When you’ve taken up permanent residency on your toilet thanks to diarrhea, you might start to wonder how normal your poop explosion really is. Sure, everyone has diarrhea from time to time, but when does it actually become a sign that you should see a doctor? Here, we consulted experts for the signals it’s time to seek treatment for diarrhea, plus what could be behind your butt’s excellent (and unfortunate) volcano impersonation.
Here’s exactly why diarrhea happens, first of all.
By definition, diarrhea means having loose, watery, stools that are more frequent than whatever amount of pooping is normal for you, the Mayo Clinic says.
Quick biology lesson: When the stuff you eat reaches your small intestine where a lot of your digestion takes place, it’s usually in liquid form, Kyle Staller, M.D., a gastroenterologist at Massachusetts General Hospital, tells SELF. Your small intestine and colon (which is the longest part of your long intestine) absorb most of the fluid, transforming that matter into the solid-ish poop you see in your toilet. But when you have diarrhea, something has interfered with your small intestine or colon’s ability to soak up that liquid, so you end up with the runny, watery poop that you know as diarrhea, Dr. Staller explains.
The general rule is that if you have diarrhea for up to two days with no other symptoms, then it disappears, you can skip going to the doctor’s office.
Why’s that? Well, having diarrhea for a couple of days is just something that happens sometimes.
You can generally lump diarrhea into two categories: acute and chronic. Acute diarrhea can last anywhere from a few days to two weeks and is usually due to a bacterial, viral, or parasitic infection, according to the Mayo Clinic. Sometimes that infection passes in a matter of days and is really nothing to worry about. That’s why if you have acute diarrhea that only lasts for a couple of days, you don’t have any weird symptoms along with it (we’ll get to what those symptoms are in a sec), and then it goes away, you should be fine to just stock up on toilet paper and roll with it, Ashkan Farhadi, M.D., a gastroenterologist at MemorialCare Orange Coast Medical Center and director of MemorialCare Medical Group’s Digestive Disease Project in Fountain Valley, California, tells SELF.
Chronic diarrhea, on the other hand, lasts for longer than four weeks at a minimum. That can point to serious issues like the inflammatory bowel diseases ulcerative colitis (a condition that causes inflammation and sores in your large intestine and rectum) and Crohn’s disease (another illness that causes inflammation in your digestive tract, but typically in your small intestine and colon), or irritable bowel syndrome, a chronic intestinal disorder that also affects your colon.
Sometimes there are major red flags that you need to see a doctor to treat your diarrhea.
Here are signs you should, at the very least, give your doctor’s office a call for guidance:
1. You’ve had diarrhea for two days and it hasn’t improved or is actually getting worse.
If your diarrhea is still terrible after at least two days, it could be a sign that you have an infection that’s sticking around, Dr. Farhadi says. While a viral infection will just have to run its course (sorry, pal), you may need antibiotics to clear up a bacterial or parasitic infection, the Mayo Clinic says.
Having persistent diarrhea could also be a sign that a medication you’re on is upsetting your stomach or that something you’ve started eating regularly isn’t sitting well with you, Dr. Staller says. And, of course, long-lasting diarrhea could be a sign of one of the aforementioned conditions, like ulcerative colitis, Crohn’s disease, or irritable bowel syndrome, although you’ll typically have other symptoms as well, which we’ll cover further down the list.
2. You’re experiencing signs of dehydration.
Diarrhea can cause dehydration because you’re losing so much liquid. In severe cases, dehydration can be life-threatening if it’s not treated, according to the Mayo Clinic. But even if you don’t pass that threshold, being dehydrated feels awful and can be treated.
The biggest signs of dehydration to look out for: You’re incredibly thirsty, your skin and mouth are dry, you’re not peeing much or at all (plus your urine is a dark yellow color when you do actually pee), and you feel weak, dizzy, faint, or fatigued. If you have any of these signs along with your diarrhea, get to the emergency room, Dr. Farhadi says. You may need IV fluids to replace what you’ve lost.
3. You’ve recently developed mouth sores.
When this happens along with diarrhea, doctors generally think of Crohn’s disease, Dr. Staller says. In addition to causing diarrhea, the inflammation that comes with Crohn's can create sores in your digestive tissue. “Crohn’s disease can affect anywhere in the GI tract, from the mouth down to the anus,” he explains. This is as opposed to ulcerative colitis, which is limited to your large intestine and rectum.
This can also be a sign of celiac disease, a condition in which eating gluten leads to an immune response in your small intestine, according to the Mayo Clinic. You might be tempted to chalk up your mouth pain to something like a canker sore, but if you’re also dealing with diarrhea, you should see your doctor to make sure something larger isn’t going on.
4. You have severe stomach or rectal pain.
Severe stomach pain with diarrhea can signal many issues, from something as simple as gas to a potentially life-threatening condition like appendicitis, Christine Lee, M.D., a gastroenterologist at the Cleveland Clinic, tells SELF.
This could also be a sign of a more chronic condition like IBS-D (irritable bowel syndrome where diarrhea is the main symptom) or, again, Crohn’s disease or ulcerative colitis, Dr. Staller says. “Any diarrheal disease can cause pain,” he says, because diarrhea inflames and irritates the area. “The rectum has very sensitive nerves,” he adds.
Unless you happen to be a gastroenterologist, it’s going to be really hard for you to tell what’s behind this pain + diarrhea equation on your own. If you’re experiencing diarrhea and a lot of pain, a visit to the doctor is in order.
5. There’s pus in your diarrhea.
Pus is a yellow-ish, mucus-y liquid your body produces when trying to fight infection, Dr. Staller says. “It’s a marker of inflammation,” he explains, adding that the inflammation is part of your body’s immune response to whatever it has deemed a threat.
Diarrhea that contains pus is a common sign of ulcerative colitis, according to the Mayo Clinic. Those sores it creates in your gastrointestinal tract can lead to pus that comes out in your poop.
6. Your diarrhea is bloody or black.
Blood in your poop could hint at a range of things. You could have a hemorrhoid (a clump of bulging veins in your rectum or around your anus), Dr. Lee says, but that typically causes only a bit of blood, not the kind that might set off alarm bells. It can also be a sign of a foodborne illness, the Mayo Clinic says. (For instance, Campylobacter bacteria is notorious for causing this, according to the Centers for Disease Control and Prevention.)
But, like with many other items on this list, this could be a sign that you have a chronic condition like ulcerative colitis or Crohn’s disease. When you have these conditions, your immune system may attack your GI tract to the point that it bleeds, Dr. Staller says. Either way, if a good portion of your poop is bloody or black (which hints at blood that has oxidized, so bleeding may be coming from higher up in your GI tract), you need to see a doctor right away, Dr. Farhadi says.
7. You have a fever of more than 102 degrees Fahrenheit.
This generally indicates that you have some kind of infection that’s compromising your system, Dr. Lee says, although a fever can also be your body’s response to the inflammation that comes along with conditions like ulcerative colitis and Crohn’s disease. “Any time there is a fever and diarrhea, you should have your guard up,” Dr. Staller says. And, as you might guess, you should see your doctor.
In the meantime, you can try taking an over-the-counter fever reducer, but be sure to follow the instructions, since drugs like acetaminophen and ibuprofen can cause liver or kidney damage if you take too much, according to the Mayo Clinic.
8. You’re losing a lot of weight.
Sure, if you’re pooping your brains out, you’re probably going to lose a little weight because of all those fluids whooshing out of you. But if your diarrhea won’t stop and you lose a few pounds (on top of your normal fluctuations) in a few days, it could be a sign that you’re dealing with an issue like a severe infection, inflammatory bowel disease, or celiac disease, Dr. Lee says. Either way, you want to make sure your doctor looks into it so they can address the root cause of your unintended weight loss.
Your doctor’s next steps in diagnosing what’s behind your diarrhea will depend on your mix of symptoms.
They’ll likely do a blood test, stool test (where they try to figure out if a bacteria or parasite is causing your diarrhea), or colonoscopy or flexible sigmoidoscopy, procedures that look at the lining of your colon using a thin, lighted tube with a lens, according to the Mayo Clinic. After that, they can prescribe treatment.
If you’re dealing with diarrhea and you’re not sure what to make of it, call your doctor anyway, even if you don’t have the other symptoms on this list. “No one knows your body better than you, so trust your instincts,” Dr. Lee says. “If something doesn’t feel right, then get it checked out.”