Article Figures & Data
Figures
- Figure 1
Algorithm for diagnosing irritable bowel syndrome-diarrhea (IBS-D).
- Figure 2
Suggested algorithm for treating irritable bowel syndrome-diarrheal type.
Tables
Inflammatory bowel disease Food intolerance or sensitivity Small intestinal bacterial overgrowth Bile acid diarrhea Pancreatic exocrine deficiency Medication side effects Functional diarrhea Colon cancer Chronic parasitic infection Microscopic colitis Thyroid disease Celiac disease Age over 50 Gastrointestinal bleeding Anemia Fever Night sweats Unintentional weight loss Family history of organic gastrointestinal disease Other symptoms that should alert provider to consider another diagnosis Nocturnal symptoms Symptoms that persist when fasting Low fecal osmotic gap (fecal osmotic gap = 290 mOsm/kg) – 2 × (stool Na + stool K); a low gap (< 50 mOsm/kg) suggests a secretory cause of diarrhea such as microscopic colitis. Patients with IBS would be expected to have a normal gap. Traditional IBS diet Eat small, frequent meals Reduce gas-producing foods, including:
Soda
Juice
Caffeine
Beans
Onions
Bagels
Pretzels
Alcohol
Wheat
Certain fruitsModified NICE diet Eat small, frequent meals Limit high-fiber foods Avoid:
Alcohol
Caffeine
Soda
SorbitolLow-FODMAP diet Avoid wheat, selected fruits and vegetables, corn syrup, onions FODMAP = fermentable oligosaccharides, disaccharides, mono-saccharides, and polyols; NICE = National Institute for Health and Care Excellence
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