Managing IBS with Predominant Diarrhea and Constipation

February 29, 2024

Irritable Bowel Syndrome (IBS) is a common disorder affecting the large intestine, leading to symptoms such as cramping, abdominal pain, bloating, gas, and changes in bowel habits. IBS is often categorized into three types, depending on the most common bowel symptom: IBS with predominant constipation (IBS-C), IBS with predominant diarrhea (IBS-D), and IBS with mixed bowel habits (IBS-M). This article focuses on understanding and managing IBS with predominant symptoms of diarrhea and constipation.

Understanding IBS-D and IBS-C

IBS-D is characterized by frequent, loose, or watery stools, often accompanied by an urgent need to have a bowel movement. Individuals may experience discomfort and an inability to control bowel movements. On the other hand, IBS-C involves hard, lumpy stools and infrequent bowel movements, often resulting in straining and discomfort during defecation.

Dietary Management

For IBS-D:

  • Limit Trigger Foods: Foods and beverages that can worsen diarrhea include caffeine, alcohol, spicy foods, fatty foods, and dairy products for some individuals.
  • Soluble Fiber: Incorporating soluble fiber from sources like oat bran, barley, nuts, seeds, and some fruits and vegetables can help solidify stools. However, it’s important to increase fiber intake gradually to avoid gas and bloating.
  • Stay Hydrated: Adequate fluid intake is crucial, especially with diarrhea, to prevent dehydration.

For IBS-C:

  • High-Fiber Diet: A diet rich in both soluble and insoluble fiber can help improve bowel movement frequency. Sources include vegetables, fruits, whole grains, and legumes.
  • Hydration: Drinking plenty of water throughout the day can help soften stools, making them easier to pass.
  • Limit Low-Fiber Foods: Reducing the intake of low-fiber foods, such as meat, dairy, and processed foods, may also alleviate constipation.

Lifestyle Modifications

Stress management plays a critical role in alleviating IBS symptoms. Regular exercise, adequate sleep, and relaxation techniques such as yoga or meditation can help reduce stress levels. Additionally, establishing a regular, relaxed eating schedule can improve bowel regularity.

Psychological Approaches to Managing IBS Symptoms

Psychological therapy has emerged as a valuable component in the management of IBS symptoms due to the disorder’s link with stress and mental health. Cognitive-behavioral therapy (CBT) is particularly effective in helping individuals alter negative thought patterns and develop coping strategies that can mitigate the impact of IBS on daily life. Additionally, hypnotherapy has shown promise in improving symptoms by encouraging deep relaxation and altering the perception of pain and discomfort. It is essential for individuals to work with a trained professional to explore these psychological approaches as part of a comprehensive IBS management plan.

Complementary and Alternative Therapies

In addition to conventional therapies, many individuals with IBS explore complementary and alternative medicine (CAM) options for symptom relief. Common CAM practices include acupuncture, which may help regulate the digestive system and reduce pain, and probiotics, which aim to balance gut flora and have been shown to alleviate symptoms for some people with IBS. It’s important for patients to discuss the use of CAM therapies with their healthcare provider to ensure safe integration into their overall management strategy.


Managing IBS requires a comprehensive approach that includes dietary changes, lifestyle modifications, and possibly medication under the guidance of a healthcare professional. Understanding your body’s responses to different foods and stressors and making adjustments accordingly is key to controlling IBS symptoms and improving quality of life. For both IBS-D and IBS-C, it’s important to maintain open communication with healthcare providers to find the most effective management strategies tailored to your specific symptoms.