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While some suffer with constipation, others deal with diarrhea. Keep reading to learn about irritable bowel syndrome with diarrhea (IBS-D), including its symptoms, diagnosis, and treatment methods.
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Symptoms
IBS-D shares many symptoms with the other types of IBS (IBS-C and IBS-M). These shared symptoms include gas, abdominal pain, and bloating.
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The primary symptoms unique to IBS-D are diarrhea, loose stools, and sudden urges to have bowel movements. About 1 out of every 3 people with IBS-D have loss of bowel control or soiling. This has a strong, negative impact on daily living.
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Diagnosis
Even if you think you have IBS-D, it’s important not to diagnose yourself. Consult with a specialist such as a gastroenterologist.
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They’ll likely perform a physical exam and get a detailed history of your health. They’ll also ask about any family history of diseases like colon cancer, Celiac disease, or Crohn’s disease.
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Doctors may order blood and stool laboratory tests. You may also need a colonoscopy, flexible sigmoidoscopy, and x-rays.
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These tests help rule out other diseases. For an official IBS-D diagnosis, you must have diarrhea as the primary symptom more than 25 percent of the time. You must also have constipation less than 25 percent of the time.
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Triggers
All types of IBS, including IBS-D, have similar triggers. Stress is a common trigger, although the symptoms are not psychological in nature.
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Certain foods, such as milk, wheat, and red wine, are more likely to cause reactions. Smoking and caffeine consumption may also trigger IBS symptoms.
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Lifestyle treatments
Managing any type of IBS requires healthy lifestyle habits. This includes reducing stress, getting regular exercise, drinking enough water, and getting adequate sleep. For those with IBS-D, dietary changes may be especially helpful.
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Here are some diet tips:
Eliminate gas-producing foods. Some foods are high in gas-producing compounds. These foods include beans, carbonated beverages, raw fruits, and vegetables like cabbage and broccoli.
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Avoiding these foods may help to reduce painful gas and bloating. Eliminate gluten. Gluten is a protein found in wheat, rye, and barley.
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A study in the journal Gastroenterology found that a gluten-free diet was effective in reducing IBS symptoms. Gluten caused symptoms of “leaky gut” or small bowel permeability. Gluten also increased markers of inflammation.
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Try a Low-FODMAP Diet. FODMAPs are a type of carbohydrate found in certain foods.
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The FODMAP acronym stands for Fermentable Oligo-Di-Monosaccharides and Polyols. FODMAP sources include: Fructose (fruits, honey, high-fructose corn syrup)Lactose (milk and dairy products)Fructans (wheat, onion, garlic, and inulin)Galactans (legumes such as beans, soybeans, and lentils)Polyols (stone fruits such as avocados, cherries, and peaches; sugar alcohols such as sorbitol and xylitol) Reducing your intake of FODMAPs may relieve common IBS symptoms. These symptoms include abdominal pain and cramping, gas, and bloating.
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However, many of the foods containing FODMAPs are good sources of fiber. You’ll need to take care to get enough fiber from other foods.
Medications
If lifestyle or dietary changes don’t relieve your IBS symptoms, you may want to add medication to your treatment line-up.
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Here are some suggestions: Antidiarrheal medications. Medications that control diarrhea include an over-the-counter drug called loperamide (Imodium).Anticholinergenic and antispasmodic medications. These medications reduce bowel spasms and associated pain.
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Examples include dicyclomine (Bentyl) and hyosycamine (Levsin). However, these can lead to constipation and difficulty urinating.Mast cell stabilizers and 5-aminosalicylic acid (5-ASA).
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Many IBS-D cases occur after a bout with gastroenteritis. These medications are anti-inflammatory agents that may be useful in treating this subset of IBS-D cases.Alosetron (Lotronex).
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Lotronex is used to treat IBS-D. The side effects from this medication can be severe, so it’s only available by prescription from doctors enrolled in a special program.
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It should be used only as a last resort after other treatments have been unsuccessful.Rifaximin (Xifaxan). Xifaxan is used to treat IBS-D without constipation and is approved by the FDA.
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A 2011 study found that patients who took Xifaxan had significantly improved symptoms.Viberzi. Viberzi is approved by the FDA to treat IBS-D specifically. Pinaverium (Dicetel).
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Dicetel is a calcium channel antagonist that can be used to treat IBS-D.
Takeaway
Although IBS-D can be a debilitating and embarrassing condition, there are ways to manage it.
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Talk to your doctor or gastroenterologist about your symptoms to ensure you get the treatment you need. Last medically reviewed on October 18, 2022
How we vetted this article
SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations.
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We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Bortley, E., et al.
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(2011). Rifaximin therapy for patients with irritable bowel syndrome without constipation.
nejm.org/doi/full/10.1056/NEJMoa1004409Pimentel M.
nejm.org/doi/full/10.1056/NEJMoa1004409Pimentel M.
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(2018). Evidence-based management of irritable bowel syndrome with diarrhea.
pubmed.ncbi.nlm.nih.gov/29372991/Subtypes of IBS.
pubmed.ncbi.nlm.nih.gov/29372991/Subtypes of IBS.
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(n.d.).
aboutibs.org/signs-and-symptoms/subtypes-of-ibs/The low-FODMAP diet. (n.d.).
stanfordhealthcare.org/medical-treatments/l/low-fodmap-diet.htmlVazquez-Rogue M, et al.
aboutibs.org/signs-and-symptoms/subtypes-of-ibs/The low-FODMAP diet. (n.d.).
stanfordhealthcare.org/medical-treatments/l/low-fodmap-diet.htmlVazquez-Rogue M, et al.
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(2013). A controlled trial of gluten-free diet in patients with irritable bowel syndrome diarrhea: Effects on bowel frequency and intestinal function.
pubmed.ncbi.nlm.nih.gov/23357715/Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 19, 2022 By Holly Case, Molly Burford Edited By John Bassham Medically Reviewed By Youssef (Joe) Soliman, MD Copy Edited By Copy Editors Aug 17, 2018 By Holly Case VIEW ALL HISTORY Share this articleMedically reviewed by Youssef (Joe) Soliman, MD — By Holly Case and Molly Burford — Updated on October 18, 2022
pubmed.ncbi.nlm.nih.gov/23357715/Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 19, 2022 By Holly Case, Molly Burford Edited By John Bassham Medically Reviewed By Youssef (Joe) Soliman, MD Copy Edited By Copy Editors Aug 17, 2018 By Holly Case VIEW ALL HISTORY Share this articleMedically reviewed by Youssef (Joe) Soliman, MD — By Holly Case and Molly Burford — Updated on October 18, 2022
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