When to See a Doctor for Diarrhea

Diarrhea is a common symptom that people often don’t like to talk about. Most households will experience it once or twice a year. Most of the time, after drinking fluids at home for a couple of days, you will be back to your normal routine. But sometimes, your symptoms may feel more severe or last longer. Here is how to know when your diarrhea can become more worrisome and reasons you should go get it checked out.

What are the most common causes of diarrhea? 

When it comes to causes of diarrhea, there are two broad groups: 

• Acute diarrhea: Symptoms last less than 2 weeks.

• Chronic diarrhea: Symptoms last longer than 4 weeks.

Acute causes

Most acute diarrhea lasts for a few days and is a result of an infection. This is also known as gastroenteritis. Every year, there are over 2 billion cases worldwide. Most of these infections go away on their own. They can be caused by:

• Viruses: There are many viruses, like the common cold, that can cause diarrhea. These infections are also known as the stomach flu. Norovirus is often the cause of outbreaks on cruise ships. Rotavirus is more common in childhood. 

• Bacteria: Bacterial gastroenteritis is less common than viral infections. Diarrhea caused by bacteria can be from food poisoning. This can happen with poorly stored or cooked foods. Bacteria is often the cause of travelers’ diarrhea. 

Chronic causes

When diarrhea lasts 4 weeks or more, an infection is less likely to be the cause. Long-term diarrhea is more likely to be from:

• Inflammatory bowel disease (IBD): This includes Crohn’s disease and ulcerative colitis. These are both autoimmune conditions that affect the gut.  

• Celiacdisease: This is another inflammatory condition caused by an abnormal immune reaction to gluten.

• Lactose intolerance: Some people experience diarrhea and gas when they eat certain dairy products. This is because their body doesn't make enough of the enzyme lactase.

• Irritable bowel syndrome (IBS): This condition can cause a range of symptoms related to bowel dysregulation. It often worsens with stress.

• Medication side effects: Many medications can have diarrhea as a side effect. Common examples include antibiotics, acid blockers, metformin, and some antidepressants. 

• Chronic pancreatitis: When the pancreas gets repeatedly inflamed, it can’t make the enzymes to break down fats.

When should you see a medical provider for diarrhea?

Like the causes, the reasons to see your provider for diarrhea depend on whether you have acute versus chronic diarrhea.   

Acute symptoms

If you just started having diarrhea, here are reasons to seek medical care:

• Fever higher than 102°F

• Bloody stool, which can look like streaks of blood or blood mixed with stool

• Black, tarry stool, which can also be a sign of bleeding in the intestine 

• Severe abdominal pain, which can be a sign of other illnesses like appendicitis

• Significant decrease in urination, which is a sign of dehydration

• Dark urine, which is another sign of dehydration or problems with the liver

• Extreme fatigue or weakness

• Symptoms that last longer than 2 days

Chronic symptoms

If you have had diarrhea for longer than 4 weeks, your body may start compensating for your fluid losses. If you do not know the cause of your chronic diarrhea, see your healthcare provider right away for the following signs:

• Bloody stool, which can be a sign of IBD 

• Abdominal pain that has worsened over time or feels more severe than mild cramping

• Sores in or around the butt

• Weight loss, which may mean low nutrient levels

• Weakness or low energy, another sign of malnutrition (even with no weight loss)

• Dizziness when changing positions

• Any of the other signs of dehydration described above

What can a provider do for diarrhea?

Your provider will ask you some detailed questions about your diarrhea. This can provide important clues to find out the cause of your diarrhea. 

After a thorough exam, your provider may recommend more tests for diagnosis. This can include: 

• Stool sample: This can check for blood and certain bacteria.

• Lab testing: Your provider may order a glucose (sugar) level, blood count, a metabolic panel, pancreas enzymes, or thyroid panel.

• Imaging: If you are having significant pain, your provider may recommend an ultrasound or CT scan.

• Colonoscopy: Your provider may recommend this procedure for chronic diarrhea. It is the only way to diagnose certain conditions, like IBD.

In addition to these diagnostic tests, you might also be treated with:

• IV (intravenous) fluids: for dehydration 

• Antibiotics: for a suspected bacterial infection

• Probiotics: a mix of “good” bacteria and yeast for recovery in certain circumstances

This may all sound like a lot. But remember — most people don’t need this testing and treatment. And symptoms of diarrhea can often pass on their own.

What can you do at home for diarrhea?

If your symptoms are on the mild side and you don’t need to go to the provider, here are things to do at home: 

• Drink fluids. It is best to try and stay hydrated. You can drink an oral rehydration solution like Pedialyte. But any fluid is better than no fluid. Avoid sugary drinks, as they can make diarrhea worse. 

• Take over-the-counter medications. Antidiarrheal medications, like loperamide (Imodium A-D) or diphenoxylate/atropine (Lomotil), can help lower the number of times you have diarrhea. Bismuth subsalicylate (Pepto-Bismol) can also help. Don’t give these medications to children without speaking with their provider. 

• Take probiotics.Probiotics can help with many different causes of diarrhea. Most people can take probiotics without any issues. Mild side effects can include gas and bloating. If you have any conditions that affect your immune system, talk to your provider before taking probiotics.  

• Change your diet. When recovering from diarrhea, it’s usually best to give your gut a break. This can mean eating foods that are gentler and easier to digest. This includes bland foods with less fat and protein. Until your diarrhea has improved, avoid spicy foods, alcohol, and caffeinated or diet drinks. 

Why trust our experts?

Written by:

Jill L. Jaimes, MD

Jill L. Jaimes, MD, is a board-certified pediatric emergency medicine physician with over 20 years of clinical experience. She received her medical degree from Baylor College of Medicine and completed her residency and fellowship training at Texas Children’s Hospital.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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