Managing the Symptoms of IBS-D

Medically reviewed by George Krucik, MD, MBA on February 22, 2016Written by Holly Case on February 22, 2016
managing ibs symptoms

Irritable bowel syndrome (IBS) is a gastrointestinal disorder with several uncomfortable symptoms. The symptoms can be mistaken for other serious illnesses, so getting a proper diagnosis is essential. IBS is divided into three subtypes based on your primary symptoms. If your primary symptom is diarrhea, your subtype is IBS-D.

Symptoms

IBS-D has several distinct symptoms, many of which present challenges in daily life. The most common symptoms include:

  • diarrhea or loose stools, especially in the morning or after meals
  • urgency before bowel movements
  • feeling of incomplete emptying after bowel movements
  • abdominal pain or cramping
  • nausea
  • loss of bowel control or soiling yourself

Lifestyle Changes

Most people find that simple lifestyle changes can help control the symptoms of IBS-D:

  • Avoid trigger foods.Certain foods are more likely to trigger diarrhea than others. Avoiding those foods can reduce its occurrence. These may include:
    • fast or deep-fried foods
    • coffee
    • caffeine
    • alcohol
    • certain artificial sweeteners, such as sorbitol and xylitol
  • Avoid tobacco. Smoking and chewing tobacco irritate the intestinal lining and make digestion less efficient. Also, extra air that’s swallowed during smoking can cause gas and bloating.
  • Eat smaller meals. Large meals can be harder to digest. This contributes to cramping and diarrhea. Try eating four or five smaller meals or eating smaller portions.
  • Manage stress. Stress doesn’t cause IBS. But most people find that stress makes their symptoms worse. Focus on ways to manage and reduce your stress, such as yoga, meditation, or journaling.

Medications

If making these lifestyle changes isn’t enough, medication may help. Over-the-counter diarrhea remedies may provide relief. These remedies include loperamide (Imodium), bismuth salicylate (Pepto Bismol), or Kaopectate. As always, ask your doctor or gastroenterologist before trying any new medications.

There are also three newer prescription medications:

  • Alosetron (Lotronex) is approved for women who have severe IBS-D. It works by blocking serotonin signals between the gut and the brain. These signals normally lead to pain and diarrhea. This medication can cause rare but very serious side effects. Your doctor should monitor you carefully if you take this medication.
  • Rifaxamin (Xifaxin) is an antibiotic. The U.S. Food and Drug Administration (FDA) approved it in May 2015. It works by altering or reducing the bacteria in the gut. Using the antibiotic for 10 to 14 days may provide relief from bloating and diarrhea. Some patients require a repeat course at a later date.
  • Eluxadoline (Viberzi) is the newest medication approved for IBS-D for both men and women. It works by activating receptors in the brain that reduce bowel spasms. The FDA approved it in Spring 2015. It’s expected to be available on the market in early 2016.

Complementary and Alternative Medicine

In addition to dietary changes and medication, some complementary or alternative treatments may help. Probiotics and prebiotics show particular promise. These microorganisms may reduce gas and bloating by altering gut bacteria.

Some studies suggest that acupuncture may provide relief. However, the studies have had mixed results. Acupuncture is generally safe when performed by a licensed acupuncturist and may be useful for patients who are sensitive to traditional medications.

Hypnotherapy may also help IBS patients find relief. Hypnosis generally includes progressive relaxation and replaces negative associations with more positive ones to reduce pain.

Most IBS-D patients need some combination of the above treatments to find adequate relief of their symptoms. With trial and error, you can manage your symptoms and live a healthier, happier life.

CMS Id: 99124