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Irritable Bowel Syndrome Diarrhea

Discover how IBS-D, characterized by frequent loose stools, cramping and urgency, stems from gut-brain miscommunication. At GastroDoxs in Houston, board-certified gastroenterologist Dr. Bharat Pothuri offers personalized diagnosis, dietary guidance and therapies to restore comfort and improve daily life and well-being.

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Difficulty Swallowing

American Society for Gastrointestinal Endoscopy

About the Expert

Dr. Bharat Pothuri is a board-certified gastroenterologist and the founder of GastroDoxs. With extensive experience in digestive health, he specializes in advanced endoscopic procedures, chronic GI disorder management, and preventive care. Dr. Pothuri is dedicated to providing expert, patient-focused insights to help improve gut health and overall well-being.

What Is Irritable Bowel Syndrome with Diarrhea (IBS-D)?

A chronic functional gut disorder marked by frequent loose or watery stools.
Characterized by recurring abdominal pain, cramping, bloating, and urgent bowel movements.
Not driven by infection or inflammation but by a miscommunication between the brain and the gut.

Common Causes and Risk Factors

Altered brain-gut signaling that affects intestinal motility and sensitivity.
Dietary triggers such as dairy products, spicy foods, caffeine, and high-FODMAP items.
Psychological stress, anxiety, and a history of gastrointestinal infections.
Genetic predisposition-IBS often runs in families.

Signs and Symptoms

Frequent loose or watery stools, often occurring soon after eating.
Abdominal cramping or pain relieved by a bowel movement.
Bloating, gas, and a sensation of fullness.
Sudden, urgent need to use the bathroom.
In some cases, alternating episodes of diarrhea and constipation, plus fatigue.

Expert Treatment for Irritable Bowel Syndrome Diarrhea by Dr. Bharat Pothuri

Dr. Pothuri uses a step-by-step approach:

Medical History and Physical Exam

He reviews your gut symptoms, stool patterns (diarrhea, constipation, alternating), epigastric pain, dietary triggers, stressors, and family history.

Rome IV Criteria Assessment

He applies the standardized Rome IV guidelines to confirm IBS-D, focusing on the frequency and characteristics of abdominal pain and bowel habit changes.

Laboratory and Stool Tests

Blood work (CBC, thyroid, inflammatory markers) and celiac screening rule out other causes. Stool studies check for infections, inflammation, and small intestinal bacterial overgrowth (SIBO).

Endoscopic Evaluation

Colonoscopy-Recommended if you're over 50 or have -red-flag- signs (bleeding, weight loss, family history of colon cancer).
Upper Endoscopy-Performed when epigastric pain or reflux symptoms are prominent to exclude ulcers, gastritis, or other upper GI disorders.

Imaging and Motility Studies

Abdominal ultrasound or CT scan-to rule out structural liver, pancreatic, or gallbladder disease if indicated.
Breath tests or motility manometry-to evaluate for SIBO or abnormal intestinal movement in refractory cases.

Advanced Diagnostics (as needed)

In select patients, neuromodulation testing or biofeedback evaluation may be used to assess nerve-muscle interactions and guide specialized therapies.

Treatment

Our Team offers a full range of care for Irritable Bowel Syndrome with Diarrhea (IBS-D).

1. Lifestyle and Diet Changes

Low-FODMAP meal plans to reduce bloating and cramping
Regular eating schedule and adequate hydration
Stress-reduction techniques such as breathing exercises and yoga
Gentle exercise programs-walking, stretching, or tai chi
Adding soluble fiber to meals for stool consistency

2. Medications

Anti-diarrheals (e.g., loperamide) to control loose stools
Bile acid binders for bile-acid-related diarrhea
Antibiotics when small intestinal bacterial overgrowth (SIBO) is present
Antispasmodics to ease abdominal cramping
Low-dose gut-targeted antidepressants to calm intestinal nerves
Additional IBS-D-specific FDA-approved therapies as needed

3. Advanced Therapies and Testing

Biofeedback training to improve bowel-movement coordination
Neuromodulation for overactive gut nerves
Imaging and motility studies to assess intestinal function
Colonoscopy for patients over 50 or with red-flag symptoms
Personalized nerve-focused treatments for refractory cases

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2.8K

Patients Treated

Dr. Pothuri has treated more than 2.8K patients, helping individuals improve their digestive health and overall well-being through expert, personalized care.

20Y

Years of Experience

With over 20 years of experience, GastroDoxs has been a trusted provider of gastroenterology care, focusing on delivering the best outcomes for patients

About the Author

Dr. Bharat Pothuri is a Board-Certified Gastroenterologist and Hepatologist. With extensive experience in digestive health, he specializes in advanced endoscopic procedures, chronic GI disorder management, and preventive care. Dr. Pothuri is dedicated to providing expert, patient-focused insights to help improve gut health and overall well-being.

Frequently Asked Questions

What can trigger IBS-D?

Stress, certain foods (dairy, caffeine, spicy dishes, high-FODMAP items), and past gut infections are common triggers.

Is IBS-D dangerous?

No. IBS-D can significantly impact quality of life, but it does not cause intestinal damage or increase cancer risk.

When will I start to feel better?

Many patients notice symptom relief within two to four weeks of starting a personalized treatment plan.

Do I need a colonoscopy?

If you're over 50 or have red-flag signs (bleeding, unexplained weight loss, family history of colon cancer), Dr. Pothuri may recommend one.

Do probiotics help?

Some probiotic strains can rebalance gut flora and reduce symptoms. Dr. Pothuri will guide you on the best options.

What if treatment does not work?

We offer advanced testing and therapies-such as motility studies, biofeedback, and neuromodulation-for patients with persistent symptoms.

Does stress make IBS worse?

Yes. Stress management techniques-like breathing exercises, mind-body therapies, and regular gentle movement-often help improve symptom control.

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