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Diarrhea (cont.)

Diarrhea Symptoms

  • Watery, liquid stools: The stools may be any color. The passage of red stools suggests intestinal bleeding and could be a sign of a more severe infection. The passage of thick, tarry black stools suggests significant bleeding in the stomach or upper portions of the intestine and is not usually caused by acute infections. The diarrhea may appear green in color, because stool passes through the intestines faster than usual.
  • Abdominal cramps: Occasionally diarrhea is accompanied with mild-to-moderate abdominal pain. Severe abdominal or stomach pain is not common and, if present, may suggest more severe disease.
  • Fever: A high fever is not common. If present, the affected person may have a more severe illness than acute diarrhea.
  • Bloating and gas
  • The urgent feeling or need to have a bowel movement
  • Dehydration: If diarrhea leads to dehydration, it is a sign of potentially serious disease.
  • Signs and symptoms of dehydration include:
    • Adults may be very thirsty and have a dry mouth.
    • The skin of older people may appear to be loose. The elderly may also become very sleepy or have behavioral changes and confusion when dehydrated.
    • Dehydrated infants and children may have sunken eyes, dry mouths, and urinate less frequently than usual. They may appear very sleepy or may refuse to eat or drink.

When to Seek Medical Care for Diarrhea

Diarrhea can usually be treated with home care. In some cases, it may become more severe. A person should go to a hospital emergency department in the following situations:

  • if the person has diarrhea along with high fever, moderate-to-severe abdominal pain, or dehydration that cannot be managed by drinking fluids;
  • if the diarrhea appears to contain blood (it may be bright red or may look like black, thick tar); or
  • if the person is sleepy and is not acting like their usual selves (others may notice this and take the person to the emergency department).

Call a doctor if a person has any of these complications:

  • vomiting and inability to tolerate any food or drink;
  • signs of dehydration;
  • high fever, significant abdominal pain, frequent loose bowel movements, or bloody diarrhea;
  • if he or she is elderly or has serious underlying medical problems, particularly diabetes, heart, kidney, or liver disease, or HIV/AIDS (contact a doctor when diarrhea first begins as the person may be at higher risk for developing complications);
  • a parent or caregiver needs advice about preventing dehydration in newborns and infants;
  • symptoms do not improve in two to three days or appear to become worse; or
  • if he or she develops diarrhea after travel within their home country, or foreign travel; or if a woman is pregnant.

Diarrhea Diagnosis

In healthy people with diarrhea, and who appear well otherwise, the health-care professional may elect to do no tests at all. Stool cultures (when a sample of the stool is taken and examined in the lab for certain bacteria or parasites) are not usually necessary unless there is high fever, blood in the stool, recent travel, or prolonged disease.

  • In some cases, the health-care professional may send a sample of the stool (or sometimes a cotton swab from the patient's rectum) to the laboratory to evaluate if the cause of diarrhea can be determined (such as certain bacteria or parasites present in the body). It usually takes approximately one to two days for the results of these tests.
  • Blood tests are sometimes necessary for patients with other medical problems or with severe disease.
  • A colonoscopy is an endoscope procedure that allows the physician to view the entire colon to evaluate for infections or structural abnormalities that could cause diarrhea.
  • Imaging tests such as X-rays or CT scans are performed to rule out structural abnormalities as the cause of diarrhea, particularly when pain is a prominent symptom.
Medically Reviewed by a Doctor on 8/5/2015
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Diarrhea »

Acute diarrhea is defined as the abrupt onset of abnormally high fluid content in the stool (more than the normal value of approximately 10 mL/kg/d).

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