Symptom of IBS: Diarrhea

Reviewed by: HU Medical Review Board | Last reviewed December 2022 | Last updated: January 2023

Diarrhea is a common symptom of irritable bowel syndrome (IBS). It is 1 of 3 main types of IBS: IBS with diarrhea, otherwise known as IBS-D.1,2

What is diarrhea?

Diarrhea is when your stools (or poop) are loose and watery. You might also have lower abdominal pain or cramping before having diarrhea. This abdominal pain usually goes away after having a bowel movement.1-4

IBS with diarrhea (IBS-D)

IBS with diarrhea (IBS-D) is characterized by frequent stools that are loose and watery. People with IBS-D report the following symptoms:1-4

  • Stomach pain and cramping
  • Loose, watery stools
  • Sudden urge to have a bowel movement
  • Bloating, gas, and flatulence
  • Whitish mucus in their stool

With IBS-D, you typically have multiple bowel movements during the day. Diarrhea that wakes you up at night is not considered to be IBS-D and should be discussed with your doctor.4

Some people with IBS-D have a sudden urge to go to the bathroom. Or, they might have a hard time controlling their bowel movements. This is called fecal incontinence. About 20 percent of people with IBS-D occasionally experience incontinence because of diarrhea.5

What causes IBS-D?

IBS-D is likely caused by multiple factors. Rapid contractions of the intestines can cause food to move faster through the gastrointestinal (GI) tract than normal. The intestines do not have enough time to absorb water, which is why stools are loose and watery.4

Other causes of IBS-D may include:4

  • Changes to your gut bacteria (gut microbiome)
  • A food intolerance or sensitivity (for example, lactose intolerance)
  • A gastrointestinal (GI) infection

Who gets IBS-D?

IBS-D affects between 7 to 21 percent of the US population. Anyone can develop IBS-D, but it is more common in young women compared to men and older people.4

Treating IBS-D

There is no cure for IBS, but there are ways to manage it. Some medicines are only successful with certain types of IBS, and some medicines make certain types of IBS worse.1-3

A common first step in treating IBS-D is to cut out foods that may trigger diarrhea, like coffee, alcohol, and fatty foods. Doctors also recommend increasing the amount of fiber you eat.2,3

For IBS-D, anti-diarrheal medicines are often prescribed. They help slow the movement of stool. These include:3

  • Loperamide
  • Rifaximin (Xifaxan®)
  • Eluxadoline (Viberzi®)
  • Alosetron (Lotronex®)

Because food moves so quickly through the GI tract, diarrhea can lead to the poor absorption of nutrients (malabsorption). Diarrhea can also be very dehydrating, so it is important to make sure you are getting lots of fluids if experiencing bouts of diarrhea.4

Treating IBS – no matter the type – involves a combination of:1-3

  • Diet and nutrition
  • Drug therapy
  • Stress management
  • Mental health counseling

Talk with your doctor about ways to manage and treat your IBS-D.

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