Irritable bowel syndrome (IBS) isn’t the same for everyone. 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.
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.
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.
Even if you think you 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 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.
All types of IBS, including IBS-D, have similar triggers. Stress is a common trigger, although the symptoms are not psychological in nature. Certain foods, such as milk, wheat, and red wine, are more likely to cause reactions. Smoking and caffeine consumption may also trigger IBS symptoms.
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. 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. Avoiding these foods may help to reduce painful gas and bloating.
Eliminate gluten. Gluten is a protein found in wheat, rye, and barley. A
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 (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. 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.
If lifestyle or dietary changes don’t relieve your IBS symptoms, you may want to add medication to your treatment line-up. 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. 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). 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). 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. 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. 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). Dicetel is a calcium channel antagonist that can be used to treat IBS-D.
Although IBS-D can be a debilitating and embarrassing condition, there are ways to manage it. Talk to your doctor or gastroenterologist about your symptoms to ensure you get the treatment you need.