Your guide to understanding Irritable Bowel Syndrome With Diarrhea (IBS-D)

What is irritable bowel syndrome with diarrhea (IBS-D)

There are three types of IBS:

• IBS-C: This type has constipation as its main symptom.
• IBS-D: This type has diarrhea as its main symptom.
• IBS-M: This type has a mixture of both constipation and diarrhea.

IBS-D is the most common subtype and affects about 40% of people with IBS. It is characterized by diarrhea as the main symptom. You may also experience abdominal pain, loose stools, and bowel urgency.

Though the symptoms of may be distressing, IBS is not dangerous and does not increase your risk of developing any other conditions.

Symptoms

IBS-D shares many symptoms with the other types of IBS (IBS-C and IBS-M). These symptoms include gas, abdominal pain, and bloating.

The main characteristics unique to IBS-D are diarrhea, loose stools, and sudden urges to have bowel movements. Some people may experience a loss of bowel control or soiling. This can significantly affect a person’s daily life.

However, it’s possible to improve your symptoms and quality of life through proper treatment and other lifestyle strategies.

Diagnosis

Even if you think you may have IBS-D, it’s important not to diagnose yourself. Consult with a specialist such as a gastroenterologist.

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.

Doctors may order blood and stool laboratory tests. You may also need a colonoscopy, flexible sigmoidoscopy, and x-rays. These tests can help rule out other diseases.

For an official IBS-D diagnosis, you must have diarrhea as the primary symptom more than 25% of the time. You must also have constipation less than 25% of the time.

Lifestyle strategies

Stress can be a common trigger for all types of IBS. Though stress can trigger or worsen symptoms, IBS is not a psychological condition. But relieving stress may help your symptoms.

Managing any type of IBS can involve healthy lifestyle habits, such as:

• reducing stress
• getting regular exercise
• drinking enough water
• getting enough sleep

Certain foods can also cause symptoms. And smoking and caffeine consumption can trigger IBS symptoms for some people.

Sometimes, during a flare, your stomach may just need time to settle. If you live with IBS, you may experience times when symptoms “flare” and are worse and other times when they are more manageable.

Dietary triggers

If you have IBS-D, dietary changes may help. Some people find particular foods are more likely to trigger their symptoms.

Here are some diet tips you may consider trying:

• Reduce or 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. Avoiding these foods may help reduce painful gas and bloating.
• Reduce or eliminate gluten. Gluten is a protein found in wheat, rye, and barley. Some people find it flares their symptoms.
• Try a low-FODMAP diet. FODMAPs are a type of carbohydrate found in certain foods. The FODMAP acronym stands for Fermentable Oligo-Di-Monosaccharides and Polyols.

FODMAP sources include:

• Fructose: Present in fruits, honey, high-fructose corn syrup.
• Lactose: Found in milk and dairy products.
• Fructans: Present in wheat, onion, garlic, and inulin.
• Galactans: Galactans may be found in legumes such as beans, soybeans, and lentils.
• Polyols: Sources include stone fruits such as avocados, cherries, and peaches. You can also find polyols in sugar alcohols, such as sorbitol and xylitol.

Reducing your intake of FODMAPs may relieve IBS symptoms such as abdominal pain and cramping, gas, and bloating.

However, many of the foods containing FODMAPs are good sources of fiber. So you’ll need to take care to get enough fiber from other foods. You may also be able to tolerate some of these foods, just in smaller amounts.

It’s important to consult with your doctor before any major changes to your diet, especially if you want to significantly reduce or eliminate a large food group.

Medications

If lifestyle or dietary changes don’t relieve your IBS symptoms, you may want to try medication to help you feel more comfortable.

Here are some medications often used to treat IBS:

• Antidiarrheal medications. Medications that control diarrhea include an over-the-counter drug called loperamide (Imodium).
• Anticholinergic and antispasmodic medications. These medications reduce bowel spasms and associated pain. Examples include dicyclomine (Bentyl) and hyoscyamine (Levsin).
• Alosetron (Lotronex). Lotronex is used to treat IBS-D. The side effects of this medication can be severe, so it’s only available by prescription from doctors enrolled in a special program. 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.
• Viberzi. Viberzi is approved by the FDA to treat IBS-D specifically.

Takeaway

Although IBS-D can be difficult to live with, there are ways to help manage your symptoms. Also, remember that bowel movements are a completely normal part of life. Though it can be tricky, and you may feel embarrassment, know that having this condition is no different than having any other condition.

You can try experimenting with food to see what works for you and what your triggers may be and try to reduce stress where you can.

Talking with your doctor or gastroenterologist about your symptoms can also help ensure you get the treatment you need. Over the counter or prescription medications can also relieve symptoms.

Remember not to make significant changes to your diet, such as cutting out large food groups, without speaking with your doctor first.