Digestive Symptoms: Red Flags and When to Get Help

First: emergencies

If you or someone with you has any of the following, get emergency help now. In the US, call 911. In other countries, use your local emergency number.

• Bleeding from the bottom that will not stop, a lot of blood, or large blood clots in the stool. [1]
• A swollen belly together with a sudden, severe stomach ache, vomiting blood or vomit that looks like ground coffee, or severe difficulty breathing. [2]
• Chest pain that feels tight or heavy, or spreads to the arm, back, neck or jaw, with shortness of breath, which may be a heart attack even if it feels like indigestion. [3]

If you think vomiting or illness may be from poisoning, call US Poison Help at 1-800-222-1222 or see what to do first in poisoning and poison help by country. [4]

Get care promptly (the same day or next day)

Contact a clinician quickly for any of these. NIDDK says to see a doctor right away if constipation comes with several of these signs. [5]

Book an appointment soon

• Symptoms that are new, keep coming back, or do not improve with self-care. [11][6]
• A sudden change in your usual bowel habits, or needing to go more or less often than usual. [11][1]
• Heartburn most days, or heartburn that does not respond to over-the-counter treatment. [9]
• Indigestion that lasts more than two weeks. [12]
• A family history of colon or rectal cancer with constipation. [5]
• Feeling very bloated regularly or bloating that does not go away. [2]

Higher-risk groups should call earlier

Diarrhea is more likely to cause problems in people who are pregnant, over 65, taking antibiotics, or who have a weakened immune system. [13] It is especially dangerous in newborns and infants and can cause severe dehydration in a day or two. [8] Babies, children and older adults are at greater risk of dehydration. [14]

Why symptoms alone cannot say what is wrong

Digestive symptoms overlap. Rectal bleeding, bloody or black stools, anemia and weight loss are symptoms that may suggest a problem other than IBS. [10] Bowel cancer symptoms are also common to other conditions; having them does not definitely mean cancer, but it is important to get checked. [1] Doctors diagnose using your history, an exam and, when needed, blood, stool or other tests, not symptoms alone. [15][10]

What not to do

• Do not use probiotics, cleanses or herbal products as a reason to delay a medical evaluation. [16] See the claim check on cleanses and tests.
• Do not start a gluten-free diet before celiac testing, because it can affect results. [15]
• Do not stop a prescribed medicine on your own. [9]