Diarrhoea & irritable bowel syndrome (IBS)

For many people living with irritable bowel syndrome (IBS), diarrhoea is an unwanted side effect.

IBS that causes diarrhoea is often called IBS-D. If you have IBS-D, you have stomach pain and other IBS symptoms plus frequent bowel movements. Your stools (faeces) may be loose, though not always. You also may have sudden urges to use the bathroom.

While there isn’t a cure for IBS-D, there are treatments that can improve the quality of your live and help you feel better.

What Causes IBS-D?

Researchers don’t know what causes IBS or IBS-D. However, women are more likely to have it than men and it’s more common in adults under 50 years of age. If you have a family member with IBS, your odds of getting IBS or IBS-D go up.

With IBS your colon (the main part of the large intestine) is more sensitive than normal. It can react to things like stress, bacteria and even certain foods.

Your brain also plays a role and may respond too much to signals that control your colon. The result: your intestines squeeze too hard, making food move too quickly through your system. That can cause pain, diarrhoea and other problems like gas.

How is IBS-D Diagnosed?

Your doctor will look at your health history and symptoms. If you have had abdominal pain and other signs of IBS for at least 3 months you may have it and receive a diagnosis

How is IBS-D Treated?

Getting relief from ISB-D may take some detective work. You’ll probably need to try several strategies and use many different techniques at a time. Make sure your GP is in the picture so they can work with you to find an effective plan.

Possible treatments include:

Diet changes – foods and beverages don’t cause IBS-D but some may trigger your symptoms or make them worse. Many believe that drinks containing caffeine can affect bowel motions. Try reducing your intake of tea, coffee and other drinks containing caffeine such as carbonated fizzy drinks. Alcohol, fried food and milk products may also make IBS-D worse.

A few changes in your diet may help ease IBS with diarrhoea. Avoid those foods that you identify as symptom triggers. Common foods that may cause diarrhoea include: 

  • Wholemeal bread and wholegrain cereals, nuts.
  • Bran and fibres such as isphagula husk and wheat bran.
  • Magnesium and vitamin C high dose supplements.
  • Caffeine from coffee, cola drinks, fast acting pain medicines and tea.
  • Lactose (milk sugar) and fructose (fruit sugar). A trial of lactose free milk and fruit juice avoidance will help identify if these natural sugars are a problem, especially if bloating is present along with diarrhoea.
  • Sugar free gums and sweets containing sorbital or xylitol sweeteners which can cause diarrhoea in relatively small amounts.

Try keeping a food diary so you can track what foods and drinks make your diarrhoea worse. You can then work towards eliminating these from your diet to see what effect they have on your bowel movements and other symptoms. It is advisable when embarking on any food/drink elimination diet to consult your GP or other healthcare professional.

Opinion is divided over when and what you should eat if you have diarrhoea. In the main, experts agree that you should eat solid food as soon as you feel able to. It is best to eat small, light meals, and avoid fatty, spicy or heavy foods.

Stress Relief

The link between stress and IBS is complicated. Stress and related issues like anxiety and depression don’t cause IBS but they can make symptoms like diarrhoea worse. This is why it is important to try and find effective ways to manage your mood. Exercise can help you feel better and improve the way your bowel functions too. Massage, yoga, hypnotherapy and forms of talk therapy can help with stress, which may lessen your symptoms.

Over the Counter Medicines- these types of medicines are sometimes referred to as Antimotility Medicines and are designed to stop diarrhoea.

Prescription Medicines - there are several options your doctor can prescribe – make an appointment to talk with your GP about the options.

Rehydration therapy - if you are still dehydrated, despite drinking water, you may want to consider taking a specialist over the counter rehydration medicine. Your pharmacist can help you to find a product that will help.

Lifestyle changes

Many people with bowel movement problems often feel like they can't go out for fear of suddenly needing to use the toilet. Toilet problems can be a real embarrassment for many people particularly if you are out and about. Charity Bladder & Bowel Foundation have a very useful Toilet card. The card clearly states that the holder has a medical condition and needs to use a toilet quickly. Although it does not guarantee access to a toilet, most places will be willing to help. The card is a small, credit card size, designed to fit easily into a purse, wallet or pocket. Simply show the card when out shopping and socialising and it may help you gain access to a toilet.

If you are in any doubt about how to treat your diarrhoea, you are advised to talk to your GP or healthcare professional.

Sources used in writing this article are available on request

Information contained in this Articles page has been written by talkhealth based on available medical evidence. Our evidence based articles are accredited by the PIF TICK, the only UK quality mark for trustworthy health information. The content however should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands or treatments.

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Information written by the talkhealth team

Last revised: 2 May 2018
Next review: 2 May 2021