I have IBSD. Can it cause colitis or malabsorption?

Question

Hello doctor,

I am 36 and recently diagnosed with IBS-D after multiple stool tests came back normal. I travel frequently for work, and diarrhea hits suddenly without warning, which is embarrassing. I was prescribed Librax, but I feel drowsy after taking it. So, my concerns are:

Is this medication safe for regular use or habit-forming?
Are there any non-sedating options for urgency control?
Also, can IBS-D ever turn into something serious later, like colitis or malabsorption?

I worry because my weight fluctuates slightly, and my appetite is inconsistent during flares.

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concerns.

Your symptoms are typical of irritable bowel syndrome with diarrhea predominance (IBS-D), especially with sudden urgency during travel or stressful situations. IBS is a functional gut disorder, meaning the bowel is structurally normal but more sensitive and reactive.

You mentioned Librax. It contains Chlordiazepoxide (a mild sedative) and Clidinium (an antispasmodic).

The drowsiness you feel is a known side effect, and because it contains a Benzodiazepine component, it is generally not preferred for long-term daily use unless carefully supervised.

There are non-sedating options that can help control urgency and diarrhea, such as antidiarrheal medicines (for example, Loperamide taken before travel or important events), antispasmodics without sedative effects, bile-acid binders, or IBS-specific therapies like Eluxadoline in selected patients.

IBS itself does not turn into inflammatory bowel disease, colitis, or cancer, and it does not cause permanent intestinal damage.

Weight fluctuation and reduced appetite during flares are common because symptoms affect eating patterns, but persistent weight loss would require reassessment.

A few helpful strategies you can follow include:

Identifying dietary triggers (often with a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet trial).
Limiting caffeine and high-fat foods,
Using stress-management techniques.
Planning medication before travel.

With tailored treatment, most IBS-D patients achieve better control of urgency and improved quality of life.

I hope this helps.

For more queries, feel free to reach out to me anytime.

Thank you.