The Best and Worst Foods for Irritable Bowel Syndrome with Diarrhea (IBS-D)

written by Skye Sherman - Apr 24, 2023

Photo Credit: stevepb, by
Photo Credit: stevepb, by

Any gut health issues can feel like a losing battle. Identifying the condition is only the first step; after that, you still need to identify triggers, make lifestyle changes, and see a doctor for other recommendations to keep your health in check.

Bowel issues are not like other conditions where you can simply cut something out of your life altogether. Everyone needs to eat food! Cutting out certain foods can help, but there’s always a chance you’ll slip up (accidentally or on purpose) and end up in another unpleasant episode.

If you suffer from any type of irritable bowel syndrome, including Irritable Bowel Syndrome with Diarrhea (IBS-D), you know that certain foods play a main role in hurting or helping your level of wellness every day. Diet can be the most significant contributing factor to managing your episodes (or not).

While everyone’s situation is different, in this article, we’ll take a look at the best and worst foods for those with Irritable Bowel Syndrome with Diarrhea (IBS-D). While not everyone has the same triggers, there are some common foods that are known to nourish or cause issues for those with Irritable Bowel Syndrome with Diarrhea (IBS-D). Read on to learn more about what you can do to take your bowel health into your own hands.

The basics of Irritable Bowel Syndrome with Diarrhea (IBS-D)

First things first: what, exactly, is Irritable Bowel Syndrome with Diarrhea (IBS-D)?

According to WebMD, “IBS that causes increased diarrhea is often called IBS-D. If you have IBS-D, you have belly pain and other IBS symptoms plus frequent bowel movements. Your stool might be loose, though not always. You also might have sudden urges to use the bathroom.”

The article also explains that scientists do not currently know what exactly causes IBS or IBS-D. However, “women are more likely to have it than men, and it’s more common in adults under 50.” In addition, if any type of IBS runs in your family, you are more likely at risk for getting IBS or IBS-D too.

WedMD also explains, “With IBS, your colon is more sensitive than normal. It can react to things like stress, bacteria, and even certain foods. Your brain also plays a role and may respond too much to signals that control your colon. The result: Your intestines squeeze too hard, making food move too quickly through your system. That can cause pain, diarrhea, and other problems like gas.”

As you can see, there’s no clear cause for people who get IBS-D, but we do know that certain stressors are triggers, including certain foods. While contributing factors like stress, lifestyle choices, presence of bacteria, and mental and emotional health each deserve articles of their own, in this article, we’ll take a look specifically at how foods play a role in IBS-D.

What foods worsen IBS-D?

First, it’s important to note that foods do not directly cause IBS-D. However, some foods may trigger symptoms or make them worse.

Some of the biggest culprits are alcohol, caffeinated beverages, carbonated beverages, fried food, milk and dairy products, chocolate, and the artificial sweetener sorbitol. Note that sorbitol is a sneaky ingredient that may pop up where you least expect it, like in gum and mints. In addition, caffeinated beverages can include coffee or soda (which is also carbonated, so it’s a major offender!).

One other food may surprise you. While fiber is sometimes helpful for some people with IBS, such as those with IBS-C (IBS with constipation), those with IBS-D may get worse from consuming too much fiber.

As Cleveland Clinic puts it, “If you have irritable bowel syndrome (IBS), knowing what to eat can feel like the holy grail. For some patients, the right diet, along with attention to exercise, can control symptoms without medication.”

For many people, the right choice is a low-FODMAP diet, a type of low-carb diet that consists of easily digestible food.

Cleveland Clinic explains, “FODMAP stands for ‘fermentable oligo-, di-, and monosaccharides and polyols’ … FODMAPs are carbohydrates that may not be digested or absorbed well … Undigested carbohydrates are then metabolized by intestinal bacterial to produce excess gas, which leads to abdominal pain, diarrhea and/or constipation.”

Those with IBS-D may need to play with their consumption of whole grains, beans, fruits, and vegetables to figure out what works for them and what does not. Cleveland Clinic explains, “Fruits contain the sugar fructose, which can cause issues for IBS sufferers. Fructose is particularly high in apples and pears, and somewhat high in watermelon, stone fruits, concentrated fruit, dried fruit and fruit juice. Fruits with lower levels of fructose include bananas, citrus, grapes and berries.”

Certain vegetables can also cause gas and other bowel issues, especially cruciferous vegetables like broccoli, cauliflower, cabbage, coleslaw, sauerkraut, artichoke, brussels sprouts, onions, shallots, leeks, and asparagus.

What foods can help IBS-D?

As you can see, some foods may make IBS-D worse, but on the flip side, there are also foods that can help with IBS-D symptoms.

Good bacteria from foods like pickles and sauerkraut can be helpful, although for some people, sauerkraut may cause irritation. Those with IBS-D should stick to lactose-free dairy products and low-fructose fruits like berries, melons, citrus, and bananas. Many vegetables (like green beans, celery, carrots, spinach, sweet potato, zucchini, and squash) and herbs can also be helpful.

Instead of beans and legumes, experts recommend similar substitutions like rice, oats, polenta, millet, quinoa, and tapioca.

In addition, it probably won’t surprise you, but no matter what type of condition you do or don’t have, drinking water is vital! Consuming six to eight glasses of water a day to stay hydrated is important, especially considering that diarrhea can cause dehydration.

What do doctors say about Irritable Bowel Syndrome with Diarrhea (IBS-D)?

Of course, those with IBS-D will need to be under the care of a qualified healthcare professional. A doctor will diagnose IBS-D not through a certain test but with a look back at your health history and symptoms. For example, those suffering from abdominal pain or other major signs of IBS (like rectal bleeding or weight loss) for at least three months may be diagnosed with it.

In these cases, a doctor will likely want to test you for other diseases and conditions to rule them out before proceeding with an IBS-D diagnosis. If you have a family history of gastrointestinal cancer, your medical provider will probably want to make sure you do not have it before moving forward on any other kind of diagnosis. Checking for cancer and other diseases (including celiac disease or abnormal growths) may include a blood test or colonoscopy.

In addition, it’s important to remember that even if a person with IBS-D is as careful as possible with what they eat, they can still suffer from flare-ups. Depending on each individual’s situation, a doctor may recommend over-the-counter anti-diarrhea medications such as loperamide (Imodium), probiotics, or even peppermint oil supplements, or they may prescribe drugs like the anticholinergic medication dicyclomine (Bentyl) or hyoscyamine (Levsin) to slow bowel contractions. In some cases, the best option may be an antidepressant or anti-anxiety drug.

Another option that doctors may prescribe is rifaximin, or Xifaxan, which is an antibiotic you take for two weeks at a time that can decrease bacterial overgrowth and diarrhea. If the symptoms return, Xifaxan treatments can be repeated up to two more times. (*Always consult your doctor before taking any prescription medications.)



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While the above article is based on thorough research, we do not claim to offer a substitute for medical advice from a qualified healthcare provider. The article was written for information and educational purposes only. We aim to provide helpful information to our readers, but cannot provide a treatment, diagnosis, or consultation of any sort, and we are in no way indicating that any particular drug is safe or appropriate for you and your individual needs. To receive professional medical attention, you must see a doctor.