Is worsening diarrhea and urgency normal in IBS-D?

Question

Hello doctor,

I am a 30-year-old male with IBS-D for almost a year. Recently, my diarrhea has increased to five to six loose stools daily with sudden urgency, especially after meals. I also experience lower abdominal cramps and bloating, which improve after passing stool. Even simple home-cooked foods sometimes trigger symptoms. I want to know the following:

Is this type of flare normal in IBS-D, or should I repeat some tests?
Can long-term use of antispasmodic medications harm my intestines?
Should I start a strict low-FODMAP diet immediately, or try probiotics first?

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for reaching out.

Your symptoms match irritable bowel syndrome with diarrhea or IBS-D. It is a common digestive problem where your stomach and intestines are sensitive. This means your digestive system sometimes reacts strongly, causing loose stools five to six times a day, urgency after meals, stomach cramps, and bloating that gets better after passing stool. Flare-ups like these are common and can come and go. They may worsen with stress, certain foods, or a sensitive gut.

If you were already diagnosed and do not have alarm signs like weight loss, blood in stool, anemia (low blood count), nighttime diarrhea, or fever, you usually do not need repeat tests. But if symptoms suddenly worsen or new warning signs appear, your doctor may do blood or stool tests to rule out other issues.

Antispasmodic medicines (like Hyoscine, Mebeverine, Dicyclomine) relax the gut muscles to reduce cramps. They are safe long-term and do not harm the intestines, though some people may get mild side effects like dry mouth or constipation.

Diet changes can help a lot. A low-FODMAP diet (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) avoids certain foods that produce gas and cause diarrhea. It works best when introduced slowly and with guidance to ensure you still get enough nutrients. Probiotics (healthy bacteria) may also help balance your gut and are safe to try for a few weeks.

Other helpful steps include eating regular meals, managing stress, sleeping well, and limiting caffeine, fatty foods, and artificial sweeteners. If these measures do not control your symptoms, your gastroenterologist can discuss other treatments designed specifically for IBS.

I hope this helps.

Please revert in case of further queries.

Thank you.