When to seek care for diarrhoea

Overview

Diarrhoea is when you have loose, watery bowel movements (poo) three or more times a day. It usually goes away on its own within a few days, but sometimes it can be a sign of a more serious problem.

Yes, diarrhoea is very common. Most adults have it once or twice a year, and children may have it more often.

Diarrhoea can affect anyone, but it is more common in young children, older adults, and people with weakened immune systems.

Symptoms

Common symptoms

• Loose, watery bowel movements (poo) that happen more often than usual
• Stomach cramps or pain
• Feeling sick (nausea) or being sick (vomiting)
• A general feeling of being unwell
• Sometimes a mild fever

Symptoms in children

• Diarrhoea that is very watery or contains mucus
• Vomiting
• High temperature (fever)
• Fussiness or crying more than usual
• Signs of dehydration: dry mouth, fewer wet nappies, sunken eyes, lack of tears when crying

Symptoms in older adults

• More frequent or more severe diarrhoea
• Signs of dehydration: feeling very thirsty, dark urine, feeling dizzy or weak
• Confusion or feeling unusually tired

Causes

Main causes

• Viral infections (like norovirus or rotavirus)
• Bacterial infections (like food poisoning from Salmonella or Campylobacter)
• Parasites (like Giardia, often from contaminated water)
• Food intolerance (like lactose or gluten)
• Side effects of medicines (like some antibiotics or laxatives)
• Digestive conditions (like irritable bowel syndrome or Crohn's disease)

Risk factors

• Travel to areas with poor sanitation or unsafe drinking water
• Eating undercooked or spoiled food
• Not washing hands properly after using the toilet or before eating
• Having a medical condition that weakens your immune system (e.g., diabetes, HIV)
• Taking medicines that affect your gut, like antibiotics

When to see a doctor

See a doctor urgently if:

• If you have signs of severe dehydration (see emergency symptoms)
• If you have blood in your poo or vomit
• If you have severe or constant stomach pain
• If you are unable to drink or keep fluids down

Book a routine appointment if:

• If diarrhoea has not improved after 7 days (adults) or 48 hours (children)
• If you have a high fever that does not come down with rest and fluids
• If you have recently been abroad and have diarrhoea
• If you have a weakened immune system and develop diarrhoea
• If you are worried about your symptoms

Diagnosis

A doctor will ask about your symptoms, how long you have had them, and whether you have travelled or been around someone with similar symptoms. They may also check for signs of dehydration and listen to your stomach.

Tests that may be done

• Stool sample test to look for bacteria or parasites
• Blood tests to check for infection or dehydration
• In rare cases, a procedure called a sigmoidoscopy or colonoscopy to look inside your bowel

What to expect at your appointment

Your doctor might recommend a stool sample test if your diarrhoea is severe, lasts a long time, or if you have blood in your poo. The test is simple and painless. Blood tests are only done if needed. For most people, no tests are required and the doctor will give advice on managing symptoms at home.

Treatment

Treatment for diarrhoea depends on the cause. Most cases get better without any specific medicine. The main goal is to replace lost fluids and prevent dehydration. If an infection is the cause, your doctor may recommend an antibiotic or antiparasitic medicine, but only if needed. Anti‑diarrhoea medicines are not always advised, especially if you have a fever or blood in your poo – always ask your doctor first.

Self-care at home

• Drink plenty of clear fluids, like water or oral rehydration solution (available from pharmacies)
• Avoid dairy, fatty, spicy, or very sugary foods until your stomach settles
• Eat bland foods like plain rice, toast, bananas, or boiled potatoes when you feel ready
• Get plenty of rest
• Wash your hands regularly to avoid spreading the infection

Medical treatments

If your diarrhoea is caused by a bacterial infection, your doctor may prescribe a course of antibiotic medicine. For parasitic infections, antiparasitic medicines are used. In some cases, a short course of an anti‑diarrhoea medicine may be advised, but only under medical guidance. Never take anti‑diarrhoea medicines without talking to a healthcare professional.

When is surgery considered?

Surgery is not used to treat diarrhoea itself. In very rare cases, if diarrhoea is caused by a serious underlying condition like a bowel obstruction or severe inflammatory bowel disease, surgery may be needed to treat that condition. This is not common for acute diarrhoea.

Living with this condition

If you have an episode of diarrhoea, plan to rest and stay near a toilet. Keep a water bottle nearby and sip fluids often. Avoid strenuous activities until you feel better. If diarrhoea lasts more than a few days, or if it becomes a chronic (long‑term) problem, work with your doctor to manage any underlying condition.

Lifestyle tips

• Practice good hand hygiene – wash hands after each toilet visit and before eating
• Avoid sharing towels or utensils while you are sick
• If you have a food intolerance, identify and avoid trigger foods with the help of a dietitian
• Manage stress, as it can worsen conditions like irritable bowel syndrome

Diet and exercise

During an acute episode, rest and stick to light, plain foods. As you recover, gradually add back your normal diet. Avoid vigorous exercise until you are fully hydrated and feeling well. For chronic diarrhoea, a dietitian can help you find a diet that works for you.

Mental health and emotional wellbeing

Having diarrhoea, especially if it is long‑term, can be embarrassing and stressful. It may affect your social life, work, and sleep. It is normal to feel frustrated or anxious. Talk to your doctor or a counsellor if it is affecting your mental wellbeing.

Prevention

Many cases of diarrhoea can be prevented with good hygiene and safe food and water practices. Washing your hands thoroughly after using the toilet and before eating is one of the most effective ways to reduce the risk. When travelling, drink bottled or boiled water and avoid raw or undercooked foods.

Vaccines

There is a vaccine for rotavirus, a common cause of severe diarrhoea in young children. It is part of the routine childhood vaccination schedule in many countries, including the UK. Ask your health visitor or GP about it.

Screening programmes

There are no routine screening tests for diarrhoea in healthy people. If you have persistent or bloody diarrhoea, your doctor may recommend tests to check for underlying conditions like inflammatory bowel disease or infections.

Complications

If left untreated

• Dehydration – if severe, can be life-threatening, especially in children and older adults
• Electrolyte imbalances – salts like potassium and sodium can get too low, affecting heart and muscle function
• Weight loss and malnutrition if diarrhoea lasts a long time
• Spread of infection to others

Long-term outlook

For most people, diarrhoea is a short‑lived problem that gets better on its own. Even in more serious cases, with proper medical care and attention to hydration, the outlook is very good. Long‑term diarrhoea from a chronic condition can be managed with the right treatment and support. You can expect to return to your normal activities once the episode is over.

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