Treatment Options for Chronic Diarrhea and IBS-D

Chronic diarrhea can interfere with your ability to enjoy your life. Sometimes, a simple diet change or over-the-counter (OTC) medication can quickly resolve the problem. Often, a combination of strategies that may include prescription medication and counseling can help relieve your symptoms. Diarrhea-predominant irritable bowel syndrome (IBS-D) is a common cause of chronic diarrhea, and many of the strategies for managing this condition also apply to other types of chronic diarrhea.


Man looking in a refrigerator

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Food can make a big difference when it comes to managing diarrhea. Some foods are friendlier to the gastrointestinal (GI) system, while others can be irritating. Many people get stomach upset and diarrhea after consuming dairy products. If you have a sensitive stomach, a heavy or fatty meal can cause diarrhea. And gluten is another common culprit.

There is a strong chance that you won't develop diarrhea from all of the foods that are commonly associated with diarrhea and that you are more sensitive to some than others. Consider eliminating one type of food from your diet at a time so you can pinpoint the problem.

High FODMAP foods may cause diarrhea in some people wiwh IBS-D.

As you are recovering from a bout of diarrhea, there are also foods you can eat while you are starting to feel better.

Self-Care Strategies

Woman relaxing with a cup of tea

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If you experience recurrent diarrhea, you may be able to prevent some episodes, stay comfortable when you have them, and recover faster by adopting some lifestyle modifications.

Diarrhea can make you dehydrated. Try to stay hydrated by sipping on water, tea, juice, or an electrolyte replacement drink.

Managing abdominal pain with at-home techniques such as applying a warm pack can help you as you are getting over a flare-up. Relaxation techniques may be helpful because there is a link between stress, anxiety, and the GI system.

One of the most upsetting symptoms is urgency, the feeling that you have to go immediately. Techniques for dealing with urgency include deep breathing and emptying on a regular schedule.

Over-the-Counter Products

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Over-the-counter medications and supplements can be effective when it comes to managing diarrhea.

Some popular supplements used for diarrhea include calcium and probiotics, which have been shown to help prevent flare-ups or alleviate them. Slippery elm is an herb that has been used for diarrhea.

Despite the rising popularity of using probiotics to treat diarrhea, it's important to understand research has been too limited for healthcare providers to formally recommend this treatment for IBS. Clinical practice guidelines from the American Gastroenterology Association recommend probiotics in the context of a clinical trial for symptomatic children and adults with IBS.

Medications you can take without a prescription include Imodium (loperamide) and Lomotil (diphenoxylate). Be sure to talk to your healthcare provider, because chronic use (even of OTC medications) can cause side effects.

Prescription Medication Options

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If you do not improve with at-home strategies and OTC medications, your healthcare provider may recommend a prescription-strength medication for you. Some of the prescription options used for chronic IBS include Xifaxan (rifaximine) and Viberzi (eluxadoline).

Chronic diarrhea may also improve with muscle relaxants, antidepressants, and bile-acid binders. However, SSRI antidepressants (including Zoloft and Lexapro) may exacerbate diarrhea.


Two women having a therapy session

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If medication isn't alleviating your symptoms (or if it causes you to have side effects), therapy and counseling can help. You may be reluctant to consider this option out of concern that your diarrhea symptoms will be viewed as "just in your head." But counseling and therapy can help reduce the symptoms of many true medical conditions.

Getting counseling for a medical problem can be effective as an adjunct to other treatments, such as diet, supplements, or medication.

Awareness of your physiological and hormonal changes can help you sense symptoms of diarrhea earlier, potentially avoiding triggers that can exacerbate them. Some people may also be able to reduce anxiety caused by diarrhea or the anticipation of diarrhea. And experts agree that reducing anxiety and depression can help decrease the frequency of diarrhea for some people.

There are several types of counseling and therapy that can help in managing chronic diarrhea. Cognitive behavioral therapy and hypnotherapy have also been found to lessen the severity of IBS symptoms.


Woman staring at herself in a bathroom mirror

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Enjoying your life can be challenging when you have frequent episodes of diarrhea. Day-to-day activities such as dining out, traveling, working, going to parties, and going to school can all be tricky when you have chronic diarrhea.

Experiencing a disruptive symptom like diarrhea on a regular basis can make you feel like you should stay home near your own bathroom. That, however, is no way to live. With a little planning, it is possible to manage the needs of your body and lead a full life.

One of the most important aspects of coping is to figure out what you will do if the worst-case scenario—a bathroom accident—occurs. Many people who have chronic diarrhea spend a lot of time being anxious about this possibility. But pushing through the negative thoughts and moving forward to decide what you would do if you have an accident will provide you with more peace of mind than just thinking of this possibility as a problem without a solution.

Be sure to pack a survival kit for bathroom emergencies and to have a plan of what to do if you have a bathroom accident.

Keep in mind that it is not normal to have diarrhea. If it is impacting your life, it's important to contact your provider.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Böhn L, Störsrud S, Törnblom H, Bengtsson U, Simrén M. Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life. Am J Gastroenterol. 2013;108(5):634-641. doi:10.1038/ajg.2013.105

  2. 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

  3. Park SH, Han KS, Kang CB. Relaxation therapy for irritable bowel syndrome: A systematic review. Asian Nurs Res. 2014;8(3):182-192. doi:10.1016/j.anr.2014.07.001

  4. Didari T, Mozaffari S, Nikfar S, Abdollahi M. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World J Gastroenterol. 2015;21(10):3072-3084. doi:10.3748/wjg.v21.i10.3072

  5. Hawrelak JA, Myers SP. Effects of two natural medicine formulations on irritable bowel syndrome symptoms: A pilot study. J Altern Complement Med. 2010;16(10):1065-1071. doi:10.1089/acm.2009.0090

  6. Su G, Ko C, Bercik, P, ET al. AGA clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders. Gastroenterology. 2020;159(2):697-705. doi:10.1053/j.gastro.2020.05.059

  7. Meleine M, Matricon J. Gender-related differences in irritable bowel syndrome: Potential mechanisms of sex hormones. World J Gastroenterol. 2014;20(22):6725-6743. doi:10.3748/wjg.v20.i22.6725

  8. Mudyanadzo TA, Hauzaree C, Yerokhina O, Architha NN, Ashqar HM. Irritable bowel syndrome and depression: A shared pathogenesis. Cureus. 2018;10(8):e3178. doi:10.7759/cureus.3178

  9. Everitt HA, Landau S, O’Reilly G, et al. Assessing telephone-delivered cognitive-behavioural therapy (CBT) and web-delivered CBT versus treatment as usual in irritable bowel syndrome (ACTIB): A multicentre randomised trial. Gut. 2019;68(9):1613-1623. doi:10.1136/gutjnl-2018-317805

Additional Reading

By Barbara Bolen, PhD
Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.