Gastroenterology

Persistent diarrhea lasting more than four weeks is rarely just something you ate; it often points to infections, inflammatory bowel disease or IBS, malabsorption such as celiac or pancreatic insufficiency, medication side effects, endocrine disorders, or bile acid issues after surgery. There are several factors to consider that could change your next steps, including red flags like fever, blood or mucus in stool, dehydration, weight loss, or severe pain, and how doctors diagnose and treat the cause; see below for complete details.

Diarrhea that wakes you from sleep is more likely from an organic condition than a functional one, commonly inflammatory bowel disease, infections, malabsorption (celiac, pancreatic insufficiency, SIBO), endocrine causes like hyperthyroidism, medication side effects, or complications of liver disease; IBS-D can do this but less often. There are several factors to consider; seek urgent care for dehydration, high fever, blood or black stools, severe abdominal pain, significant weight loss, or diarrhea lasting over 48 hours, and see below for the full warning signs, diagnostic tests, and treatments that could guide your next steps.

Visible mucus in diarrhea signals irritation of the colon and worries clinicians because it often points to infection or inflammation, including serious bacterial colitis or C. difficile, risk of dehydration, or a chronic condition like inflammatory bowel disease. Seek prompt care for red flags like fever, blood, significant abdominal pain, dehydration, recent antibiotics, or symptoms beyond 2 days; tests, home care, cirrhosis-specific risks, and when to see a specialist are detailed below.

Fatigue with diarrhea points to anemia or chronic inflammation when diarrhea lasts more than four weeks, fatigue does not improve with rest, or there are red flags like blood or mucus in the stool, unexplained weight loss, low-grade fevers or night sweats, joint pains or rashes, signs of nutrient deficiency such as pallor or hair loss, or a family history of IBD or celiac disease. There are several factors to consider. See below for the full list of warning signs, related conditions like IBD, celiac, or chronic liver disease, and the key next steps including CBC, iron studies, inflammatory markers, stool tests for gut inflammation, imaging or endoscopy, and when to seek urgent care.

A persistent feeling of not being finished after a bowel movement, called incomplete evacuation or tenesmus, is common and often due to treatable causes like pelvic floor dyssynergia, IBS, hemorrhoids, structural narrowing, medications, or inflammation; seek prompt care for bleeding, unintended weight loss, severe pain, anemia, pencil-thin stools, or new onset after age 50. There are several factors to consider, and the details below can change your next steps; see below for practical fixes and evaluations from fiber, fluids, and routine to pelvic floor biofeedback, targeted laxatives, and procedures, plus special guidance for cirrhosis and when to use a symptom check or ask for specialized testing.

Normal bowel frequency ranges from three times per week to three times per day; going more than three times daily is most concerning when paired with loose watery stools, urgency, blood or black stools, unintended weight loss, severe pain, waking at night to go, dehydration, or fever. There are several factors to consider besides frequency, including stool consistency, volume, color, odor, ease of passage, and potential causes like infections, IBS-D, malabsorption, medications, thyroid problems, and liver treatments such as lactulose. See below for key details, red flags, and practical next steps that could influence when and how you seek care.

Joint pain with diarrhea can suggest IBD when inflammatory patterns are present; red flags include diarrhea over four weeks, blood or weight loss, fever or night sweats, morning stiffness, migratory large-joint pain or inflammatory low back pain under 45, enthesitis, skin rashes, eye inflammation, or a family history of IBD or related conditions. Evaluation may include CRP/ESR, fecal calprotectin, targeted imaging, and colonoscopy, with treatment aimed at controlling gut inflammation and careful use of pain medicines; there are several factors to consider, and important details that can affect your next steps are outlined below.

There are several factors to consider: low iron with diarrhea often points to a gut problem such as celiac disease, inflammatory bowel disease, infections, small intestinal bacterial overgrowth, medication injury, or advanced liver disease. See below to understand more. If diarrhea lasts longer than 2 to 4 weeks, iron does not improve with supplements, or there is weight loss or blood in the stool, ask about targeted blood and stool tests and possible endoscopy so the cause can be treated while iron is replaced, and review urgent warning signs and next steps outlined below.

Location and pattern matter: right lower quadrant pain often suggests Crohn’s ileitis or sometimes appendicitis, left lower quadrant points toward diverticulitis or ulcerative colitis, suprapubic pain can indicate UTI or proctitis, and periumbilical pain aligns with gastroenteritis or, if severe and out of proportion, possible ischemia. Patterns that refine the cause include duration (acute vs persistent vs chronic), stool features (blood or mucus suggests colitis, large-volume watery suggests secretory), nocturnal stools and weight loss as red flags, and context like recent antibiotics or liver disease; there are several factors to consider, and the detailed guidance on what these mean and when to seek care is below.

There are several factors to consider; small amounts can be normal, but more or discolored mucus can signal IBS, infections, inflammatory bowel disease, hemorrhoids or fissures, food intolerances, or even complications of advanced liver disease. Watch for red flags like blood or black stool, fever, persistent diarrhea, weight loss, dehydration, or worsening pain and seek care promptly; tests, treatments, and self-care steps you can take are detailed below.

Small, occasional, clear mucus without pain, blood, fever, or bowel habit changes is usually normal, but mucus that is thick or abundant, lasts more than a week, or comes with blood, pus, urgency, cramps, fever, fatigue, or weight loss can signal colitis. There are several factors to consider. See below for important details on the types of colitis, the exact red flags that need urgent care, and what diagnosis and treatment steps to expect.

Waking up at night to have diarrhea is a red-flag because the gut normally quiets during sleep; when that rhythm is disrupted, it often points to an organic cause such as inflammatory bowel disease, infection, malabsorption, medication effects, or certain systemic conditions rather than IBS. There are several factors to consider, including red flags like blood or black stools, weight loss, fever, severe pain, dehydration, and episodes that persist beyond a week or recur more than once or twice a month. See below for the full list of causes, tests your doctor may use, and treatment options that could change your next steps.

There are several factors to consider: fissures cause sharp, tearing pain during and after bowel movements with scant bright red blood and sometimes a visible crack, hemorrhoids typically cause painless bleeding unless an external clot triggers sudden severe pain and swelling with itch, and proctitis brings a constant ache with urgency, mucus, and sometimes fever. See below for the complete answer, including red flags that need urgent care, how each is diagnosed, and specific home care and treatment options that can guide your next steps.

There are several factors to consider: overlapping symptoms, familiarity and stigma, and the short-term relief of over-the-counter treatments lead many people to self-diagnose rectal pain as hemorrhoids. Yet fissures, abscesses, infections or proctitis, pelvic floor spasm, rectal prolapse, inflammatory disease, liver-related varices, and even cancer can mimic hemorrhoids, with red flags like severe pain, fever, persistent bleeding, discharge, bowel changes, weight loss, or anemia that warrant prompt care; see complete details and next steps below.

Typical early symptoms include frequent, urgent diarrhea with blood or mucus, lower abdominal cramping with tenesmus, mild fatigue or low-grade fever, and sometimes unintended weight loss. Often missed are small intermittent rectal bleeding, subtle but persistent changes in bowel habits or nighttime urgency, signs of iron-deficiency anemia, and extra-intestinal issues such as joint pain, skin or eye inflammation, or recurrent mouth sores. There are several factors to consider that could affect your next steps; see below to understand more.

There are several causes beyond stress to consider, including IBS or functional diarrhea, infections, inflammatory bowel disease, bile acid diarrhea, small intestinal bacterial overgrowth, thyroid disease, medications, and post-infection or surgery changes. Because red flags such as blood or black stool, severe abdominal pain, fever, weight loss, dehydration, or new onset after age 50 require prompt medical care, and testing and treatments differ by cause, see the complete guidance below for the key evaluations, targeted therapies, and special situations like cirrhosis that can change your next steps.

Bowel urgency feels like an emergency when gut nerves are hypersensitive, stool moves too fast, or the rectum is less stretchy, and anxiety can amplify these signals; common causes include IBS, infections, inflammatory bowel disease, malabsorption, bile acid problems after gallbladder removal, medication or food triggers, and pelvic floor dysfunction. There are several factors to consider. See below to understand more, including red flags that need prompt care, practical diet and pelvic floor strategies, and when testing and targeted treatments may be appropriate.

Bright red blood in stool usually comes from the lower GI tract colon to anus, commonly hemorrhoids or anal fissures, but it can also be from diverticular bleeding, inflammatory bowel disease, colonic polyps or cancer, and occasionally brisk upper GI bleeding. There are several factors to consider. Seek urgent care for heavy or ongoing bleeding, clots, lightheadedness or fainting, severe abdominal pain or fever, or if you are over 50 or have risks like liver disease, IBD, a family history of colorectal cancer, or blood thinner use; even mild but persistent bleeding deserves a medical visit. See below to understand more, including self care, testing, and when to see a specialist.

Chronic diarrhea means loose or frequent stools lasting 4 weeks or more; beyond this timeframe it is considered too long and merits medical evaluation. Standard workup begins with history and exam plus basic labs and stool tests such as CBC, metabolic panel, inflammatory markers, celiac serology, calprotectin, C. difficile, and ova and parasites, with colonoscopy, imaging, and specialized tests guided by findings and red flags like bleeding, weight loss, fever, nocturnal symptoms, or dehydration. There are several factors to consider that can change next steps and treatment; see below for a concise, stepwise checklist and when to seek urgent care.

Most common Crohn’s symptoms are chronic diarrhea and abdominal pain or cramping, often with urgency, blood or mucus in stool, reduced appetite and unintended weight loss; fatigue, anemia and joint, skin or eye symptoms can also occur. Seek prompt evaluation for diarrhea lasting more than two weeks, recurrent or severe pain, blood in stool, fever, significant weight loss, dehydration, or new perianal pain or drainage, and urgent care for severe unrelenting pain, massive bleeding or high fever with chills. There are several factors to consider. See below for key details that can affect next steps, including extra symptoms, risk groups and how diagnosis and treatment are tailored.