Irritable Bowel Syndrome - Diarrhea Type (IBS-D)

Irritable Bowel Syndrome with Diarrhea (IBS-D) is a disorder of gut–brain interaction. This means the signals between your gut and nervous system become oversensitive. IBS-D is a real and sometimes debilitating condition, where abdominal pain is the main symptom, often accompanied by frequent loose or urgent bowel movements. You may feel discomfort or pain even when there is no dangerous problem.

Doctors diagnose IBS-D using internationally accepted standards called the Rome IV criteria.

IBS-D is different from conditions such as Crohn’s disease or ulcerative colitis. Unlike those diseases, IBS-D does not cause inflammation or damage to the bowel. Instead, it changes how the bowel functions and how the gut senses pain.

A colonoscopy is not always required to make the diagnosis. It may be recommended if there are concerning features, such as:

A strong family history of colon cancer
Unexplained weight loss
Blood in the stool
Symptoms that wake you at night or seem unusual

If these warning signs are absent, your doctor can usually diagnose IBS-D based on your symptoms, medical history, and physical examination.

Common Causes and Triggers

Changes in gut bacteria (microbiome imbalance)
Overactive pain signals in the gut nerves
Stress or anxiety, which can worsen gut sensitivity
Certain foods (especially high in FODMAPs—fermentable sugars that draw water and gas into the gut)

Typical Symptoms

More frequent bowel movements than usual
Soft or watery stools
Abdominal bloating, cramping, or pain

Treatment Approach

Managing IBS-D works best with a multifaceted plan. No single option works for everyone, so we build a tailored plan together.

Lifestyle and Diet

Low-FODMAP diet: With the help of a dietitian, reducing certain hard-to-digest sugars (such as lactose, fructose, and some fibers) can ease bloating, gas, and pain. This diet can be complex, so the best results come when it is guided by a trained dietitian rather than trying to follow it on your own.
Probiotics: A multi-strain probiotic can help balance gut bacteria.
- i.e. Jamieson Probiotic 10 billion - 14-strain daily probiotic(Costco) or Weber Naturals Probiotic 30 billion - 8 strain daily probiotic (Walmart)
Fluids: Help prevent dehydration.
Exercise: Brisk moderate physical activity(Brisk walking 20-30 minutes, 3-5 times a week) improves abdominal pain by desensitizing visceral nerves, reducing urgency, bloating, and cramping.

Medications

If lifestyle changes are not enough, medications may help:

Amitriptyline
Eluxadoline (Viberzi)

These medicines are primarily intended to reduce nerve sensitivity, which helps pain. They also help to improve bowel frequency and cramping.

Mind–Body Care

Psychotherapy (such as CBT): Can help reduce the stress and anxiety that often worsen IBS symptoms. This is especially helpful if symptoms are long-lasting or affect quality of life.

What You Can Expect

IBS-D is a chronic condition, but it can be well-controlled with the right combination of diet, lifestyle, and medications.
It is not dangerous and does not increase your risk of cancer.
Symptoms often come and go. You may have better weeks and tougher weeks.

When to Seek Medical Advice

Contact your doctor if you notice:

Blood in your stool
Unexplained weight loss
Symptoms waking you at night
Symptoms not improving despite treatment