Symptoms of IBS-D
As opposed to the other IBS subtypes, people who have IBS-D typically experience:
Frequent bowel movements Loose stools Feelings of urgency
In addition, people who have IBS-D also have some or all of the following symptoms of IBS:
Abdominal pain Gas and bloating A feeling of incomplete evacuation Mucus in the stool
According to the Rome IV diagnostic criteria for IBS, symptoms must occur at least once a week, on average, for a period of at least three months.
Some people who have IBS may find that they switch from times of having IBS-D to times of experiencing constipation-predominant IBS (IBS-C).
Others alternate between constipation and diarrhea on a regular basis, which is a subtype known as IBS-mixed type (IBS-M) or IBS-alternating type (IBS-A).
Causes
Although the exact cause of IBS-D remains unknown, researchers are investigating several different possibilities. These include:
A dysfunction in the brain-gut connection, with possible neurotransmitter involvement Food sensitivities Gut dysbiosis Idiopathic bile acid malabsorption (I-BAM) Inflammation in the lining of the gut Small intestinal bacterial overgrowth (SIBO)
Treatment
If you think that you might have IBS-D, please make an appointment with your healthcare provider. There are other serious health conditions that share many of the same symptoms with IBS-D. It is essential to rule these out.
If your healthcare provider concludes that you have IBS-D, they will work with you on a treatment plan. They may recommend over-the-counter treatments or prescribe you a medication. Options include:
An anti-diarrheal medication, such as Imodium (loperamide) An antidepressant to slow down motility and ease pain An antispasmodic to reduce gut cramping and pain Xifaxan (rifaximin), a targeted antibiotic A bile acid binder such as Prevalite (cholestyramine) A targeted opioid medication such as Viberzi (eluxadoline) Soluble fiber supplements Peppermint oil Probiotics
In addition, the American College of Gastroenterology recommends all IBS patients try a low-FODMAP diet to see if it helps ease symptoms. IBS-D symptoms may also benefit from other dietary changes, such as:
Eating smaller meals Avoiding high-fat meals Avoiding fried foods Keeping a food diary Identifying and avoiding your IBS trigger foods
Last, IBS-D symptoms may be reduced through mind/body approaches, with cognitive-behavioral therapy (CBT) and hypnotherapy having the most research backing their effectiveness for IBS.
