Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Get emergency help for heavy bleeding, black tar-like stools, fainting, confusion, severe unrelenting abdominal pain, or signs of severe dehydration.
These can include being unable to keep fluids down, passing very little urine, or becoming unusually drowsy.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Seek prompt medical assessment for:
Blood mixed into the stool or repeated rectal bleeding
Unexplained weight loss
Persistent fever or diarrhea that wakes you at night
New or steadily worsening symptoms
Marked tiredness, paleness, or breathlessness that could suggest anemia
A family history of bowel cancer, celiac disease, or inflammatory bowel disease
These are not typical IBS-D symptoms and need urgent assessment.
3
Does any of this apply?
Book an appointment
Arrange a routine appointment if you have recurring abdominal pain with diarrhea, symptoms that are affecting daily life, or a bowel pattern that has changed without a clear reason.
Follow-up is also appropriate if your current management is no longer working or food restriction is becoming difficult to manage.
Every sign above is quoted from the sofidex article on IBS-D. If you are not sure, err upward — it is always reasonable to be checked.