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Diarrhea when to call the doctor. Diarrhea: When to Call the Doctor – Symptoms, Causes, and Tests Explained

by alexxlab

What are the main symptoms of diarrhea. How can diarrhea lead to dehydration. When should you see a doctor for diarrhea. What tests are used to diagnose the cause of persistent diarrhea. How is COVID-19 related to diarrhea symptoms.

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Understanding Diarrhea: Symptoms and Associated Conditions

Diarrhea is a common digestive issue characterized by loose, watery stools occurring three or more times a day. While often temporary, it can sometimes indicate a more serious underlying condition. Understanding the symptoms and knowing when to seek medical attention is crucial for proper management and treatment.

The primary symptoms of diarrhea include:

  • Loose, watery stools
  • Abdominal pain or cramping
  • Urgent need to use the bathroom
  • Nausea
  • Bloating
  • Anal irritation
  • Loss of bowel movement control

Are there additional symptoms when diarrhea is caused by an infection? In cases of infectious diarrhea, individuals may also experience:

  • Bloody stools
  • Vomiting
  • Fever and chills
  • Light-headedness and dizziness

Complications of Diarrhea: Dehydration and Malabsorption

Prolonged or severe diarrhea can lead to serious complications, primarily dehydration and malabsorption. These conditions have their own set of symptoms that require attention.

Signs of Dehydration

How can you recognize dehydration caused by diarrhea? Look out for these symptoms:

  • Extreme thirst
  • Decreased urination frequency
  • Dark-colored urine
  • Dry mouth
  • Fatigue
  • Sunken eyes or cheeks
  • Feeling faint
  • Decreased skin turgor (skin doesn’t flatten back quickly when pinched)

In children, additional signs of dehydration may include lack of energy and absence of tears when crying.

Symptoms of Malabsorption

Malabsorption occurs when the body is unable to properly absorb nutrients from food. The symptoms include:

  • Bloating
  • Gas
  • Abdominal pain
  • Nausea
  • Vomiting
  • Changes in appetite
  • Weight loss
  • Fatty stools

The Connection Between COVID-19 and Diarrhea

In recent years, the relationship between COVID-19 and gastrointestinal symptoms, including diarrhea, has become a topic of interest in the medical community. How does COVID-19 affect the digestive system?

Diarrhea, along with other gastrointestinal issues like nausea and vomiting, has been identified as a symptom of COVID-19. In some cases, these digestive problems may be the first sign of the illness. Research has shown that approximately 20% of people experience diarrhea as their initial symptom of COVID-19.

Is diarrhea associated with COVID-19 severity? Some studies suggest that experiencing diarrhea with COVID-19 may be linked to an increased risk of severe illness. Furthermore, ongoing diarrhea has been observed in many individuals with long COVID, persisting even three months after hospital discharge.

While the exact mechanisms behind the relationship between COVID-19 and gastrointestinal symptoms are still being studied, it’s clear that the virus can affect the digestive system in various ways.

Diagnostic Tests for Persistent Diarrhea

While most cases of diarrhea resolve on their own within a few days, persistent diarrhea may require medical investigation to identify the underlying cause. What tests are typically used to diagnose the cause of prolonged diarrhea?

Initial Examination

When you visit a doctor for persistent diarrhea, they will typically perform:

  • A physical examination
  • A review of your medical history and current medications
  • A careful abdominal examination
  • Potentially, a rectal exam

Common Diagnostic Tests

Depending on the severity and duration of your symptoms, your doctor may recommend one or more of the following tests:

  1. Stool Test: This test helps identify bacterial or parasitic infections. You’ll be provided with containers to collect stool samples for analysis.
  2. Blood Test: A complete blood count can reveal signs of infection, anemia, inflammation, or electrolyte imbalances that might be causing your diarrhea.
  3. Colonoscopy or Sigmoidoscopy: These procedures use a lighted tube with a camera to examine the inside of your colon. A colonoscopy examines the entire colon, while a sigmoidoscopy focuses on the rectum and lower portion of the colon.
  4. Hydrogen Breath Test: This test is used to diagnose lactose intolerance by measuring the amount of hydrogen in your breath after consuming lactose.
  5. Fasting Test: Your doctor may ask you to eliminate certain foods from your diet to determine if a food intolerance or allergy is causing your diarrhea.

When to Seek Medical Attention for Diarrhea

While occasional diarrhea is common and usually not cause for concern, certain symptoms warrant immediate medical attention. When should you see a doctor for diarrhea?

Seek medical care if you experience any of the following:

  • Diarrhea lasting more than two days
  • Fever of 102 degrees Fahrenheit (38.9 degrees Celsius) or higher
  • Six or more loose stools within 24 hours
  • Severe, unbearable abdominal or rectal pain
  • Bloody stools
  • Signs of severe dehydration

These symptoms may indicate a more serious underlying condition that requires prompt medical attention and treatment.

Treatment Options for Diarrhea

The treatment for diarrhea depends on its cause and severity. What are the common approaches to managing diarrhea?

Home Remedies and Over-the-Counter Treatments

For mild cases of diarrhea, the following measures may help:

  • Staying hydrated with water, clear broths, and electrolyte solutions
  • Eating small, frequent meals of easily digestible foods
  • Avoiding caffeine, alcohol, and fatty or spicy foods
  • Using over-the-counter antidiarrheal medications (after consulting with a healthcare provider)

Medical Treatments

For more severe or persistent cases, medical treatments may include:

  • Antibiotics for bacterial infections
  • Antiparasitic medications for parasitic infections
  • Intravenous fluids for severe dehydration
  • Probiotics to restore gut flora balance
  • Medications to address underlying conditions (e.g., inflammatory bowel disease)

It’s important to consult with a healthcare professional before starting any treatment, especially for persistent or severe diarrhea.

Prevention Strategies for Diarrhea

While not all cases of diarrhea can be prevented, certain measures can reduce your risk. How can you lower your chances of developing diarrhea?

Hygiene Practices

Maintaining good hygiene is crucial in preventing infectious diarrhea:

  • Wash your hands thoroughly with soap and water, especially before eating and after using the bathroom
  • Use hand sanitizer when soap and water are not available
  • Clean and disinfect surfaces regularly, particularly in the kitchen and bathroom

Food Safety

Proper food handling and preparation can prevent foodborne illnesses that cause diarrhea:

  • Cook foods thoroughly, especially meats and eggs
  • Refrigerate perishable foods promptly
  • Avoid consuming unpasteurized dairy products
  • Wash fruits and vegetables before eating
  • Be cautious when eating food from street vendors, especially in areas with poor sanitation

Travel Precautions

When traveling, especially to areas with different sanitation standards:

  • Drink only bottled or boiled water
  • Avoid ice cubes in drinks
  • Eat only well-cooked, hot foods
  • Avoid raw fruits and vegetables unless you can peel them yourself
  • Consider taking probiotics before and during your trip

Long-Term Management of Chronic Diarrhea

For individuals dealing with chronic diarrhea due to underlying conditions, long-term management strategies are essential. How can chronic diarrhea be effectively managed?

Dietary Modifications

Adjusting your diet can help manage symptoms:

  • Identify and avoid trigger foods
  • Increase fiber intake gradually to improve stool consistency
  • Stay hydrated with water and electrolyte-rich fluids
  • Consider a low FODMAP diet under medical supervision

Stress Management

Stress can exacerbate diarrhea in some conditions. Stress-reduction techniques may include:

  • Regular exercise
  • Meditation or mindfulness practices
  • Adequate sleep
  • Cognitive-behavioral therapy

Medication Management

Work closely with your healthcare provider to:

  • Adjust medications as needed
  • Monitor for side effects
  • Explore new treatment options as they become available

Remember, chronic diarrhea management is often a long-term process that requires patience and collaboration with your healthcare team.

The Impact of Diarrhea on Quality of Life

Chronic or recurrent diarrhea can significantly affect an individual’s quality of life. How does diarrhea impact daily activities and overall well-being?

Physical Effects

Diarrhea can lead to various physical challenges:

  • Fatigue due to nutrient malabsorption and dehydration
  • Weight loss or difficulty maintaining a healthy weight
  • Skin irritation around the anal area
  • Weakened immune system due to nutrient deficiencies

Social and Emotional Impact

The unpredictable nature of diarrhea can affect social interactions and emotional well-being:

  • Anxiety about leaving home or being in public places
  • Social isolation due to fear of symptoms
  • Embarrassment or shame associated with the condition
  • Disrupted sleep patterns affecting mood and energy levels

Work and Productivity

Chronic diarrhea can impact professional life:

  • Increased absenteeism from work or school
  • Reduced productivity due to physical discomfort or frequent bathroom breaks
  • Difficulty participating in work-related social events

Addressing these quality of life issues is an important aspect of managing chronic diarrhea. Support groups, counseling, and open communication with healthcare providers can help individuals cope with the challenges posed by this condition.

Emerging Research and Future Treatments for Diarrhea

The field of gastroenterology is constantly evolving, with new research shedding light on the causes and potential treatments for diarrhea. What are some of the promising areas of research in diarrhea management?

Microbiome Studies

Research into the gut microbiome is revealing new insights:

  • Understanding the role of specific bacterial strains in preventing or causing diarrhea
  • Developing targeted probiotics for different types of diarrhea
  • Exploring fecal microbiota transplantation for recurrent C. difficile infections

Immunotherapy

Immunological approaches are being investigated for certain types of chronic diarrhea:

  • Developing monoclonal antibodies to target specific inflammatory pathways
  • Exploring the use of immune modulators in inflammatory bowel diseases

Personalized Medicine

Advances in genetic testing and biomarker identification are paving the way for more personalized treatments:

  • Identifying genetic predispositions to certain types of diarrhea
  • Tailoring treatments based on individual patient characteristics and biomarkers

Novel Drug Delivery Systems

Research is ongoing into new ways to deliver medications more effectively:

  • Developing targeted drug delivery systems to minimize systemic side effects
  • Exploring the use of nanotechnology in antidiarrheal medications

These emerging areas of research hold promise for more effective and personalized approaches to managing diarrhea in the future. As always, it’s important to consult with healthcare professionals for the most up-to-date and appropriate treatment options.

Know the Symptoms of Diarrhea and When to See a Doctor

The main symptom of diarrhea is passing loose, watery stool that occurs three or more times a day.

Someone with diarrhea may also experience one or more of the following symptoms:

  • Pain or cramping in the abdomen
  • An urgent need to go to the bathroom
  • Nausea
  • Bloating
  • Anal irritation
  • A loss of control of bowel movements

If diarrhea is caused by an infection, people may also experience:

  • Bloody stools
  • Vomiting
  • Fever and chills
  • Light-headedness and dizziness

Diarrhea can lead to dehydration and malabsorption, each of which have their own symptoms.

Signs of dehydration include: extreme thirst, urinating less frequently than normal, dark-colored urine, dry mouth, fatigue, sunken eyes or cheeks, feeling faint, and a decreased skin turgor (when the skin is pinched and released, it does not flatten back to normal right away). In children, additional signs of dehydration can include a lack of energy and the absence of tears while crying.

Symptoms of malabsorption include bloating, gas, abdominal pain, nausea, vomiting, changes in appetite, weight loss, and fatty stools.

COVID-19 and Diarrhea

Diarrhea, along with other gastrointestinal issues like nausea and vomiting, is a symptom of COVID-19.

In some people, digestive problems are the first sign of the illness. One study, for example, found that about 20 percent of people experienced diarrhea as their first symptom of COVID-19.

Other research suggests having diarrhea with COVID-19 is associated with an increased risk of severe illness.

Ongoing diarrhea is also an issue for many people who have long COVID. Research has found loose, watery stools, as well as other digestive issues, like nausea, acid reflux, and loss of appetite, are common in patients three months after being discharged from the hospital due to COVID-19.

Scientists are still working to better understand the relationship between COVID-19 and gastrointestinal symptoms.

Tests for Diarrhea

Most diarrhea goes away on its own in a few days. When diarrhea lasts for longer, tests are needed to find out what’s causing it so proper treatment can be administered.

A visit to the doctor for diarrhea will consist of a physical examination and a full medical history, including a review of your medication. A physician will also carefully feel your abdomen and may perform a rectal exam.

Additionally, testing for acute diarrhea may include:

  • Stool Test This might be recommended to determine whether you have a bacteria or a parasite infection. A healthcare professional will give you containers for catching and storing your stool samples, as well as instructions on where to send or take the containers for analysis.
  • Blood Test A complete blood count can show signs of infection, anemia, inflammation, or imbalances of electrolytes, to help determine the cause of your diarrhea.

If diarrhea persists, or if there are worrisome signs like bleeding, your doctor may order other tests, which include:

  • Colonoscopy or Sigmoidoscopy These are both tests involving a lighted tube with a camera. A colonoscopy involves following a special diet the day before the exam, typically with no solid foods and usually not eating or drinking anything after midnight the night before the exam. You will also need to take a laxative in either pill or liquid form or use an enema kit to empty your colon. During the procedure, for which you are sedated, the tube is inserted into the rectum and the camera gives the doctor a view of the inside of the entire colon to check for abnormalities.A sigmoidoscopy is a similar procedure but looks at the rectum and lower portion of the colon only.
  • Hydrogen Breath Test This test is used to diagnose lactose intolerance by measuring the amount of hydrogen in your breath. When someone is lactose intolerant, undigested lactose produces high levels of hydrogen in the breath. The test involves drinking a beverage with a known amount of lactose and then breathing into a balloon-type container to measure breath hydrogen levels. A high level of hydrogen will lead to a diagnosis of lactose intolerance.
  • Fasting Test This will help determine if a food intolerance or allergy is the cause of your diarrhea. Your physician may ask you to avoid certain foods, including dairy, wheat, carbohydrates, or other ingredients in an effort to see if your symptoms of diarrhea respond to those diet changes.

When to See Your Doctor

While occasional bouts of diarrhea are common and not cause for concern, diarrhea can become dangerous if it leads to severe dehydration. It can also signal an infection or a more serious health issue.

Visit your doctor right away if you experience any of the following symptoms:

  • Diarrhea that lasts more than two days
  • Diarrhea accompanied by a fever of 102 degrees F or higher
  • Six or more loose stools in 24 hours
  • Severe, unbearable pain in the abdomen or rectum
  • Bloody stools or stools that are black and tarry or contain pus
  • Diarrhea accompanied by frequent vomiting
  • Signs of dehydration

Infants, toddlers, and young children should be taken to the doctor if they have any of these symptoms or diarrhea lasting more than 24 hours.

Older adults and people with compromised immune systems should also seek medical care if they have diarrhea.

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When is It Time to See a Doctor

Diarrhea is a menace in the form of hard-to-control bowel movements and loose, watery stools three or more times per day—quite the hassle when you’re at work, traveling, or doing everyday activities. Other unpleasant diarrhea symptoms include:

  • An urgent need to use the bathroom
  • Inability to control bowel movements
  • Nausea
  • Stomach pain

But along with being annoying, severe diarrhea can dehydrate the body, leading to further health complications, such as low blood pressure or fainting.
Diarrhea comes in two forms: acute and chronic. The conditions have similar symptoms, but much different implications for patients. Acute diarrhea lasts for less than two weeks and gets better on its own. It’s usually a sign of an infection, food poisoning, lactose intolerance, or gastroenteritis. Chronic diarrhea can last much longer and can be a symptom of a more serious condition, such as ulcerative colitis, Crohn’s disease, celiac disease, or C. difficile infection.
Most acute cases can be managed at home, but severe diarrhea warrants a visit with the doctor. Let’s discuss how to manage diarrhea and the tell-tale signs of when to go see your doctor.

5 ways to overcome diarrhea

1. Stay hydrated

There are over-the-counter oral rehydration solutions sold in pharmacies, but I always suggest to patients an easy way to make it at home. Mix six teaspoons of sugar, one-half teaspoon of salt, and a half-gallon of water in a container and drink it throughout the day. The sugar and salt help your body absorb water better, which keeps you better hydrated.

2. Consider taking zinc supplements

Zinc been shown to reduce the severity and duration of diarrhea, especially in children. This is used more commonly in developing countries, but something to keep in mind if you’re having ongoing acute diarrhea.

3. Eat a healthy diet

I advise my patients to eat a healthy, nutritious diet full of plant-based protein, increased yogurt intake, and additional prebiotic foods. These nutrients can restore the beneficial bacteria that diarrhea causes your body to flush out.

4. Avoid antibiotics

Antibiotics could be used to treat diarrhea, but most times they can do more harm than good. Antibiotics can disrupt the microbiome, or the trillions of bacteria, viruses, and fungi found primarily in a person’s gut, and can cause more long-term symptoms. Plus, they can cause antibiotic-associated diarrhea from irritation or changes to the colon bacteria and even cause an infection with C. difficile. I reserve antibiotic treatment for those patients for whom it’s the only feasible treatment, such as for a proven, serious infection.

5. Consider taking probiotics

If I do prescribe an antibiotic, I typically recommend eating yogurt, which includes Lactobacillus, a natural probiotic that reduces the severity and duration of antibiotic-associated diarrhea. Keep in mind, most probiotic supplements are not FDA regulated, so buying a probiotic and expecting big results could be a shot in the dark. Fermented foods are an excellent source of prebiotics as well and a great addition to your daily food intake. Examples of such foods are sauerkraut, kombucha tea, tempeh (made from fermented soy beans), and miso (a Japanese seasoning made from soybeans fermented with koji, which is a natural fungus.
Prebiotics are foods that feed the good bacteria in our gut. You can find prebiotics in plant-based foods such as dandelion greens, onion, garlic, leeks, and common foods like asparagus, green unripe bananas, oats, and barley.

When to seek treatment

Even when taking preventative measures, there are times, what I call “red flag symptoms,” when a person should visit their doctor, such as when there are:

  • Nocturnal stools or waking up in the middle of the night to have a bowel movement
  • Signs of blood in the stool
  • Symptoms of weight loss, fevers, or night sweats
  • Times when diarrhea occurs even without eating, or on an empty stomach

I remember treating a young woman who had been on antibiotics many times for sinusitis and urinary tract infections, and she was suffering with chronic diarrhea. After tests from her primary care provider showed no obvious conditions, we gave her a breath test and discovered she was suffering from small bowel bacterial overgrowth. After initially treating her with a non-absorbable antibiotic (we had to in order to get rid the overgrowth), we helped the patient improve her diet with more plant-based foods, adding prebiotic foods, and probiotics. Her condition vastly improved in the following months.
For most patients, the first step in diagnosing the cause of chronic diarrhea is a stool study to uncover undiagnosed infections or diseases. The doctor also might conduct lab work to identify any conditions, such as anemia or abnormal liver numbers.
If your doctor identifies any underlying conditions, you might need further testing. For example, an endoscopy may be necessary so we can take biopsies of the small bowel. Sometimes, a colonoscopy may be necessary if there’s blood in the stool or ongoing nocturnal stools, as it could show inflammatory bowel disease or microscopic colitis.
Diarrhea can make everyday activities a hassle, but it also can signify a more serious condition. If you’re suffering from severe or chronic diarrhea, see your doctor for help right away.

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