Digestive Health Irritable Bowel Syndrome IBS With Diarrhea An Overview of Diarrhea Predominant IBS (IBS-D) By Barbara Bolen, PhD twitter Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome. Learn about our editorial process Barbara Bolen, PhD Medically reviewed by Medically reviewed by Robert Burakoff, MD, MPH on October 13, 2020 linkedin Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases. Learn about our Medical Review Board Robert Burakoff, MD, MPH on October 13, 2020 Print Table of Contents View All Table of Contents Symptoms Causes Treatment Diarrhea predominant irritable bowel syndrome (IBS-D) is a subtype of IBS in which a person experiences frequent episodes of diarrhea with accompanying abdominal pain. Like IBS, IBS-D is a functional gastrointestinal disorder (FGD) in that there is no visible disease, inflammation, or injury to account for its symptoms. It is estimated that approximately a third of people who have IBS experience the disorder with diarrhea as the predominant bowel habit. Peter Cade/The Image Bank/Getty Images Symptoms of IBS-D As opposed to the other IBS sub-types, people who have IBS-D typically experience: Frequent bowel movementsLoose stoolsFeelings of urgency In addition, people who have IBS-D also experience some or all of the following symptoms of IBS: Abdominal painGas and bloatingA feeling of incomplete evacuationMucus in the stool According to the Rome III criteria for FGDs, other health disorders must be ruled out and symptoms must be experienced for at least three days per month over the past three months for a diagnosis of IBS-D to be made. 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, a condition known as irritable bowel syndrome - alternating type (IBS-A). Causes Although the exact reason why a person would develop IBS-D may not necessarily be pinpointed, researchers are investigating several different areas of inquiry. These include: A dysfunction in the brain-gut connection, with possible neurotransmitter involvementFood sensitivitiesGut dysbiosisIdiopathic bile acid malabsorption (I-BAM)Microscopic inflammation of the lining of the gutSmall intestinal bacterial overgrowth (SIBO) Treatment If you think that you might have IBS-D, please make an appointment with your doctor. There are other serious health conditions that share many of the same symptoms with IBS-D. It is essential that these be ruled out. If your doctor concludes that you have IBS-D, they will work with you on a treatment plan. They may recommend or prescribe you a medication. Options include: An anti-diarrheal medication, such as ImodiumAn antidepressant to slow down motility and ease the painAn antispasmodic to reduce gut cramping and painXifaxan, a targeted antibioticA bile acid binder such as cholestyramineA targeted opioid medication such as Viberzi IBS-D symptoms may also benefit from dietary changes. Eating smaller meals and avoiding large fatty meals may be of help. Keeping a food diary may identify possible food sensitivity. In addition, the low-FODMAP diet has research support for easing the symptoms of IBS-D. 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. Was this page helpful? Thanks for your feedback! One of the most challenging aspects of having IBS is trying to figure out what's safe to eat. Our recipe guide makes it easier. Sign up and get yours now! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article 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. Saha, L. Irritable Bowel Syndrome: Pathogenesis, Diagnosis, Treatment, and Evidence-Based Medicine. World Journal of Gastroenterology 2014 20:6759–6773.