When To Seek Care for Diarrhea (and Where To Go)

When you’re laid low with diarrhea, the last thing you want to do is have a conversation about it — with a healthcare provider or anyone else. But sometimes it can’t be avoided.

Family medicine specialist Neha Vyas, MD, explains when to see a doctor for diarrhea and when it counts as an emergency.

When diarrhea is a concern

Diarrhea can be extremely uncomfortable, but you only need to seek medical help if:

• It lasts for more than a day or two (or more than 24 hours for young children)
• You’re showing signs of dehydration, like dry mouth, dizziness and peeing less (or less often) than usual.
• It’s accompanied by a fever, vomiting, severe abdominal pain or bloating
• Your poop is black, tarry, bloody or contains pus.

Who is at high risk for diarrhea complications?

You may also want to reach out to a provider if you or a loved one is at high risk of complications from a severe bout of diarrhea. That includes:

• People over 65 years old: “As we get older, we become more susceptible to dehydration, which makes severe diarrhea riskier,” Dr. Vyas explains.
• Young children with diarrhea: Babies and young children can lose fluids extremely fast. Call their pediatrician if their diarrhea is severe, lasts more than a couple days and/or comes with other symptoms or behavioral changes.
• Pregnant women: When you’re expecting, it’s important to stay hydrated. Reach out if you’re showing signs of dehydration or think you may be dealing with an infection.
• People with weakened immune systems: “Your provider will want to figure out what’s causing your diarrhea,” Dr. Vyas says. “If you have an infection, your body may need a little extra help fighting it off.”
• Those living with certain chronic illnesses: Conditions like heart disease, kidney disease, diabetes and irritable bowel disease (IBD) need to be monitored closely if you’re experiencing persistent diarrhea.

Where to go for care

You can probably get by with a telehealth appointment for diarrhea if you:

• Have been sick for more than two days, but your symptoms are otherwise mild
• Are in a high-risk group and want guidance in case your symptoms get worse
• Have questions about over-the-counter (OTC) medications

Try to get an in-person appointment with your primary care provider (PCP) if you:

• Have moderate symptoms and aren’t getting relief with OTC medications and home remedies
• Need to be tested, and potentially get antibiotics, for a specific type of infection, like C. diff or cyclosporiasis
• Might be dehydrated

If you need same-day treatment for severe symptoms and can’t get in to see your PCP, go to an express care or urgent care center.

Diarrhea is an emergency if you:

• Have a high fever and feel very ill
• Have symptoms of severe dehydration, like fainting, extreme weakness or difficulty peeing
• See blood or pus in your diarrhea or notice that it has a black, tarry appearance
• Are experiencing severe abdominal pain, swelling, rigidity or bloating
• Have symptoms of sepsis, like a rapid heartbeat, low blood pressure and confusion
• Have a serious health condition, and your symptoms are getting worse

Severe diarrhea is also an emergency for very young infants.

“In any of these situations, you should call emergency services or have someone take you to the nearest emergency room (ER) right away,” Dr. Vyas stresses. “Don’t drive yourself.”

Tips for managing at home

Sure, there are times when a doctor needs to be involved. But what if you’re dealing with a standard bout of diarrhea? Here’s what to do when your gastrointestinal situation doesn’t merit medical attention.

• Focus on rehydration. Water, clear broth and mild electrolyte drinks are good options. Avoid soda, tea, juice and sweetened beverages.
• Stick to bland foods. The BRAT diet (bananas, rice, applesauce and toast) is easy on your stomach when you’re weathering short-term GI issues.
• Avoid foods that can make diarrhea worse. Greasy, fatty, sugary and spicy foods are a no-go when you’ve got a crummy tummy. Ditto for alcohol and caffeine.
• Find out if OTC antidiarrheal meds are safe for you. Talk to your provider first if you have severe symptoms, chronic medical concerns or are pregnant, immunocompromised or giving them to a small child.
• Sooth irritated skin. Get relief from the “ring of fire” by wiping gently, wearing loose-fitting cotton underwear, taking sitz baths, and using diaper rash cream or petrolatum jelly to protect your skin.
• Wash your hands. It’s always important to wash your hands, especially after using the bathroom. But it’s extra important if diarrhea could be the result of an infection. The last thing you want to do is spread it to anyone else.
• Stay out of the water. “Stay out of swimming pools, lakes, hot tubs and recreational water areas when you have diarrhea for at least two weeks after it ends,” Dr. Vyas urges. “This helps prevent spreading an infection to other people.”
• Rest up. Now is not the time to do an ambitious workout or stay up late. Give your body the time and TLC it needs to recover.

Chances are, this episode will pass with little more than rest and fluids to help it along. But if you have questions or something seems off, pick up the phone. With diarrhea, it’s always better to be safe than sorry.