When to Go to the Emergency Room for Diarrhea
You should go to the emergency room for diarrhea if you have signs of severe dehydration, bloody stools, high fever, severe abdominal pain, or if you are immunocompromised. 1
Signs and Symptoms Requiring Emergency Care
Severe Dehydration
- Extreme thirst, dry mouth, decreased urination, dizziness upon standing, or altered mental status 1
- Inability to keep fluids down due to persistent vomiting 1
- Signs of shock including rapid breathing, weak pulse, or decreased consciousness 1
Concerning Stool Characteristics
- Bloody diarrhea (dysentery), which may indicate a bacterial infection requiring specific treatment 1
- Black or tarry stools suggesting gastrointestinal bleeding 2
- Severe, persistent diarrhea with high stool output (>10 stools per day) 1
Other Warning Signs
- High fever (≥38.5°C or 101.3°F) with diarrhea 1, 2
- Severe abdominal pain or cramping 1, 3
- Symptoms lasting longer than 3 days without improvement 4, 3
- Significant weakness or lethargy 1, 2
Special Populations Requiring Lower Threshold for ER Visit
Immunocompromised Individuals
- Cancer patients, transplant recipients, or those on immunosuppressive medications should seek immediate care for any significant diarrhea 1, 5
- HIV-positive individuals with diarrhea may need urgent evaluation 1
Age Considerations
- Infants under 3 months with diarrhea should be evaluated promptly 1
- Elderly patients are at higher risk for severe dehydration and complications 6, 3
Recent Travel
- Travelers returning from high-risk areas with fever and diarrhea should seek immediate medical attention 1, 5
Home Management Before Seeking Emergency Care
Hydration
- Begin oral rehydration with reduced osmolarity oral rehydration solution (ORS) for mild to moderate dehydration 1
- Adults should consume 2-4 liters of ORS, while children should receive 50-100 mL/kg over 3-4 hours 1
- Administer ORS in small amounts (5-10 mL) every 1-2 minutes if vomiting is present 1
Dietary Considerations
- Continue breastfeeding infants throughout the diarrheal episode 1
- For older children and adults, maintain nutrition with easily digestible foods 1
- Avoid dairy products, caffeine, alcohol, and high-sugar foods 1, 7
When Home Management Is Insufficient
- If unable to maintain hydration despite oral rehydration attempts 1
- If symptoms worsen despite home management for 24-48 hours 4, 3
- Development of new symptoms such as fever, severe pain, or bloody stools 1, 2
Common Pitfalls to Avoid
- Delaying care for bloody diarrhea, which may indicate serious infection requiring antibiotics 1
- Using antidiarrheal medications like loperamide in cases of bloody diarrhea or suspected inflammatory conditions 1, 3
- Assuming all diarrhea is viral and self-limiting when persistent symptoms may indicate a more serious condition 4, 5
- Failing to recognize medication-induced diarrhea, which may require adjustment of current medications 7, 6