Irritable Bowel Syndrome (IBS) Quiz

Q.

Bloody diarrhea—when is this an “ER now” problem?

A.

Go to the ER now if you have heavy or frequent bleeding or clots, severe abdominal pain, fever of 101 F or higher, signs of dehydration, dizziness or fainting, confusion, a rapid heartbeat or low blood pressure, you are pregnant or immunocompromised, have major conditions like heart, kidney, or liver disease, or you have a sudden severe IBD flare. If symptoms are mild, with fewer than 3 bloody stools a day, no or low grade fever, and you can drink and urinate, you can monitor closely, hydrate, and see a doctor within 24 to 48 hours. There are several factors to consider, and key causes, red flags, safe home care, and what to expect in the ER are explained below.

Q.

Can’t stop pooping: when does this become a red-flag symptom doctors take seriously?

A.

Doctors take persistent diarrhea seriously when key red flags are present: blood or pus, high fever, severe abdominal pain, signs of dehydration, unintentional weight loss, symptoms lasting more than 48 hours, recent antibiotics or travel, older age, or immunocompromise; see below for the full list and what to do next. These signs may point to infections like C. difficile, inflammatory bowel disease, malabsorption, or dangerous complications such as severe dehydration or acute kidney injury, so seek urgent care if any occur. There are several factors to consider, and the detailed guidance below explains self-care, when to see a doctor, and the tests doctors use.

Q.

Chronic diarrhea—what if your gut is inflamed, not “sensitive”?

A.

There are several factors to consider. Chronic diarrhea lasting 4 or more weeks can reflect true gut inflammation rather than a sensitive gut, often from inflammatory bowel disease, microscopic colitis, or bile acid malabsorption; see below for specifics that could change your next steps. Red flags and tests that help distinguish causes include blood in stool, weight loss, anemia or fever, fecal calprotectin or lactoferrin and, if elevated, colonoscopy with biopsies, with treatments that differ from IBS such as anti-inflammatory drugs, bile acid binders and targeted nutrition; find the full checklist and when to seek urgent care below.

Q.

Diarrhea for weeks: what causes persist past a virus, and what should you test?

A.

When diarrhea lasts weeks, look beyond a virus: common causes include postinfectious IBS, inflammatory or microscopic colitis, malabsorption such as celiac, pancreatic insufficiency or bile acid diarrhea, chronic infections or parasites, medication effects including C. difficile, endocrine issues like hyperthyroidism or diabetic neuropathy, and liver disease; there are several factors to consider, and key nuances that can change your next steps are outlined below. Useful tests include blood work for anemia, inflammation, electrolytes, liver and thyroid function; stool studies for culture, ova and parasites, C. difficile, fecal calprotectin and fat or elastase; celiac antibodies and breath tests for lactose or SIBO; and, when indicated, colonoscopy with biopsies or imaging. Seek prompt care for red flags like bleeding, fever, severe pain, dehydration or weight loss, and see below for full details and step-by-step guidance.

Q.

Diarrhea with mucus: what does mucus suggest about inflammation in the gut?

A.

Mucus in diarrhea usually signals irritation or inflammation of the colon lining, as goblet cells ramp up mucin to protect an inflamed gut; mucus with blood, fever, or severe abdominal pain is more suggestive of an inflammatory or invasive process than a simple viral upset. There are several factors to consider, and mucus can also occur in IBS without true inflammation; see below for key causes, red flags that warrant medical care, and the diagnostic and treatment options that could shape your next steps.

Q.

Fatigue and diarrhea—what if your tiredness is coming from your gut?

A.

Fatigue with diarrhea often points to a gut cause, driven by inflammation, nutrient and fluid losses, or microbiome imbalance, with common culprits including IBD, bile acid diarrhea, infections, liver disease, and malabsorption issues like celiac disease or SIBO. There are several factors to consider, including urgent red flags, the tests doctors use, and proven treatments from medications and diet to supplements, probiotics, and self care; see below for the details that can shape your next steps.

Q.

Fecal calprotectin—could one stool test end months of guessing?

A.

A fecal calprotectin stool test can rapidly indicate whether gut symptoms are due to intestinal inflammation, helping tell IBD from IBS and sometimes sparing you an immediate colonoscopy. Low values make significant inflammation unlikely, while higher results point to active inflammation and the need for further evaluation. There are several factors to consider, including infections, medicines like NSAIDs, and how to act on borderline results. See complete details below, including result ranges, when to repeat testing, red flags that need urgent care, and how this test fits into your next steps.

Q.

If diarrhea wakes you up at night, what are you supposed to suspect?

A.

Nighttime diarrhea usually points to an organic cause rather than typical daytime IBS; key suspects include infections, inflammatory bowel disease, malabsorption such as celiac or bile acid diarrhea, hormonal issues like hyperthyroidism, medication effects, and complications of advanced liver disease. There are several factors to consider, and red flags like blood in the stool, fever, weight loss, severe abdominal pain, dehydration, or jaundice need prompt care; see below for the full list of causes, alarm signs, and how doctors evaluate and treat this.

Q.

Lower abdominal pain and diarrhea—why do the location details matter so much?

A.

Where your lower abdominal pain sits with diarrhea is a key clue that narrows causes and directs testing, for example right-sided pain pointing toward appendicitis or Crohn's, left-sided toward diverticulitis or ulcerative colitis, and midline toward bladder, uterus, or small bowel issues. There are several factors to consider. See below for the full list of causes, red flags that require urgent care, how diarrhea changes the picture, and the tests and treatments that can guide your next steps.

Q.

Rectal bleeding: what symptoms make it more likely inflammation vs a tear?

A.

There are several factors to consider. Diarrhea, urgency or tenesmus, cramping, mucus or pus, and systemic signs like fever, fatigue, or weight loss suggest inflammation, whereas small amounts of bright red blood on the paper or stool surface with sharp, well localized pain during or after a bowel movement, often after constipation, suggest an anal tear. See below for key red flags that need urgent care such as heavy bleeding, dizziness or fainting, black tarry stools, severe abdominal pain, or high fever, plus evaluation steps and treatments that can guide your next steps.

Q.

Right lower abdominal pain and diarrhea: what diagnoses are usually considered first?

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First-line diagnoses include acute appendicitis, infectious ileocolitis (Yersinia, Salmonella, Campylobacter, C. difficile, parasites), and Crohn’s disease of the terminal ileum. Depending on age and risk factors, clinicians also consider mesenteric adenitis, IBS, NSAID enteropathy, and less commonly Meckel’s diverticulitis, ileocecal tuberculosis, ischemia, or tumors; important red flags and next tests are outlined below.

Q.

Sensation of incomplete evacuation: what does this symptom mean clinically?

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Clinically, the sensation of incomplete evacuation is the feeling that stool remains after a bowel movement even when the rectum is empty, most often tied to functional anorectal disorders like dyssynergic defecation or IBS-C, though structural issues such as rectocele or rectal prolapse can also play a role. There are several factors to consider, and appropriate next steps often include a focused history and exam, possible anorectal testing, and first-line care with fiber, hydration, pelvic floor physical therapy, and cautious use of laxatives, with urgent evaluation for red flags like bleeding, weight loss, or severe pain. See below to understand more.

Q.

Urgent diarrhea: what does urgency suggest about the colon and rectum?

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Urgent diarrhea usually points to involvement of the distal colon and rectum, where inflammation or irritation reduces storage capacity, speeds transit, and makes the rectum hypersensitive with poor compliance. This leads to rapid, loose stools, tenesmus, and a strong need to pass small amounts of stool or mucus. There are several factors to consider, including infectious colitis, inflammatory bowel disease, IBS-D, radiation or ischemic injury, and medication effects, along with red flags that may require urgent care; see below to understand more.

Q.

Urgent need to poop: what symptoms point to inflammatory bowel disease?

A.

Persistent urgent diarrhea, especially at night, with blood or mucus, abdominal cramping, tenesmus, unexplained weight loss, and fatigue suggests inflammatory bowel disease rather than IBS; extra clues outside the gut include joint pain or swelling, skin rashes, and eye inflammation. There are several factors to consider; see below for the key differences from IBS and the specific tests and red flags that guide next steps, including fecal calprotectin, blood work for inflammation and anemia, colonoscopy with biopsy, and imaging.