea. Usually, those parasites are slower to manifest than bacteria and viruses.

Depending on the culprit, travelers' diarrhea may occur through non-inflammatory or inflammatory pathways. Non-inflammatory pathways reduce the ability of your intestines to absorb nutrients. As a result, your waste products increase. In contrast, inflammatory pathways damage your intestines, which increases bowel movements.

Risk Factors

Travelers' diarrhea is more likely to occur if you travel outside the country to a place with poor sanitation. A lack of clean water makes practicing proper hygiene and food preparation hard.

Other risk factors for travelers' diarrhea include:

Warm climates

A lack of refrigeration

Inadequate food storage practices

Proton pump inhibitor (PPI) and antibiotic use

Unprotected sex

Pregnancy

Age (i.E., older adults and young children)

Health conditions affecting the gastrointestinal (GI) system

Weak immune system

Depending on the culprit, travelers' diarrhea can be contagious. For example, cruise ships are a common culprit of travelers' diarrhea. 

"Cruise ships are known for two viruses specifically that spread like wildfire," Rabia De Latour, MD, a gastroenterologist and assistant professor in the department of medicine at the NYU Grossman School of Medicine, told Health. 

Norovirus is a highly contagious virus that causes diarrhea and vomiting. Cruise ships help the virus spread because so many people stay in such proximity, and many people are not great at washing their hands before touching their faces or eating, noted Dr. De Latour.

In contrast, some cases of travelers' diarrhea are not spread between people. For instance, you may develop acute diarrhea because you are not used to the food or water in the place you are traveling.

"There may be different probiotic bacteria that live on lettuce or other foods there that you're just not accustomed to," explained Dr. De Latour. In that case, the diarrhea is about the change in environment, not an infection, and should clear up in a couple of days, added Dr. De Latour.

Traveling can be stressful, especially traveling internationally. For example, your body might respond with loose, watery stool if you are stressed and physically tired after a 12-hour flight. Diarrhea caused by stress isn't infectious and will get better quickly.

Healthcare providers can diagnose traveler's diarrhea by asking about your symptoms, recent travels outside the country, and what you ate. For example, having acute diarrhea three or more times within 24 hours or double the amount of regular bowel movements may signal travelers' diarrhea. 

A healthcare provider can palpate the stomach to check whether your abdomen is tender. Abdominal cramps, nausea, vomiting, and fever often accompany acute diarrhea.

Healthcare providers do not usually require laboratory tests or imaging to diagnose travelers' diarrhea. In contrast, a healthcare provider may acquire a stool sample if you have blood in your stool or feel like you need to pass stool even if your bowels are empty. 

In severe cases, a healthcare provider may send for X-rays of the kidneys, ureters, and bladder and an abdominal CT scan.  

Treatment for travelers' diarrhea depends on the severity of the case and may include the following:

Fluid replenishment: To avoid dehydration, increasing your water intake is essential. Sports drinks and electrolyte mixes can help, too. In contrast, milk and fruit juices can worsen diarrhea, increasing the risk of dehydration. You may require oral rehydration salt or intravenous (IV) fluids to replenish fluids for severe cases. 

Anti-diarrheal medicines: A healthcare provider may advise taking an anti-diarrheal like loperamide for mild cases. 

Antibiotics: In some cases, a healthcare provider may prescribe a round of antibiotics. Common antibiotics for travelers' diarrhea include ciprofloxacin, azithromycin, and rifaximin. The type of antibiotic may depend on your symptoms and where you are traveling. 

Mainly, mild to moderate cases of travelers' diarrhea involve supportive therapy. For many people with travelers' diarrhea, the illness simply runs its course. 

Try the following to make yourself as comfortable as possible:

Hydrate to prevent dehydration.

Get lots of rest.

Eat small, gentle meals on your stomach, such as salty (e.G., pretzels, crackers, soup, sports drinks) and high-potassium (e.G., bananas, potatoes without the skin, fruit juices) foods.

Preventing travelers' diarrhea can be tricky, especially when traveling abroad. On a cruise ship, one of the best ways to avoid travelers' diarrhea is to watch where you put your hands, wash your hands frequently, and avoid touching your face, advised Dr. De Latour. Steer clear of buffet lines, where someone carrying norovirus could touch the food or serving utensils.

When traveling to underdeveloped countries, be careful what you eat and drink to prevent traveler's diarrhea. In the United States, many people are used to eating pasteurized foods partially sterilized through heat or irradiation. Sometimes, that is different in other countries.

"[G]etting that exposure to a digestive system that has never had an unpasteurized product, we would be very vulnerable," Christine Lee, MD, a gastroenterologist at the Cleveland Clinic, told Health. When traveling, be extra careful to check if something is pasteurized before you eat or drink it. You will want to avoid undercooked meats and seafood, too. 

"If you're traveling to an underdeveloped country, that might not be where you want to eat a rare steak," said Dr. Lee. The same goes for sushi made with raw fish or dishes like ceviche or tartare made with raw seafood and meat. Instead, cooked foods are your safest option while traveling anywhere you are unsure how safe the water is.

Fruit and vegetables are risky since they could have been washed in contaminated water. In that case, the fruit you can peel (e.G., bananas or oranges) may be the safest option.  

Finally, paying attention to what you drink is also vital in preventing travelers' diarrhea. Alcohol is considered safe because it can kill bacteria. Likewise, bottled drinks are safe if they have an unbroken seal. Boiled water is your next safest bet if those options are not available. 

Remember that contaminating water can get into your mouth in other ways, like showering and swimming. Try not to swallow during those times, brush your teeth with bottled water, and avoid ice in drinks, advised Dr. Lee.

Finally, a healthcare provider may advise taking precautions if traveling outside the country. For example, you might take two tabs of bismuth subsalicylate four times daily to decrease the risk of travelers' diarrhea. Usually, healthcare providers do not advise bismuth subsalicylate for pregnant people and children. 

A healthcare provider may recommend a round of antibiotics to prevent travelers' diarrhea if you are traveling to a high-risk area for a short period.

Most people with travelers' diarrhea make full recoveries. In rare, severe cases, complications can occur. For example, dehydration is one of the most common complications of travelers' diarrhea. Dehydration happens if you lose too many fluids through acute diarrhea, requiring immediate medical attention.

Other complications of travelers' diarrhea may include:

Malabsorption: This happens if the small intestine cannot absorb enough nutrients.

Sepsis: This is an infection that develops secondary to an existing one. Sepsis causes inflammation, which leads to organ damage and failure and, in some cases, death. 

Hemolytic uremic syndrome: This occurs if an infection damages the blood vessels in your kidneys.

Reactive arthritides: Some infections may cause painful and swollen joints.

Typically, those complications are more common in older adults and children younger than 4 than others.

To manage travelers' diarrhea, follow a healthcare provider's advice and treatment plan. Other steps to keep comfortable while your symptoms resolve include staying hydrated and practicing proper hygiene, such as handwashing. 

Mostly, people with travelers' diarrhea only require emergency medical attention if they are dehydrated. Consult a healthcare provider if your symptoms do not subside after 10 days.

Travelers' diarrhea causes acute diarrhea that comes on while traveling. You can avoid travelers' diarrhea as much as possible by watching what you eat and drink while traveling outside the country. To treat mild cases, staying hydrated is essential. 

Although you are at risk for diarrhea when traveling, it should not be scary. South America, Central America, Mexico, Africa, the Middle East, and Asia offer unique, enriching experiences worth the risk.

Is Folliculitis Contagious?

Folliculitis generally isn't very contagious. But certain types can spread from person to person under the right conditions.

Folliculitis is the infection or inflammation of hair follicles. Most types of folliculitis do not spread from person to person, but it can be contagious in certain forms.

While folliculitis often occurs due to a bacterial infection, it can also be caused by a virus, fungus, or another agent.

Folliculitis can affect anywhere that hair grows on the body, even if the hair is sparse and thin. Folliculitis typically appears as red, inflamed bumps and can be white-headed like acne. Its appearance may differ depending on the amount of melanin in your skin.

We'll go over the types of folliculitis, when it's contagious, and how to prevent infection.

Anyone can get folliculitis, but it's more common in people who:

take certain medications

have a health condition that weakens the immune system

use hot tubs

frequently wear tight, restrictive clothing

have coarse or curly hair that they shave

overweight

have diabetes

Once you have folliculitis, it can spread to other parts of your body. Folliculitis can occur anywhere there's hair.

Common areas affected by folliculitis include the:

scalp

buttocks

arms

armpits

legs

If you scratch at the bumps then touch another part of your body, or use a towel or razor that has touched an affected area, this can transfer the bacteria that can cause folliculitis. Itching can spread folliculitis to nearby follicles.

Overall, it is very difficult to acquire folliculitis from another person, but not impossible.

These types of folliculitis are known to be contagious in certain conditions:

Folliculitis caused by the herpes simplex virus. Herpes can be spread by exchanging bodily fluids.

Folliculitis caused by a staphylococcal (staph) infection. Close skin contact, especially if you have open cuts, can put you at risk of acquiring a staph infection. Sharing a razor can also spread this type of folliculitis.

Hot tub folliculitis. This type of folliculitis can be passed on from person to person through contact with hot tub or pool water containing the infectious agent.

We'll go over these types of folliculitis and others in more depth below.

Though all cases of folliculitis may look similar, there are different types with different root causes.

Viral folliculitis

Herpes simplex virus, the virus that causes cold sores, can cause folliculitis. This is an uncommon form of folliculitis. The bumps will appear close to a cold sore and can be spread by shaving.

Herpes can be passed on through skin-to-skin contact and contact with bodily fluids (via sharing food utensils, kissing, or sexual activity).

Drug-induced folliculitis

Drug-induced folliculitis often resembles acne (acne vulgaris). However, unlike acne, this type of folliculitis doesn't have comedones.

Other names for drug-induced folliculitis are:

acneiform eruptions

drug-induced acne

papulopustular eruptions

Certain medications can cause this type of folliculitis in a small percentage of people.

These medications include:

isoniazid

steroids

lithium

certain seizure medications

Staphylococcal folliculitis

Staphylococcal folliculitis is one of the more common types of folliculitis. It develops from a staph infection. You can contract staph from direct body contact with someone else who has a staph infection.

In some areas of the skin, staph may be naturally present. It becomes problematic when it breaks through the skin barrier via a cut or open wound.

If you share a razor with someone with staphylococcal folliculitis, you may also get it if you have a cut on your skin.

Fungal folliculitis

Fungus or yeast can also cause folliculitis. Pityrosporum folliculitis is characterized by pustules or papules on the upper body, including the face. It is typically itchy.

A yeast infection causes this type of folliculitis. It's also a chronic form, meaning it recurs or persists. This type of folliculitis needs to be treated with an oral or topical antifungal medication.

Hot tub folliculitis

Pseudomonas bacteria are found in hot tubs and heated pools (among other places) that aren't properly cleaned, or where the chlorine isn't strong enough to kill them.

The bacteria can cause folliculitis, often called hot tub rash. The first red, itchy bumps will typically form a few days after a person has used a hot tub. If the infection is in the water, it can spread to others.

Folliculitis decalvans

Folliculitis decalvans is a hair loss disorder that can lead to scarring.

Some believe it's due to an irregular immune system response to a staph infection on the scalp, although this is not definitively proven.

This type of folliculitis destroys hair follicles, resulting in scarring. This typically makes it difficult or impossible for the hair to grow back.

A small 2010 study found antimicrobial medications helped prevent the destruction of hair follicles in some people with folliculitis decalvans. The researchers identified Rifampicin or Clarythromycin in combination with Minocycline as the most effective. However, more research is needed.

Other treatment approaches include oral antibiotics, topical lotions, and light or laser therapies done over multiple sessions.

Pseudofolliculitis barbae (razor bumps)

This kind of folliculitis often occurs after a close shave, earning the name "razor bumps." It can become a chronic, but manageable, condition. "Razor burn," or general irritation after shaving, is not the same thing.

Pseudofolliculitis barbae usually refers to hair follicle inflammation on the face and neck, but other shaved areas of the body can be affected too. Shaving can give hairs a sharp edge, making it easier for them to poke into your skin (ingrown hairs). In some cases, this type of folliculitis can cause scarring and keloids (hard growths of extra scar tissue).

Razor bumps can occur in anyone who shaves. It occurs most frequently in Black men who shave their faces, and others who may have curly hair. Overall, having thick or curly hair can increase your likelihood of having ingrown hairs. The most effective solution is to stop the shaving or hair removal processes on the affected follicles.

Below, we'll discuss how ingrown hairs occur, and what else you can do to prevent them.

Ingrown hairs occur most frequently after shaving or other hair removal techniques. It can also happen if your skin isn't properly exfoliated or cleaned. Dead skin can clog hair follicles, preventing hairs from growing in the proper direction.

Ingrown hairs happen when a hair doesn't grow straight up through the skin like it's supposed to, but instead, it becomes trapped underneath. These hairs can penetrate the surrounding skin, causing inflammation.

Signs of ingrown hair may include:

red, swollen bumps

whiteheads or pus at the site

pain, itching, or soreness

in some cases, seeing the trapped hair under the skin

Folliculitis isn't considered a sexually transmitted infection, though in some cases it can transfer via close skin contact.

However, the herpes simplex virus is spread through sexual contact. In rare cases, this virus can cause folliculitis.

Most cases of mild folliculitis can be treated at home. In certain situations, it's advisable to consult with a doctor.

A quick remedy is stopping the behavior that's causing the folliculitis, even if just temporarily. This includes shaving or hair removal routines or wearing tight and restrictive clothing.

Other home remedies include:

Warm compress. Apply a warm compress to the affected area a few times a day. This can help your skin relax and release the trapped hair.

Topicals and body washes. In many cases of bacterial folliculitis, an over-the-counter (OTC) antibacterial wash, such as chlorhexidine (Hibiclens) or benzoyl peroxide, can provide relief. Avoid using Hibiclens above the neck. If you suspect yeast is causing your folliculitis, try an OTC antifungal cream.

Bathe with lukewarm water. Hot water may further irritate or inflame folliculitis.

Laser hair removal. If your folliculitis is recurring due to hair removal, you may consider laser hair removal to destroy the hair follicle.

It's important to talk with a doctor before trying any home remedies.

If your folliculitis doesn't improve or worsens after a few days of treatment at home, reach out to your doctor.

You should seek medical attention if:

your folliculitis hasn't improved after several days of treatment at home

your skin is extremely red, warm, swollen, or painful

pus is leaking from the affected area

you have a fever

Your doctor may prescribe prescription-strength antibiotic topicals or oral medications, as well as recommend an antibacterial wash.

Folliculitis can be treated by your primary care doctor, but you may be referred to a dermatologist (skin expert).

You can view doctors in your area through the Healthline FindCare tool.

There are several ways to help prevent folliculitis:

Avoid restrictive clothes, which can trap sweat and irritate skin.

Avoid shaving, or shave less frequently. Use shaving cream, and apply moisturizer after shaving. Practice proper shaving techniques, and don't rush.

Only go in hot tubs and pools that you know are clean and well chlorinated.

Shower with soap immediately after using a hot tub, Jacuzzi, or heated swimming pool.

Shower with soap after exercise.

Avoid sharing towels, face cloths, and razors.

There are many types of folliculitis. Most types aren't contagious and won't easily transfer from person to person.

Folliculitis from infectious agents may spread by sharing razors, towels, or through hot tubs. It can also spread from one part of the body to another if you're not careful.

Some types of folliculitis may require treatment with topical or oral medication (including antibiotics or antifungals). Many cases of folliculitis can resolve on their own if you stop the cause of irritation, such as shaving, or wearing tight clothing.

Talk with a doctor if you're experiencing painful, red bumps on your skin that don't resolve with treatment at home. You may need further care to treat your type or case of folliculitis, and prevent it from recurring.

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