Urgent Need to Poop: Could It Be Inflammatory Bowel Disease?

Feeling an urgent, uncontrollable need to poop can be alarming. While occasional urgency often stems from diet, infection, or stress, persistent or severe urgency may signal inflammatory bowel disease (IBD)—including Crohn’s disease and ulcerative colitis. Recognizing key symptoms early can help you get the right diagnosis and treatment.

What Is Inflammatory Bowel Disease (IBD)?

• IBD is a chronic condition marked by inflammation in parts of the digestive tract.
• Ulcerative colitis affects the colon and rectum; Crohn’s disease can occur anywhere from mouth to anus.
• Inflammation can lead to ulcers, bleeding, and scarring, causing a range of digestive and systemic symptoms.

Red-Flag GI Symptoms

Not every bout of urgency means IBD. Watch for these persistent or severe signs:

• Frequent urgent diarrhea
  • Need to rush to the toilet more than three times a day
  • Especially troubling if it awakens you at night
• Blood or mucus in stool
  • Bright red blood or darker tar-like stools
  • Slimy mucus mixed with bowel movements
• Abdominal pain and cramping
  • Often relieved temporarily by passing stool
  • Pain may be deep, colicky, or constant
• Tenesmus (feeling of incomplete evacuation)
  • Despite urgent trips, you still feel you haven’t fully emptied
• Unexplained weight loss
  • Loss of appetite or avoiding meals for fear of urgency
  • Losing more than 5% of body weight in a few months

Extraintestinal (“Outside the Gut”) Clues

IBD can affect more than your bowels. Noticeable signs elsewhere include:

• Joint pain or swelling
• Skin changes
  • Red, tender bumps (erythema nodosum)
  • Patches of irritated skin (pyoderma gangrenosum)
• Eye inflammation
  • Red, painful eyes (uveitis or episcleritis)
• Chronic fatigue
  • Feeling tired despite resting

Key Laboratory and Diagnostic Findings

According to the 2019 ECCO-ESGAR guidelines¹, diagnosing IBD involves a combination of clinical, lab, endoscopic, and imaging tests:

• Blood tests
  • Elevated inflammatory markers (CRP, ESR)
  • Anemia (low hemoglobin) from chronic bleeding or poor nutrient absorption
  • Abnormal platelet count (thrombocytosis is common; thrombocytopenia may indicate complications)²
  • Low albumin (protein loss)
• Stool tests
  • Fecal calprotectin or lactoferrin—high levels point to intestinal inflammation
  • Rule out infections (bacterial, parasitic)
• Endoscopy (colonoscopy or upper scope)
  • Direct visualization of ulcers, inflammation, strictures
  • Tissue biopsy for definitive diagnosis
• Cross-sectional imaging (MRI or CT enterography)
  • Detects small-bowel involvement, fistulas, abscesses

Distinguishing IBD from IBS and Other Causes

Irritable bowel syndrome (IBS) can also cause urgency, diarrhea, and cramping. A 2012 study³ showed that up to 30% of IBD patients in remission still report IBS-type symptoms. Key differences:

• Objective inflammation (IBD) vs. none (IBS)
• Bleeding & weight loss more common in IBD
• Lab markers of inflammation abnormal in IBD, normal in IBS
• No ulcers or strictures on imaging or endoscopy in IBS

Other causes of urgency include infections (e.g., C. difficile), medication side effects, and ischemic colitis, so professional evaluation is important.

When to Seek Medical Help

Consider prompt medical evaluation if you experience:

• Blood in your stool
• Severe abdominal pain or cramping
• Fever higher than 100.4°F (38°C)
• Unintentional weight loss or severe fatigue
• Signs of dehydration (dizziness, dry mouth)
• Any alarming lab result you’ve been told about

Early diagnosis can prevent complications such as strictures, fistulas, malnutrition, and increased risk of colorectal cancer.

Next Steps You Can Take

• Track your symptoms: urgency, frequency, appearance of stool, associated signs (fever, pain).
• Try a free, online symptom check for to get a preliminary assessment and guidance on when to see a specialist.
• Discuss your symptom diary and any online assessment results with your primary care provider or a gastroenterologist.

Remember: Talk to Your Doctor

Only a healthcare professional can diagnose IBD. If any of the above symptoms are new, worsening, or cause you concern—especially if life-threatening signs (high fever, severe pain, dehydration) appear—speak to a doctor right away. Early intervention leads to better long-term outcomes and quality of life.

¹ Maaser C, Sturm A, Vavricka SR, et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD. J Crohns Colitis. 2019;
² Merli M, Giannelli V, De Santis A, et al. Thrombocytopenia is associated with increased mortality in… Clin Gastroenterol Hepatol. 2011;
³ Halpin SJ, Ford AC. Prevalence of IBS-type symptoms in IBD. Am J Gastroenterol. 2012.