Diarrhea and IBS: How to Ease Symptoms

Diarrhea episodes caused by irritable bowel syndrome (IBS) always seem to strike at the most inopportune times.

Invariably, the minute you’re far from a bathroom, in the middle of an important business meeting, or out on a date, that familiar rumble starts in your gut and you urgently need to find a bathroom. Perhaps the stress of those inconvenient times and the fear of an IBS episode are part of what makes diarrhea strike just at that moment — or maybe it’s related to something in your diet.

If you are living with diarrhea-predominant IBS, there are ways to manage your symptoms.

What Causes IBS Diarrhea?

IBS can cause a number of different symptoms, including diarrhea, constipation, abdominal pain, cramping, and gas, according to the Cleveland Clinic. These symptoms can occur individually, together, or alternate. People whose primary IBS symptom is diarrhea — a sudden, urgent need to have a bowel movement that results in loose and watery stools — have what’s called diarrhea-predominant IBS, or IBS-D.

Doctors don’t understand what causes diarrhea to occur in IBS patients, but some people notice that diarrhea strikes when they feel stressed or anxious. Others notice a pattern of diarrhea following certain foods, like dairy.

“Generally, IBS patients need to see if there are any food triggers that aggravate diarrhea. If dairy products tend to aggravate or trigger their symptoms, they may have associated lactose intolerance, and so dairy products may need to be avoided,” says Norman Gilinsky, MD, a gastroenterologist and a professor emeritus of medicine in the division of digestive diseases at the University of Cincinnati in Ohio.

A growing body of evidence suggests FODMAPs, or fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, may also be culprits. These foods result in an increased volume of liquid and gas in both the small and large intestine, leading to GI distress like abdominal pain, bloating, and gas. Avoiding foods high in FODMAPs can help relieve IBS symptoms.

Foods high in FODMAPs that may trigger IBS include:

• Fruits like apples, peaches, pears, and watermelon
• Vegetables including onions, garlic, beets, and Brussels sprouts
• Grains like barley, wheat, and rye
• Dairy
• Legumes
• Some artificial sweeteners, specifically sorbitol and mannitol

If you notice that your diarrhea episodes seem to always occur around stressful situations, the stress that your body feels could be what’s triggering your gut to react.

“If they recognize certain stress situations will produce diarrhea — and we can’t avoid stress in what we do these days — it may be reasonable to take an Imodium ahead of time. If someone is going to take part in a meeting that may be stressful and knows that they are likely to have diarrhea and cramps, an antidiarrheal ahead of time could be very useful,” says Dr. Gilinsky.

It’s important to note that it’s unusual for those with IBS to have urgent diarrhea in the middle of the night, according to UpToDate. Talk to your doctor if you are experiencing diarrhea in the middle of the night or any persistent changes in bowel habits or other symptoms of IBS — these may indicate a more serious health condition, notes the Mayo Clinic.

RELATED: 11 Foods to Avoid When You’re Having Digestive Problems

6 Ways to Manage IBS Diarrhea

No matter the cause of your IBS, there are ways to manage your symptoms to keep it from interrupting your life once, twice, or 10 times a day. Here are some suggestions to help you manage your diarrhea caused by IBS:

1. Take fiber. Fiber pill supplements or a powder mixture that contains psyllium (like Metamucil) can help some people with IBS control their diarrhea. “Some individuals may use a fiber preparation, which some people find useful to bind and increase the bulk of the stool for those who have diarrhea,” recommends Gilinsky. He also notes that fiber is more likely to be effective in those who experience stress-related diarrhea. Not all people will benefit from fiber supplements, though, and too much fiber can also cause gastrointestinal issues, so it’s best to consult your doctor.
2. Take an antidiarrheal. Try taking an over-the-counter antidiarrheal medication, such as loperamide (Imodium), as Gilinsky suggests. If you’ve got a situation coming up that you’re nervous about, try a dose of medication ahead of time to see if it settles your stomach.
3. Avoid trigger foods. If you notice that dairy products have you running to the bathroom, cut them out of your diet — particularly before an event or activity where you can’t be interrupted. Some other common triggers of diarrhea include fried and fatty foods, chocolate, caffeine, artificial sweeteners such as sorbitol, and carbonated drinks. Sometimes different foods can take time to trigger diarrhea, making it harder to pinpoint the offending food, so it’s worth experimenting with your diet to see what works best.
4. Manage stress. Stress is impossible to avoid, but can be managed in a variety of ways. Exercise is a great stress reliever — particularly types that allow for focus and meditation, like yoga. Even just taking a walk or going for a bike ride or a run can help relax your mind and body. Deep-breathing techniques and meditation are also good methods of managing stress and promoting relaxation.
5. Try therapy. Hypnotherapy and cognitive behavioral therapy have been shown to help some people manage diarrhea caused by IBS. These methods work on controlling fears and changing the way you think about your disease in order to prevent the body from responding with diarrhea.
6. Ask your doctor about medications and supplements. Antispasmodic medications, antidepressants, antibiotics, and other medications can offer some IBS patients relief from their diarrhea. Peppermint oil can also sometimes work as an antispasmodic. It’s important to note that some doctors no longer recommend probiotics to manage IBS-related diarrhea. You should always check with your doctor before beginning a new course of medication or supplements.
   

There are many different ways to try to control your diarrhea caused by IBS. It may take some time and a combination of methods, but keep trying. You don’t have to spend your life near a bathroom — you just have to figure out what works for your body.