Inflammatory bowel disease (IBD) causes various gastrointestinal issues, including diarrhea, because inflammation causes damage to the mucus lining of the digestive tract.

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IBD refers to a group of conditions that cause digestive tract inflammation. The two most common types include Crohn’s disease and ulcerative colitis (UC).

This article reviews IBD diarrhea and its symptoms, causes, treatment, prevention, management, and when to see a doctor.

IBD diarrhea can vary based on the type of IBD a person has.

People with Crohn’s disease may have watery, loose stool. Whereas people with UC may notice blood in their stool.

Diarrhea is the most common symptom people with IBD experience, with around 80% of people reporting the symptom. Other symptoms associated with IBD include:

Symptoms and their severity may vary from mild to severe. They may also go away for several months or years and then return. Experts often refer to this as a “flare-up.”

IBD causes inflammation in the digestive tract. The inflammation can cause damage to the mucous lining and disrupt the ion transport channels of the intestinal tract.

Damage to the intestinal ion transportation system causes the retention of electrolytes and water in the intestines, which leads to diarrhea.

The damaged barrier further worsens diarrhea by allowing pathogens into the tissues of the intestines. This causes the immune system to respond, damaging more tissue and worsening symptoms, such as diarrhea.

Treating IBD diarrhea often involves taking medications that specifically target the symptom.

In general, a doctor may recommend two types of antidiarrheal medications. The first type of medication helps alter the muscle activity of the intestine and slow digestion. Some examples include:

  • loperamide (Imodium)
  • diphenoxylate (Lomotil), only available with a prescription
  • cholestyramine (Prevalite and Questran) is available as a prescription
  • codeine sulfate, prescribed for short-term use
  • Pepto-Bismol provides anti-inflammatory effects that can help with diarrhea

Learn more about medications for diarrhea.

The second type of medication a doctor may prescribe helps adjust the amount of water in the intestines, helping a person’s body form stool better. A doctor may recommend inulin fiber (Benefiber) or psyllium husk (Metamucil).

These medications help regulate stool consistency and may help a person with IBD form more solid stool.

In addition to medications designed to help reduce a person’s diarrhea, people may need additional treatments for other symptoms and treatments for symptoms that do not involve the bowel. Some additional treatments a doctor may recommend for IBD include:

  • use of over-the-counter (OTC) or prescription pain relievers, such as acetaminophen
  • supplements to help boost blood counts
  • anti-inflammatory medications, such as:
  • surgery to repair or replace parts of the intestine

Read more about medications for UC.

A person can take steps to help manage their IBD flare-ups and symptoms, such as diarrhea, through some lifestyle modifications, including:

  • limiting alcohol consumption
  • avoiding foods that may trigger or worsen symptoms
  • taking steps to reduce stress
  • using vitamins or supplements
  • taking probiotics

Before starting any new supplements or changes to their diet, people should consider talking with a doctor. They can help recommend foods to avoid or eat and help manage medications and supplements a person takes regularly.

A person should follow all instructions from a doctor to help manage their symptoms and prevent flare-ups. They may also benefit from working with specialists to help manage their symptoms.

Systemic medications, which treat the whole digestive system, can help prevent flare-ups, while symptomatic medications can help prevent or treat diarrhea.

People may find that avoiding some foods may help, but experts do not recommend one diet over another to manage IBD. Instead, a person may benefit from keeping a food journal to help them figure out which foods trigger their symptoms, so they can avoid them.

More than 50% of people with IBD experience fecal urgency associated with the condition. Experts associate increased urgency with:

  • a lower quality of life
  • increased anxiety
  • more feelings of social isolation

False urges, also known as tenesmus, occur in several people living with IBD. The sensation feels similar to other periods of urgency, but when a person tries to relieve themselves, nothing or very little comes out.

In a smaller 2018 study, 32 of the 71 people with IBD reported experiencing tenesmus. Similar to diarrhea urgency, it can cause distress and disruptions to people’s normal routines.

A person can discuss any concerns with a doctor for suitable treatment methods.

A person should consider seeing a doctor if they:

  • have symptoms that may indicate IBD
  • experience worsening IBD symptoms despite taking medications and taking steps to control the condition
  • are considering starting or stopping medications or supplements
  • have questions about their treatment, symptoms, or others

A doctor can help diagnose and treat a person’s IBD, including helping them control their diarrhea.

Diarrhea is one of the most common symptoms of inflammatory bowel disease conditions. Crohn’s disease stool is often watery and loose, while ulcerative colitis often causes bloody stools.

A person can use OTC or prescription medications to control diarrhea. They should also alter their diet as needed and follow treatment recommendations from a doctor.

With treatment, an individual may better control diarrhea and other symptoms associated with IBD.