This post was written by Kaely Bade, MD, PPG – Gastroenterology.

We’ve all experienced diarrhea at one time or another. The kids may have brought a bug home from school, or you may have eaten some questionable pasta salad at the family reunion. Either way, most cases tend to resolve in a few days. In some instances, however, what starts as a minor episode can drag into weeks or months, affecting your ability to work, go to school or have a social life. For this reason, and because diarrhea can be so variable, it’s important to know what is normal and when to seek help.

Defining diarrhea

Diarrhea occurs when your bowel movements change from a formed, solid consistency to a loose or watery texture and may increase frequency. The most common causes of diarrhea are infectious and usually due to a virus, bacteria or bacterial toxin. Most cases caused by infection are self-limited, meaning they will go away or resolve independently. However, lactose intolerance, celiac disease, and, in some cases, medications can cause short bouts or long-lasting diarrhea. So, even if diarrhea occurs sporadically, as in irritable bowel syndrome (IBS), you should consider speaking to your primary care provider.

Treatment

The treatment for diarrhea is usually time and supportive care that includes staying hydrated and ensuring you’re getting enough electrolytes and sugar. It’s rare for diarrhea to become severe enough to cause significant dehydration, but you may need to visit the emergency department if it does happen. They will likely replenish your fluids through an IV. The very young and very old tend to be most at risk for severe dehydration. In these populations, it may be helpful to prescribe antibiotics. But, for a healthy individual, this isn’t usually necessary, and, in some instances, they could even make things worse.

When to see a doctor

Diarrhea that lasts longer than a month is never normal and needs evaluation. Additionally, blood in your stool, unintentional or unexplained weight loss, waking from sleep to have a bowel movement, or episodes of incontinence are all symptoms of concern and should prompt further examination.

Many tests can help evaluate the condition, including blood work and stool sample analysis. However, a gastroenterologist referral may be necessary if the cause remains unknown after initial testing. They may even need to perform a colonoscopy to help pinpoint any gastrointestinal issues such as inflammatory bowel disease, Crohn's disease or ulcerative colitis.

Furthermore, nearly all evaluations can occur as outpatient procedures when dealing with chronic diarrhea. Yet, if symptoms such as decreased urination, severe abdominal pain, or passing a large amount of blood/clots develop, you should seek immediate medical attention.

Final thoughts

With a common illness like diarrhea, it’s good to know that most cases are mild and typically resolve quickly without any special treatment. However, it’s also vital to know when to escalate care. And at the end of the day, if you have any concerns, please speak with your primary care provider.