Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Diarrhea-predominant IBS (IBS-D) is a subtype ofirritable bowel syndromethat causes frequent bouts of diarrhea with abdominal pain and bloating. IBS-D is considered a disorder of gut-brain interaction (previously called afunctional gastrointestinal disorder), in which there is no visible disease to account for the symptoms.
The diagnosis of IBS-D is based on the exclusion of all other possible causes. The condition can often be managed with changes in your diet, while certain over-the-counter (OTC) and prescription drugs can also help ease pain and diarrhea.
This article explains the causes and symptoms of IBS-D, including how this disorder is diagnosed and treated.
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How Are IBS-D Symptoms Different?
The primary symptoms of allthree subtypes of IBSare abdominal pain or discomfort. With diarrhea-predominant IBS, there will also be:
According to the diagnostic criteria for IBS, symptoms must occur at least once a week for at least three months.
Some people with IBS-D will suddenly stop having diarrhea and meet the diagnostic criteria forconstipation-predominant IBS (IBS-C). If you switch back and forth between diarrhea and constipation, you are said to havemixed-type IBS (IBS-M).
What Causes IBS-D?
These communications, in turn, direct all of the other systems that regulate digestion, including theendocrine system(which directs the production of digestive enzymes) and theautonomic nervous system(which regulates involuntary functions like the muscular contractions of the intestines).
When the gut-brain axis is working as it should, your bowel movement and stool consistency will be normal. If the communications go awry, gut motility and digestive enzyme production can suddenly increase, leading to diarrhea, cramping, and other symptoms of IBS-D.
While the cause of this dysfunction is unknown, there are several explanations as to why these systems will suddenly speed up. They include:
How Is ISB-D Diagnosed?
You may meet the diagnostic criteria for IBS-D if you have the characteristic symptoms and they happen at least once weekly for no less than three months. However, to confirm the diagnosis, your healthcare provider will need to exclude all other possible causes.
This is an important step because it may reveal an otherwise treatable condition—or ones that are serious and need immediate, aggressive treatment.
Examples include:
As part of thedifferential diagnosis, various tests and procedures may be ordered, including blood tests, stool cultures, abdominal ultrasound, hydrogen breath test, endoscopy, and biopsies.
How Is IBS-D Best Treated?
If you have been diagnosed with IBS-D, your treatment plan may involve dietary changes and OTC or prescription drugs. The selection of treatment is based on the severity and frequency of your symptoms.
Diet
The American College of Gastroenterology recommends that all people with IBS try alow-FODMAP dietto see if it helps ease symptoms.
FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.” These are short-chain carbohydrates (sugars) that the small intestine can’t fully absorb and end up fermenting the gut, causing gas and pain.
People with IBS-D may benefit from other dietary changes, such as:
IBS-D symptoms may also be reduced with mind/body therapies orcognitive-behavioral therapy (CBT)to help ease stress that contributes to IBS symptoms.
Medications
There are certain prescription drugs approved for the treatment of IBS as well as OTC or prescription medications used off-label to relieve symptoms.
OTC drug options include:
Prescription drug options include:
Summary
Diarrhea-predominant IBS (IBS-D) is a form of irritable bowel syndrome that causes frequent loose stools along with abdominal pain, cramping, gas, bloating, and mucus. It can be diagnosed if these symptoms occur at least once weekly for three months and all other causes have been excluded. The treatment may involve a FODMAP diet and targeted drugs like Viberzi and Xifaxan.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036Saha L.Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine.World J Gastroenterol. 2014;20(22):6759-6773. doi:10.3748/wjg.v20.i22.6759Vasant DH, Paine PA, Black CJ, et al.British Society of Gastroenterology guidelines on the management of irritable bowel syndrome.Gut. 2021;70(7):1214-1240. doi:10.1136/gutjnl-2021-324598Wilkinson JM, Gill MC.Irritable bowel syndrome: questions and answers for effective care.Am Fam Physician. 2021;103(12):727-736.Additional ReadingDrossman DA, Hasler WL.Rome IV-functional GI disorders: disorders of gut-brain interaction.Gastroenterology. 2016;150(6):1257-1261. doi:10.1053/j.gastro.2016.03.035
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036Saha L.Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine.World J Gastroenterol. 2014;20(22):6759-6773. doi:10.3748/wjg.v20.i22.6759Vasant DH, Paine PA, Black CJ, et al.British Society of Gastroenterology guidelines on the management of irritable bowel syndrome.Gut. 2021;70(7):1214-1240. doi:10.1136/gutjnl-2021-324598Wilkinson JM, Gill MC.Irritable bowel syndrome: questions and answers for effective care.Am Fam Physician. 2021;103(12):727-736.Additional ReadingDrossman DA, Hasler WL.Rome IV-functional GI disorders: disorders of gut-brain interaction.Gastroenterology. 2016;150(6):1257-1261. doi:10.1053/j.gastro.2016.03.035
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036Saha L.Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine.World J Gastroenterol. 2014;20(22):6759-6773. doi:10.3748/wjg.v20.i22.6759Vasant DH, Paine PA, Black CJ, et al.British Society of Gastroenterology guidelines on the management of irritable bowel syndrome.Gut. 2021;70(7):1214-1240. doi:10.1136/gutjnl-2021-324598Wilkinson JM, Gill MC.Irritable bowel syndrome: questions and answers for effective care.Am Fam Physician. 2021;103(12):727-736.
Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036
Saha L.Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine.World J Gastroenterol. 2014;20(22):6759-6773. doi:10.3748/wjg.v20.i22.6759
Vasant DH, Paine PA, Black CJ, et al.British Society of Gastroenterology guidelines on the management of irritable bowel syndrome.Gut. 2021;70(7):1214-1240. doi:10.1136/gutjnl-2021-324598
Wilkinson JM, Gill MC.Irritable bowel syndrome: questions and answers for effective care.Am Fam Physician. 2021;103(12):727-736.
Drossman DA, Hasler WL.Rome IV-functional GI disorders: disorders of gut-brain interaction.Gastroenterology. 2016;150(6):1257-1261. doi:10.1053/j.gastro.2016.03.035
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