When should you see a doctor urgently?
Most digestive complaints do not mean an emergency. But some symptoms can be the first sign of an important health problem.
If one of the situations below applies to you
Go to a medical facility without delay.
Do not wait — this may need urgent assessment
Vomiting blood
Fresh red blood in the vomit, or vomit that looks like coffee grounds, can suggest bleeding in the upper digestive tract.
Urgent assessment is needed particularly where there is dizziness, cold sweating or a feeling of faintness.
Black, tarry stools
Stools that become black, shiny, sticky or tarry can be a sign of bleeding in the digestive system.
Iron tablets and some other medicines can also darken the stool; but unexplained black stools should not be disregarded.
Heavy red or maroon bleeding
Heavy bleeding, whether with the stool or independently of opening the bowels, should be assessed — particularly if it recurs.
If the bleeding comes with weakness, palpitations, dizziness or fainting, do not wait.
Sudden and severe abdominal pain
Abdominal pain that begins suddenly in a way you have not had before, that is very severe, or that keeps increasing, can herald an important condition.
If the pain is unbearable, or your general condition is deteriorating quickly, go to an emergency department.
A hardening abdomen
An abdomen that becomes much harder than usual, with pain increasing markedly on touch or on movement, can suggest a problem inside the abdomen that needs urgent assessment.
Vomiting that will not stop
Continued vomiting, and particularly being unable to keep even water down, can lead to serious fluid and electrolyte loss in a short time.
Do not delay if it comes with reduced urine, a dry mouth, marked weakness or dizziness.
Abdominal swelling with an inability to pass wind or stool
Increasing swelling of the abdomen together with an inability to pass wind or stool, with pain or vomiting, can mean an important condition such as bowel obstruction.
Jaundice with fever or shivering
Yellowing of the whites of the eyes or of the skin, accompanied by fever, shivering or pain in the right upper abdomen, can be a sign of infection or obstruction in the bile ducts.
That combination can need urgent assessment.
Food stuck in the gullet
A mouthful lodging in the chest during a meal, and particularly being unable to swallow even water or saliva, can mean complete obstruction of the oesophagus.
Do not try to force food or water down; go to a medical facility.
Fainting, severe dizziness or cold sweating
Particularly where these appear together with abdominal pain, vomiting blood or bleeding in the stool, they can be a sign of blood loss or low blood pressure.
A change in consciousness in someone with liver disease
In a person with known advanced liver disease, drowsiness, a change in behaviour, absent-mindedness, indifference to their surroundings or clouding of consciousness can be important.
Medical assessment is needed without delay.
Severe diarrhoea and fluid loss
Very frequent diarrhoea or vomiting, together with extreme thirst, a dry mouth, a marked reduction in urine, dizziness or an inability to take fluids, can indicate serious fluid loss.
New severe symptoms after an endoscopic procedure
After endoscopy, colonoscopy, polypectomy, ERCP or any other procedure, if:
- severe or steadily increasing abdominal or chest pain
- heavy bleeding
- fever
- breathlessness
- persistent vomiting
develops, the facility that carried out the procedure should be contacted immediately, or an emergency department attended.
It may not be an emergency, but do not put it off
Some symptoms may not mean going to an emergency department at that moment. But because they can herald an important underlying condition, a gastroenterology assessment should not be delayed.
Unexplained weight loss
Losing a noticeable amount of weight without dieting or exercising is a finding that needs investigating.
Early satiety and loss of appetite
Feeling full on much less food than before, persistent loss of appetite, or either of these accompanied by weight loss, should be assessed.
Steadily increasing difficulty swallowing
Difficulty swallowing that begins with solid food in particular and increases over time should not be disregarded.
Unexplained anaemia
Iron deficiency anaemia in particular can be a sign of chronic bleeding in the digestive system that is invisible to the eye.
A new and lasting change in bowel habit
Constipation, diarrhoea, or marked changes in how often you open your bowels or in how the stool looks — new and continuing — should be investigated.
Repeated blood in the stool
Even if you know you have haemorrhoids, it is not right to attribute repeated bleeding to them automatically.
Abdominal pain that will not settle, or that wakes you at night
Abdominal pain that is long-lasting, steadily increasing, or that wakes you from sleep at night should be assessed.
Repeated vomiting
Vomiting that appears particularly after meals, that recurs often, or that leads to weight loss should be investigated.
Newly developed jaundice
Newly started yellowing of the eyes or the skin should be assessed without delay, even where there is no fever or pain.
Steadily increasing abdominal swelling
Marked enlargement around the abdomen should be assessed, particularly where it comes with weight loss, swelling of the legs or breathlessness.
Who should be more careful?
The same symptom may not carry the same meaning in every person. In particular:
- older people
- those with digestive cancer in the family
- those in whom colon polyps have been found before
- those with inflammatory bowel disease
- those with chronic liver disease
- those whose immune system is suppressed
- those taking blood thinners
should not disregard new or unusual digestive symptoms.
If you are not sure
Do not try to assess a symptom that is severe, sudden, quickly worsening, or unlike anything you have had before using information from the internet alone.
Go to a medical facility without delay, particularly where there is bleeding, severe pain, fainting, persistent vomiting, jaundice with fever, or a change in consciousness.
Remember
In an emergency, get medical help rather than looking for a diagnosis online.
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