How To Tell if Weird Changes in Your Poop Are an Emergency or NBD, According to an ER Doctor

Photo: Getty Images/Matt Cardy
If you’ve ever had a bad case of the stool sweats, you know they feel like a crisis. However, that urgent need to go right now, is more likely to cause a wardrobe emergency than a medical one.

Though we don’t always talk about it, we’ve all been there. Because into every life a little poop must, well, fall. And there are times when that sh** is decidedly… not normal. But do you know what constitutes an actual poop emergency?

Usually, changes in poop are no big deal. But sometimes, this very mundane, daily activity can signal medical issues that require more than just toilet paper. Before you hit the panic button (or go bidet shopping), read on.

Common poop emergencies: How to know when to go

The most common poop problems are usually diarrhea, blood in stool, and constipation. While less than fun, these conditions can typically be handled at home with over-the-counter medication and a little TLC. Dietary changes, medications, and even herbal supplements can all alter the consistency and frequency of poop, so it could just be a matter of eliminating the guilty party.

In some instances, however, there may be additional symptoms that signal a need for immediate medical attention, or signs of serious conditions that warrant a doctor’s input sooner rather than later.

Diarrhea

Loose, watery stool can be caused by viral or bacterial infections you get from person-to-person contact. Ingested pathogens (food poisoning) are another common culprit. You can even get diarrhea from emotional upsets, such as anxiety. Diarrhea can also be a symptom of an underlying condition, like irritable bowel syndrome or inflammatory bowel disease.

No matter the cause, you probably don’t need immediate emergency care unless diarrhea is accompanied by additional symptoms, like dehydration, significant pain or discomfort, or a sustained fever over 101 degrees fahrenheit, says Matthew Warner, MD, chairman of emergency medicine for Inspira Medical Centers. Any symptoms that worry you or differ from your norm, like dizziness or fainting, should also be checked out ASAP if they accompany diarrhea.

Dehydration might not sound serious, but it is absolutely a medical emergency: Dr. Warner cautions that dehydration may set in quickly when diarrhea is accompanied by vomiting. “Signs of dehydration to look out for include decreased urination, dark-colored urine, and dry, cracked lips,” he says. Babies may appear listless, have a sunken fontanel, or cry without producing tears. The people most likely to get dehydrated quickly from having diarrhea are children, the elderly, and those with pre-existing medical conditions, like immune system disorders and cancer.

Chronic diarrhea that lasts longer than a week, or that comes and goes consistently over any period of time, may not need a trip to the ER, but it warrants a chat with your healthcare provider. This is especially important if it contains dark blood, small solid specks, mucus, or pus.

Bloody stool

It can be scary to see blood in your poop. However, it doesn’t necessarily mean something awful is going on internally. “Bloody stool can be alarming, but often the bleeding is from local perianal irritation or hemorrhoids,” explains Dr. Warner. Hemorrhoidal bleeding is typically painless, and bright red in color.

While not an immediate emergency, bloody stool can also be a symptom of conditions that require medical treatment, like diverticulitis or Crohn’s disease. If you notice blood in your stool on an ongoing basis, have it checked out soon, especially if the blood is dark red, black, tarry, or contains specks, like coffee grounds.

However, don’t wait to go to the ER if you’re passing more than a cup of blood, or if your bloody stool accompanies any of these symptoms:

  • Fever
  • Severe abdominal pain or cramps
  • Feeling dizzy or faint
  • Rapid heartbeat
  • Vomit that looks like coffee grounds

Constipation

Not everyone poops every day. What constitutes constipation for you may be different for someone else.

Like diarrhea, constipation can sometimes be caused by underlying medical conditions that require a healthcare provider’s input, like irritable bowel syndrome or hypothyroidism. But according to Dr. Warner, the main causes of this uncomfortable condition are not drinking enough fluids and not eating enough fiber.

Still, whatever your normal pooping schedule, if it’s been a week or longer since you did the deed and you’re in pain or have significant bloating, go to the ER. Providers there can help you pass the stool before it hardens and bulks up too much.

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