If you suffer from IBS-D or diarrhea predominant Irritable bowel syndrome you will know the symptoms already - persistent diarrhea symptoms, urgency, abdominal pain, wind and bloating to name but a few, sound familiar?
The worst thing about all this is that symptoms can occur at any time, but sudden diarrhea after eating or diarrhea in the mornings are the most common.
If you find your symptoms are occurring at night, the diagnosis should be reconsidered as this is really very unusual.
In this section, I will discuss your diarrhea, the diet that may help your symptoms and other treatment options that may help your symptoms.
When you look at the various causes of diarrhea, you have to consider whether this is true diarrhea or not.
A lot of people describe diarrhea which would seem pretty obvious to most, but if you only open your bowels 1-2 times a day, it is very unlikely that you have true diarrhea.
Diarrhea is defined in various ways, but most of my patients define their diarrhea as going to the toilet to open their bowels too frequently and/or producing loose to watery stools.
Now for the technical stuff! If you ask a doctor what diarrhea is they will define it by the stool weight. The diagnosis of diarrhea is made if the stool weight is greater than 250g a day, although in practice this is rarely confirmed as most people really don’t want to go weighing stools. So, if you want to know that you have true diarrhea or not - weigh your stools in a 24 hour period.
IBS-D diarrhea is normally less than 250g a day, so whilst going to the toilet is frequent, the actual amount passed is small in comparison to the urgency of the symptoms your experience.
I’m sure you recognize the need to get to the toilet urgently, but only to pass small amounts from the effort. That’s not to say that its all over very quickly, oh no It usually means sitting there sometimes for hours because the urge remains doesn't it.
No one knows the underlying cause for your symptoms, but it is likely to be multifactorial including influences such as foods, infections, environment, lifestyle and maybe genetics too as sometimes you do see an increase in IBS in some families.
Your IBS-D is diagnosed by the symptoms you experience and length of your illness. To clarify this it is classified by the Rome Criteria as abdominal pain with symptoms of diarrhea for 3 months or at least recurring diarrhea symptoms over this time. Sudden diarrhea after eating is common with it or in the mornings.
Investigations for your diarrhea are not always necessary, although the amount of investigation really depends on your age and history. If you are over 50 years of age with new onset of symptoms or have a young family history of bowel cancer, it would be wise to have further investigations. These may include blood tests, a stool sample and referral to a gastroenterologist for further investigations such as a colonoscopy, flexible Sigmoidoscopy, CT Colon or barium enema procedure.
Your treatment for IBS diarrhea needs to be both effective and simple. Whilst drugs or “antidiarrheals” such as loperamide (Imodium), Codeine Phosphate, Kaolin and Morphine or more unusual treatments such as cholestyramine (Questran) or Colestipol can be effective, most sufferers understandably don’t want to take drugs in the long term.
So, what you need to be doing is determine other strategies to reduce your diarrhea symptoms in the longer term. By far the most common or best way of dealing with this is through special diets. The saying “you are what you eat” really does have some bearing in Irritable Bowel Syndrome. We all know that diet has an effect on Irritable Bowel Syndrome symptoms don’t we?
You probably know some foods that upset your diarrhea already. Sudden diarrhea after eating is well recognized by sufferers. Taking a good fluid intake to maintain hydration, avoiding complex carbohydrates, fats and dairy products can all be helpful in reducing symptoms. A nutritionist or dietitian can be very helpful when reviewing this, but you can also learn more about the right diet for your IBS if you look on my diet page.
Share your IBS with other sufferers here as outlined.