13 Causes of IBS-D Most Doctors Never Test For (But Should)

by Steven Wright


Over 60 Million Americans are affected with Irritability Bowel Syndrome (IBS). IBS-D is when it’s diarrhea predominate IBS. In other words, if you suffer from diarrhea or loose stools weekly, then this is the label you get.

If you’re anything like me, you were probably told to supplement with fiber and prescription drugs. If you’re lucky your doctor might have mentioned that food changes could help. I wasn’t and the several doctors I saw said what I ate didn’t matter. But after a few years of choking down Metamucil® and spending way too much time in the bathroom I decided I didn’t want this “life sentence.”

The medical community is now learning that IBS is a diagnosis by exclusion. It puts people in a box but delivers nothing of value to the patient. IBS-D is a syndrome… not an actual disease. A label makes this group of symptoms easier to talk about but actually does a major disservice to patients.

Regardless of what a doctor has told you, it’s not “all in your head,” “not normal”, and Food DOES Matter. A doctor who’s interested in fixing you will be willing to spend the resources necessary to figure out the real cause of your reoccurring diarrhea.

IBS is Real and Can Lock You in Your Home

When you are having diarrhea, it’s pretty hard to do much of anything. You’re confined to a small radius around a toilet. Hopefully you have family or friends who can help out. If you have IBS-D, it’s likely you spend several hours a day in the bathroom, are scared that every fart might give you more than you bargained for and you’ve probably skipped several social events because you were scared how your stomach would respond.

Once I learned that IBS wasn’t actually normal and that people had cured themselves, I got kind of mad. Then I got resolute, I wanted to know how to make sure this stopped and never happened again.

How Would You Know If You Have IBS-D?

An IBS-D diagnosis is based on chronic diarrhea or altered bowel habits towards loose and watery stools. It’s also very likely that you suffer from abdominal pain, bloating, gas, and other gut pain. If you suffer slower motility and tend to be more constipated then it’s called IBS-C.

Common conventional medical practice is for a doctor to rule out other inflammatory bowel or organ conditions like Crohn’s disease or stomach ulcers. The Merck Manual suggests that diet can bring relief (gasp…) and also antidiarrheal drugs and antidepressants (seriously!?) as ways to treat IBS-D. Of course, any conventional treatment guide will mention fiber, laxatives and exercise as helpful but the reality is none of these actually solve the underlying problem. And for most people these options don’t offer much relief from the symptoms.

When I was ready for a different opinion, I wish I would have found a resource like this. Below are 13 common root causes of your chronic diarrhea and a few ideas on how you can rule them out. The point is: you have the power to change your health. But it starts with you first bringing these ideas to your doctor. Then,  if he/she are unwilling to help and find a better one here, here, or here.

13 Root Causes of IBS-D

The root causes of IBS-D are actual problems that, until corrected, will continue to cause diarrhea and can lead to further health decline. This list is in no particular order and if need be could be printed to take to your next doctor’s appointment.

1. Gut Dysbiosis: Is simply a condition in which the gut flora is disrupted.

Patient Translation: You have a bug problem in your gut. Each of us has over 100 trillion bacteria in our intestines and they live in a very complex and unique community. What we know at this point is if you upset that community, you hurt your health. And if bad bacteria, yeast or parasites take over it can result in diarrhea, constipation, gas, bloating, etc.

What to Do About It: The first step is to get a snap shot of what is actually happening down there. A very broad and in-depth stool test will be the ticket you need to figure out what is happening. Ask for a Metametrix GI Effects Complete stool test.

2.  Carbohydrate Malabsorption: The poly- and di-saccahride carbohydrates you’re eating are not being broken down normally and are causing digestive problems.

Patient Translation: The complex carbohydrates (wheat, rice, quinoa, etc) you’ve been told are good for your health are actually causing gas, diarrhea, bloating and other GI problems. Over the course of our lives, toxins, antibiotics, bad bugs, stress and many other problems damage the intestine’s ability to digest food. When a damaged gut lining can’t split sugar molecules like it normally should, these molecules end up sitting around in the small intestine, not being absorbed by the body, and provide a great food source for bacteria and other organisms that shouldn’t eat them.

What to Do About It: The Specific Carbohydrate Diet was designed to combat this problem. You could try the diet first, or you can ask your doctor for lactose and or fructose breath tests. A positive result will determine if you do have some deficiency in the digestion of carbohydrates.

3.  Dairy Intolerance: Inability to properly digest and assimilate cow, goat, or sheep milk products.

Patient Translation: You cannot properly digest either the carbohydrate and/or protein contained in milk products. This causes symptoms like diarrhea, gas, or bloating. The carbohydrate is lactose, and most people are familiar with Lactose Intolerance. There is a major marketing movement by corporations to create lactose free products… the problem is that just as many people cannot tolerate the protein in dairy called casein.

What to Do About It: You can stop eating all dairy and see if you notice any changes. You can also ask your doctor for two tests to rule this out (skip the skin allergy stuff, and regular blood testing it’s not reliable). The first test is to check lactose tolerance, using a breath test. The 2nd test is an Enterolabs test to check your ability to handle the casein protein.

4.  Gluten Sensitivity: New research shows that a group of people still have measurable inflammatory reactions to wheat even though they are negative for Celiac disease.

Patient Translation: Wheat contains many problematic proteins and chemicals that can cause significant diarrhea, brain and skin issues. It’s not just Celiac disease anymore. Research is still emerging, but suffice to say this is a much bigger problem than most thought.

What to Do About It: Get a saliva IgA test, Celiac blood tests, and if you really want to rule it out get this Cyrex Lab #3 to check to make sure all forms of wheat are okay for you.

5.  Celiac Disease: Is an autoimmune condition in which the villi of the small intestine get flattened/destroyed causing reoccurring diarrhea, loose stools and many other non GI health problems.

Patient Translation: For a Celiac, their small intestine is damaged to a degree in which it makes it very hard to digest and absorb foods. Wheat will continue to damage the gut wall if it is eaten and create further autoimmunity. Actually, all grains contain a toxic component very close to wheat that is likely problematic to these people.

What to Do About It: Ask your doctor to rule this out with an endoscopy taking a biopsy of the villi. The truth is it’s not just about wheat, so while you’re waiting stop eating all grains.

6.  Crohn’s Disease: Is an inflammatory bowel disease that can be found from the mouth to the anus and is characterized by patchy spots of inflammation.

Patient Translation: Crohn’s disease can literally affect any area of the digestive tract and comes in several forms. What is shared among these are patches of high inflammation. These areas can be deep into the tissue or just surface level. Most people have symptoms of reoccurring diarrhea that can be mild to violent.

What to Do About It: If after reading about Crohn’s you want to rule it out ask your doctor for an endoscopy and colonoscopy.

7.  Ulcerative Colitis: The other major inflammatory bowel disease usually located in the large intestine.

Patient Translation: Ulcerative Colitis is usually defined by wounds that do not heal (hence the name Ulcer-ative) in the large intestine. Most patients with Ulcerative Colitis have diarrhea and other abdominal pains. The loose stools or diarrhea can be mild to violent.

What to Do About It: Ask your doctor for a colonoscopy, which will be needed to rule it out.

8.  Small Intestinal Bacterial Overgrowth (SIBO): Is an overgrowth of bacteria in the small intestine.

Patient Translation: Bacteria are normal to the intestines, but not in high numbers in the small intestine (the majority is supposed to be in the large intestine). Due to a number of reasons, sometimes they creep out and make a home in the small intestine. Here they have free reign on the place and cause all kinds of trouble.

What to Do About It: Ask your doctor for either a lactulose breath test (standard) or a Metametrix Organix urine test (newer).

9.  Antibiotic Use: Extended or repeated antibiotic use for any reason can lower the total number of bacteria and lower the number of bacteria species that live in a normal healthy digestive tract.

Patient Translation: Antibiotics are not targeted missiles, instead they are like massive nuclear bombs for all bacteria in the body. So, if you get a sinus infection the antibiotic helps treat the infection. However, studies show that it also damages your gut flora, potentially long-term on every single use.

What to Do About It: The first step is to stop using them unless it is a life-threatening situation. The second step is getting a good idea about how healthy your gut really is. Get the Metametrix GI Effects complete stool test.

10.  Probiotics: Some people are intolerant to the probiotic bacteria they are supplementing with causing repeated loose stools or diarrhea.

Patient Translation: Probiotics are extremely helpful for almost everyone, unless the kind you’re taking is causing you GI problems. How could this be? Well, the strain in the supplement could be your enemy, the fillers, the capsule or supplementing bacteria to a gut that isn’t ready.

What to Do About It: If you’re still having diarrhea and you’ve tried several other tweaks to stop the diarrhea, think about stopping your probiotics for 7 days and see what happens. Try eating fermented foods instead.

11.  Egg Intolerance: Due to a leaky gut, the body can mount an immune response to egg, causing digestion, distress, and inflammation.

Patient Translation: Eggs have the potential to cause problems for people who are susceptible to them. They contain the protein albumin that the body will sometimes, in a state of sickness, mount a reaction to. When this happens you get sicker and feel bad. Oftentimes these people will get diarrhea several hours after eating eggs, but it could even take up to several days.

What to Do About It: You can get tested to see if you are mounting a response to egg, but that test doesn’t tell you much more than if you stop eating egg and feel better. Try removing egg from your diet for 4 days and see how you feel.

12.  Low Stomach Acid: Hypochlorhydria or achlorhydria are cases in which the stomach doesn’t produce enough acid in response to the food eaten. This disrupts digestion right from the beginning and can cause GI distress.

Patient Translation: If your stomach doesn’t’ make enough acid to digest the food you eat, then you won’t digest it. When you don’t digest your food, it can ferment and the wrong bugs can feed on it or it can get flushed out of the system because the body thinks something is wrong.

What to Do About It: The first step is to test for low stomach acid. If possible, get a Heidelberg test done for the best accuracy and find out exactly what is going on.

13.  Chronic Stress: The body’s stress response happens whether the stressor is an emotion, a thought, an email or a tiger. The response is a chemical process that can cause an increase in inflammation over a long period of time.

Patient Translation: Stress is normal, but it’s not supposed to happen all day long. In today’s environment, the human body is usually outmatched and thinks we are always fighting life and death scenarios. This causes the stress chemicals to always be high and deplete our body’s ability to heal and reduce inflammation. Chronic stress or even single high-stress events have significant stomach impact and can cause loose stools, diarrhea or pain.

What to Do About It: This should be checked for almost everyone. Unless you’re actively managing your stress in today’s world, you’re almost guaranteed to be chronically stressed. Ask your doctor for a 24-hr adrenal stress index test.

The One Step That Helps Everyone Suffering From Diarrhea

There is one common change that will help stop IBS-D, regardless of the root cause.

And that is changing the foods you eat.

The Specific Carbohydrate Diet gave me results in less than a week and I haven’t looked back since. You still should invest the time and effort to get the testing done that I’ve listed above, though. But while you’re waiting, if you’re sick of the pain then change the number one thing you have control over – what you eat.

To get started, you can download our free quick start guide here.


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About the author

Steven Wright Steve Wright is a health engineer and author. In 2009, he reached a breaking point when IBS took over his life and the doctors didn't know how to help. Since then, he has transformed his health and started SCDLifestyle.com to help others naturally heal stomach problems. You can check out his story here and find him on Google+, Facebook or Twitter.

The Specific Carbohydrate Diet Works

{ 62 comments… read them below or add one }

Caralyn @ glutenfreehappytummy August 30, 2012 at 5:53 pm

this is such a helpful post. thank you!


Charlie August 30, 2012 at 7:21 pm

This is a great overview that I wish I had been around 10 years ago. It would have saved me many months of googling! I’ve got to get the Metametrix tests sometime…


Steven Wright October 9, 2012 at 2:02 pm

@Charlie – Thanks I wrote it hoping that people will pass it on to those in their lives who may be struggling with loose stools or diarrhea. let us know what you find out.


Scott October 30, 2012 at 5:47 am

Will you do a similar article about IBS-C?


Steven Wright October 30, 2012 at 10:49 am
Kimberly January 29, 2013 at 4:56 am

Hi! I had a question & I’m having trouble finding an answer online that I trust, so I thought I might see if you guys know…
I am prepping for a colonoscopy tomorrow, and I’m just wondering if this is going to wipe out all the hard work I’ve done to build up the good bacteria in my gut (by consuming fermented foods)? Thanks for your help…
~ Kimberly


Jordan Reasoner January 31, 2013 at 3:27 am

Take lots of probiotics after and do a 2-3 intro diet to reboot after.



BH May 2, 2013 at 7:26 pm

You left out another major cause of GI distress, hormonal fluctuations. These fluctuations not only cause digestive issues, but can also be responsible for migraines.


dana May 17, 2013 at 8:51 am

I think I have ibs-d which is contributed from anxiety..i have always had a “nervous-fluttery” stomach…which is now 24/7. i can honestly say my day is not centered around a toilet (thank goodness)…but i do have to stay around one in the mornings. my health care provider is treating me with a slow introduction to Prozac…will have to see how that works.


Liz April 20, 2014 at 12:14 am

Did the Prozac help? I am having similar problems. Mostly when I wake in the morning and have intense anxiety that wears off by about noon. They have run a million tests with all negative results. I am on Lexapro and Xanax with no results.


John May 27, 2013 at 7:05 pm

Steve, this is the best article I’ve found on IBS and what to do about it. Thank you for sharing your knowledge with us!


Steven Wright May 30, 2013 at 9:48 am

Your Welcome!


Mr Ley June 26, 2013 at 1:27 pm

You should add 1 more cause of IBS-D that never gets looked at.
Bacteria in your drinking water- many people who are on well water or that have poor habits in handling their drinking water such as not running the faucet for 20 seconds before filling their glass are getting high amounts of bacteria every time they fill their drinking glass.


neal September 30, 2015 at 8:15 am

My town water has fluorides – I stop drinking it and went to bottle water.
Maybe the fluorides are killing the good and the bad. I started taking probiotics to replace what was killed off. It seems to work.


Sara July 6, 2013 at 3:30 pm

I was agreeing with what you wrote, until I found the spot about celiac disease…CHANGE YOUR INFORMATION!!! If a person is going to get a biopsy to confirm the diagnosis, they CAN NOT stop eating gluten. This will give a false negative, as the body has started healing the damage already. If they already stopped eating gluten and don’t want to start again, there is no point in having the biopsy done; it will just be a waste of money. This also applies to many food intolerances or allergies. Without the offending food in your body, there is no reaction. You have some really good information, but you have to be careful with what you tell people about serious diseases. There’s people out there that have CD, but got a false negative due to incorrect information about how to handle tests.


Daniel Butler December 1, 2013 at 11:51 pm

My background starts from a few years ago when one day out of nowhere I started
getting heart palpitations and constant burning in my stomach.
It was finally discovered I had a hiatal hernia and I got a Nissen Fundoplication.
About a year after the Nissen I started feeling quite a bit better.
(Im not sure if any of the above is super relevant to my problem now)

I still have some burning in my stomach occasionally, but I seemed to have developed ibs, (mostly in the morning)
I also get nauseated pretty frequently after eating, and my stomach really doesnt like it when i lay down flat.
Im only 24 and I am always scared of what I eat…
The worst offenders seem to be…
Tomato based foods
Spicy foods

Im sick of feeling crappy all the time and not being able to eat almost anything without my stomach disagreeing.
Any help would be appreciated…
Where do you think I should start?


Sherry T September 23, 2015 at 1:24 pm

Daniel Try a Vegan Diet. I’ve had much success with it…..if I stray the IBS D AND C returns with a vengeance. Sometimes I can eat chicken without problems test meats out and find out which ones you can handle and which ones you can’t it’s in your best interest to stay away from hard cheese and egg yolk and milk at all costs. Egg yolk= gas and the runs milk= gas and the runs hard cheeses= gas and the runs feta is a good cheese it’s made from goat goat cheese doesn’t seem to bother me at all. Just some recommendations from someone who’s been there. Hope it helps some. And Good Luck!


Lisa January 8, 2014 at 11:58 am

Hey.. Thanks for the advice.

I have what doctors have labelled me as having IBS. I do not fit into the usual criteria of IBS sufferers though. My main problem is the constant nausea that can happen very suddenly and at any time of the day but usually it is evening times. I have an extremely limited diet now where I have cut out food that I know will make me feel poorly and I basically live off toast beside other basic food. I still get bad times and still get nauseous a lot.

I am currently being treated as I have a bad lung infection and it looks like I will have to have part of my lung removed as the 10 week course of penicillin didn’t kill off all the infection or the fungal growth in the lung. I cough up a small amount of crap in the mornings so I know the infection is still there even if it’s just a little bit now.

I too, like Daniel, are so very tired of feel ill all the time and having no quality of life at all. Everyone enjoys food, it’s part of the pleasures of living, but not me… Food is my enemy and I want to know why this is and to put a stop to it.

I have had all the usual camera down into the stomach, xrays, ct scans, pelvic scans, blood tests, trip something test etc but I have never heard of some of these tests mentioned here.

I have been going downhill slowly for a good 12+ years now and I am at rock bottom. 6 stone – skin and bones :(

If anyone can help me, please get in touch. Thank you.


MiMi February 16, 2014 at 9:41 pm

I suffered from constant nausea for three months, regurgitating everything I ate. Lots of doctors and tests. Thought gall bladder, but my hida-scan showed bile ejection at over 40%, so this was dismissed. Finally found a great GI man who reviewed the tests and discovered that mine was hyperactive, at over 95%. Removed it a week later, and enjoyed my Mom’s meatloaf that same night.


Lori March 27, 2015 at 2:31 am

IF any of you are on any antidepressents , and others try to slowly gettting off , they had me on all that crap , for yrs, couldn’ figure it out’ it made everthing worse, I got deathly sick,still deal with IBS but Im not being ambulanced to the hospital everytime I turn around , seemed like it took forever to get all the toxins out of my system, got to were I thought I was struggeling just to live . Hope this helps


Randy February 18, 2014 at 10:13 am

Mr. Wright,

This was a great article and I appreciate the efforts and information. I feel bad trying to harvest more guidance from you sir. I am a soldier in the United States Army and have been for almost ten years. Over the last year I have seen my bowel issues growing more and more unpredictable. Often painful, watery, movements accompanied by the very pains your routinely mentioned.

Now, I have changed my diet as much as possible but there is only so much I can do while deployed to Afghanistan. I was wondering if there was anything you could offer to maybe help supplement while taking in consideration that I do not always have access the the freshest most beneficial leafy greens.

Additionally, trying to get a military Physician’s Assistant to approve an in-depth test, or assume it is anything other than an “upset stomach” is rather difficult. Mostly the treatment is Pepto, “drink water” and drive on.

Thank you for your time, and sharing this powerful stuff,



ms mc rory May 6, 2014 at 9:27 pm

Hi … I think I have ibs a lot of bloating and gas. Over the past week I have started to feel nausea though out the day, and feeling full even when I should eat , it feels like my food is in my throat , I eat a healthy diet and exercise every morning I drink weatgrass first thing each morning and almost every morning I have a normal bowel motion ,but sometimes feel incomplete


Stacy September 13, 2015 at 12:13 am

Try looking at GERD. I recently read something on it, and the one thing that stuck out was the lump in the throat that made it difficult to swallow, or felt like nothing was moving. I had several times where I would try drinking, and the liquid literally would not go down my throat. It sat in the back of my throat. I had to make it come back out so I did not chock on it. An episode could last for up to an hour. It felt like there was a balloon in my throat that blocked my throat not allowing anything to go down.. I can empathize with you, good luck in finding something that helps.


Mariel Heiss September 14, 2015 at 10:35 am

Thanks for sharing yur experiences Stacy. It’s amazing to see the community support each other.

You both might be interested in these resources for heartburn and GERD: http://heartburnhelp.scdlifestyle.com


Amelia May 13, 2014 at 5:40 am

Hi, I’ve recently been diagnosed with post infection IBS, i wonder if any of you have this problem also? It doesn’t seem too bad most of the time (touch wood) most days I wake up and have a single bowel movement that is mostly normal, maybe slightly soft. But then occasionally i will wake up, have a BM then need another which will turn out to be diarrhea or very loose stool, i usually do not risk having another and take immodium after this which stops the urge to go but i still feel discomfort and i’m fine by the afternoon. I have exams coming up a few of which are 9am exams – most mornings i would most likely be fine but i don’t want to risk having a bad morning before an exam – would taking immodium the night before help? Whenever i take immodium it seems to stop BM’s the next day also so I think that is what i’m going to try for morning exams.


Kathy June 8, 2014 at 8:23 pm

Amelia, you have the exact same symptoms as I do. I have never been diagnosed, but I am pretty sure I suffer from post infectious IBS as well. I too am mostly normal with the odd day with diarrhea. Some weeks it gets a lot worse, usually when I am stressed. I also use Imodium to control the symptoms and I totally agree about the effects taking the full effect the next day. For morning exams I take the Imodium the night before and I find it’s a lot better to do that than try to take it the morning of.


Linda June 12, 2014 at 2:01 pm

There is not enough space or time to list how i have lived my life. IBS with constipation was the diagnosis. Days and days of constipation followed by laxatives. IN my 30’s, my gall bladder was removed. For years the suffering was worse, now it was more and more diarrhea,often combined with vomiting! On a whim, dr prescribed CHolestramine. Thank God! Usually given for high cholesterol it is sometimes given for chrones disease. After taking meds.laxatives,anti diarrheals, and being a prisoner in my own home,always mapping where the restrooms were,and yes, at times not making it and having embarrassing accidents, i now have a normal life!! If you have had gall bladder removed,please talk to your doctor.There is help for you.


Kalidasan June 15, 2014 at 9:20 am

I am from the southern part of India. I am having pain in different areas around the abdomen. The pain just increases when I fart or burp. The pain increases significantly after some days. I pass loose stools 4-6 times everyday. What do you suggest me to eat and what medicine should I take? What habits should I undergo? Pleaseeee help me….


Veronika R January 11, 2015 at 1:27 am

Eggs! I was diagnosed with IBS-D around age 30, and got most of my symptoms under control with dietary changes, antidepressants (anxiety and depression made it worse) and yoga/meditation (for stress relief). However, I continued to have chronic diarrhea till my early 40s. I mentioned this to a dietician I was seeing for PCOS, and she said “that’s not normal!” It had become MY normal, though. She had me do a food sensitivity blood test (I’ve had allergen testing, i.e. skin prick, no food allergies, but lots of environmental allergies). I am lactose intolerant (discovered through food elimination testing in my late 20s), and the blood test showed eggs along with Brewers yeast were huge triggers for me. The Brewers yeast sensitivity explained why every time I drank beer or wine, my sinuses closed up even more than from regular allergies (I rarely drink anymore now). For eggs, I eliminated them for 4 months and my diarrhea stopped. I was able to add them back once a week without issue, but if I eat them more often, it comes back. I’m actually battling it again right now after a course of antibiotics. And the delicious birthday dinner I treated my husband to tonight, already gone! Eating out is often a trigger, as the food is richer than what I cook at home, but I can usually get back on track in a few days. Digestive enzymes are a huge help, I couldn’t go out for sushi without having to speed home afterwards every time. Now I take one capsule before and one after eating sushi and I have no problem with the big D.


Mary March 27, 2015 at 1:14 pm

Been dealing with this for over 4 years. Sorry everyone else on this site is too but there is a level of comfort in knowing I’m not alone. I just recently found an gastroenterologist who cares, yea, and is working with me. At this stage I’m managing it by staying away from eggs and milk, taking Imodium, Metamucil and probiotics daily. Had a colonoscopy and biopsies taken. The article is great and has a few more things to try. Thanks.


Whitney April 30, 2015 at 12:41 pm

In the past year I realized something just wasn’t right with my stomach and how often I was going to the bathroom. I slowly weeded out dairy, some cheeses are okay. I also realized eggs were a major cause of my IBS issues. I also can not eat a lot of spicy foods either. It has all just been trial and error for me. If something upsets me it goes on the do not eat list. So far I am still getting bloating and gas but my stools are healthy and firm. So I am sure there is something else I am eating that is causing the gas and bloat. I have yet to go to a doctor for it due to insurance issues. I hope to go soon and get tested! This article helped a lot though!


Joe May 14, 2015 at 9:37 am

I have major heartburn daily I eat a roll of ultra strength tums a week and I have dirrehea everyday.


Lori Jo Berg May 17, 2015 at 12:37 pm

Hi Joe, The SCD diet has helped many people in your same shoes regain their health.
The best place to start is with our Free quick start guide here: http://scdlifestyle.com/scd-quick-start-guide/
From here, we highly recommend following the directions in the eBook for best results: http://scdlifestylebook.com/ Also, we have a big event on heart burn coming up and if you are interested, you can go here: http://heartburnhelp.scdlifestyle.com/


Barnie November 1, 2015 at 9:07 am

Joe, you might have a hiatus hernia. Go for a gastroscopy.

A hiatal hernia occurs when part of your stomach pushes upward through your diaphragm. Your diaphragm normally has a small opening (hiatus) through which your food tube (esophagus) passes on its way to connect to your stomach. The stomach can push up through this opening and cause a hiatal hernia.

In most cases, a small hiatal hernia doesn’t cause problems, and you may never know you have a hiatal hernia unless your doctor discovers it when checking for another condition.

But a large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn. Self-care measures or medications can usually relieve these symptoms, although a very large hiatal hernia sometimes requires surgery. (Nissen procedure)

I had my hernia repaired in 1999 and never had heartburn again. However you would not be able to vomit ever again, which is not good, specially if you have a stomach bug, because your body’s first defence is to vomit to get rid of the bug.

But on the flipside of the coin, an untreated haitus can cause esophagus cancer if untreated.

You also should check your diet to control the diarrhea. To much fatty foods trigger the gallbladder and in return might cause diarrhea.

I’m not a GP and only speaks out of personal experience.


Lori May 15, 2015 at 12:10 pm

I’ve been bad for 2 years now after getting bad food poisoning and developing lactose intolerance and IBS. Everything in this article has just got me like !! As I haven’t been tested for a couple of these things as I’ve been told the NHS in England doesn’t fund these things. Which is stupid really!
But all the food things and that are spot on.
I have been pretty much housebound for the past 7 months now after it just got too much and have been on so many tablets that nothing has worked.
Read a few people have been taking imodiums, has that helped people? It’s never helped me as it just makes me go the same amount of times as would normally do.
My weight has dropped ridiculous, I have to starve myself just to leave the house for appointments and I just feel like I’m slowly wasting away. Currently under investigations with a gastric doctor as they aren’t certain it is just IBS-D and the next route to go down will be to get a colostomy bag fitted. Has anybody been given one of these through IBS-D?

As bad as it sounds, it’s good to hear people are going through the same things so we know we aren’t alone in this.

Big hugs to everyone!!! :)


Lori Jo Berg May 20, 2015 at 10:32 am

Hi Lori, have you tried the SCD diet or something similar?


Shawn W June 4, 2015 at 4:31 am

I am not alone. I stumbled onto this site. Thank you, my Dr said I need to learn to manage it. I am sick of being sick. I am going to do the diet restrictions first. One food at a time. Already on anti anxiety pills. Leaving the house is a nightmare. Unless you have this you cannot grasp the problems with this. Husband tries to understand but doesn’t get that sometimes I am unable to be more than 10 feet away from restroom. Again God Bless everyone. Thank you for suggestions. I have never heard of some of the tests, when I get a gastroenterologist I will ask for these tests.


Mariel Heiss June 5, 2015 at 8:36 pm
Armaan June 12, 2015 at 11:59 pm

Great piece of work.


lcarter June 24, 2015 at 7:49 am

With #2 Carbohydrate Malabsorption in your article – besides lactose and fructose you talked about starches..but you did not mention sucrose..[CSID] Congenital Sucrase Isomaltase Deficiency is seldom even considered by GI doctors and is mis-dignosed as IBS-D. There are 5 kinds of CSID and it can involve all 3 above mentioned sugars + starch malabsorption.


Brent Kovacs June 24, 2015 at 3:39 pm

Thanks lcarter for sharing this!


beverly July 15, 2015 at 8:14 am

Ive done tests & colonoscopy, everything is normal, but I still have diarrhea all the time, it’s hard to deal with, ive tried everything, taking probiotics, watching what I eat, taking iron tablets, what else can I do,


Mariel Heiss July 15, 2015 at 7:16 pm
Christine July 16, 2015 at 9:02 pm

I have been suffering with IBS-D for about 20 years. It has recently gotten to the point where it has cost me my job. Is anyone else out there unable to work and how do you get by? Is anyone on disability and how difficult was the process? Mine is definitely anxiety/stress induced. Any input and/or advice would be greatly appreciated!


Mariel Heiss July 17, 2015 at 1:03 pm

Hi Christine, we’re so glad you reached out to us. I’m so sorry you’re going through such a hard time right now. Steve and Jordan can both relate to their illness impacting their ability to work. Jordan’s diarrhea got so bad at one point that he stayed up all night hand-writing his will. However, they’re both well now. We aren’t doctors and can’t make any promises, but we’ve seen many people make incredible transformations in their health. We want to help you feel better! We recommend these two articles as a next step: http://scdlifestyle.com/2014/12/12-common-causes-of-diarrhea/
and http://scdlifestyle.com/2013/06/stop-diarrhea-fast/#more-6707 Please also email us at [email protected] anytime you have questions or need support.


Jonathan Christie August 16, 2015 at 7:27 pm

I had IBS-D for years, but sadly the SCD diet did absolutely nothing for me. However the FODMAPs diet was another story altogether, I found that asparagus, celery, sugar snap peas and cucumber were major triggers – but wait, cucumber is FODMAPs-safe, you say. Quite true, found it quite by accident, juiced a cucumber for the potassium after getting cramps and set off a flare which lasted for days. Evidently, I had FODMAPs and something else going on. So I did the Mediator Release Test from Oxford Labs, and found inflammatory reactions to soy, saccharin, black pepper and yogurt (also celery, cucumber, crab, lemon and a bunch of other stuff I don’t eat). No more BestFoods mayonnaise, no more SCD yogurt, switched to stevia and things quieted down. It’s a miserable business, confusing as hell, Steve is right in saying there are many causes – don’t give up!


Mariel Heiss August 17, 2015 at 6:12 pm

Hi Jonathan – thanks for sharing your experience. I’m sorry you didn’t feel better on SCD totally, but glad you’re making progress now.

This is why Steve and Jordan recommend you follow the Intro diet and then introduce foods one at a time following the three-day-rule…. sometimes the most unlikely foods can be a trigger!

Glad to know you’re making good progress! Don’t give up is right :)


Machele September 10, 2015 at 4:01 pm

I have not been diagnosed with ibs-d but have suffered with uncontrollable diarrhea for years. It’s continually gotten worse and I to have lost a job due to the inability to be an distance from a restroom. This interferes with muy daily living. About the only thing that doesn’t give me immediate diarrhea is water. I can wake in the morning and feel good but the minute I eat, and this means anything, I within minutes have cramping, bloating, pain, and raging diarrhea. This continues until my body has voided everything, or at least that’s how it seems. Then I’m ok again until I eat. The chronic nausea and diarrhea are just overwhelming. I hope to get some answers soon.


Mariel Heiss September 12, 2015 at 9:07 am
Vikki September 13, 2015 at 6:55 pm

My oldest son Chris suffers from horrible pain in his stomach and it actually makes it so he can’t move the pain is so bad it comes out of nowhere and drops him. He has had scopes and was told he has ibs nothing has helped him he lost his job due to being so sick. I’ve seen the attacks and I want to call an ambulance it’s scary he goes white he gets soaking wet from sweating and is freezing and will end up with violent stools for a long period of time. He was hospitalized in az and they thought it was his gallbladder and removed it but he is still suffering from the pain and violent diarrhea. Any ideas would be great! Thanks his momma


Mariel Heiss September 14, 2015 at 10:26 am
Sandy September 18, 2015 at 12:27 pm

Fritos are the only food I can eat and be able to go anywhere. Imodium is a must if I want to go out to eat, but I must come home immediately. My best bet is just not to eat at all. Diarrhea constant, all day, every day, every night. It really does drain you. I work, and my office is by the bathroom, I keep matches at my desk to offset the terrible smell from my diarrhea. Quite debilitating.


Mariel Heiss September 18, 2015 at 8:57 pm

Hi Sandy – I’,m so sorry you’re experiencing this. Jordan and I have both been there.

The best place to start is by changing your diet.

You can use our Free quick start guide here: http://scdlifestyle.com/scd-quick-start-guide/

From there, we highly recommend following the directions in the eBook for best results: http://scdlifestylebook.com/

I hope this information helps you – we’ve seen it help so many people in similar situations to yours.


PatriciaO September 21, 2015 at 5:45 pm

I’ve had loose watery soft surprise s for about 8 years now I’ve had my gall bladder taken out. And about a year later everything had gotten worse. The hot weather makes it worse. The stress makes it worse. Food makes it worse. With it the anxiety of needing a restroom makes it worse! Always hungry and waiting till 7 or 8 sometimes 9pm to eat a meal cause at least I’m home. I wasn’t working when it all started but needed to now so that’s another stresser! My mornings Start with 2 always two potty breaks if not that stresses me cause I’ll need a 2nd so running late and stress is miserable. After that I’m ok no breakfast no snacks still. If weather is hot or warming than my stomach starts to let’s call it activate and turn and I can almost feel curdle inside me. Then I start to get nervous cause I’m at work and need to be available and ready. By 2 or 3 00pm I’ve gone to potty at least 4 times and hopefully getting ready to go home and hope nothing comes up or out..lol. I’ve taken so many different meds it was tiring one gastrointestinal doctor gave me the 411 on everything I was given was just making it worse….so I stopped all of them. But happen to come across one that just gave me vicodin for the stomach pains. They actually regulated my stools and helped with the pains… I was able to actually have a normal day and not put things off with my family… but it doesn’t fix my problems. And thank you I finally hear someone else say this is not all in head, c@cause if it was it wouldn’t be coming out of my other end right……… and water makes it worse. Water does not help at all. Thank you for the list …… signed TIRED!


Mariel Heiss September 23, 2015 at 7:08 pm

Hi Patricia – we’re so glad this list resonated with you but sorry to hear you’re going through this hard time.

Stress can be such a big trigger of IBS – I really recommend you check out these resources in addition to starting a dietary change like SCD >>> http://scdlifestyle.com/category/relieve-stress-2/

To start the diet, download the free quick start guide here: http://scdlifestyle.com/scd-quick-start-guide/


Sherry T September 23, 2015 at 1:10 pm

For Real IBS for me is a dietary thing. I am just intollerable to certain foods and they give me either constipation or the runs……It’s not really stress related or mind related.
I don’t know what you guys are talking about but I know Cooked runny egg yolk and my stomach don’t get along–end result–the runs. Real Bad. Think before you speak.


Mariel Heiss September 23, 2015 at 5:10 pm

Hi Sherry – thanks for contributing your experiences!

Food can definitely be a tirgger for IBS-D, but for some people no amount of elimination/special preparation etc. of food is enough to alleviate symptoms – sometimes it is more than just food!

That’s why we advocate a customized healing path for each person – no two people are the same!


Mitch Rowley September 28, 2015 at 1:07 pm

While not a cure, I have found that a small amount of cannabis daily makes a world of difference. It took me from having to go to the bathroom over ten times a day to around 3. The biggest improvement is stomach pain and cramping. When I use cannabis in the evening it is similar to taking an antacid when you have heartburn. It provides immediate relief.

I’m probably just treating the symptoms and not the problem, but it does help immensely. And it’s not psychosomatic. If I stop using cannabis for a few days my IBS comes back full force with a vengeance.

Obviously medical cannabis is not legal everywhere, bit if it is I do strongly recommend it to help treat symptoms.


Judy October 26, 2015 at 11:34 pm

Since April 2015 I’ve had uncontrolable diarreha I’ve had colonoscopy s barium enigmas endoscopes I was told I had IBS colitis and lactose intolerance I’ve had stomach issues sine 1972 and since April of this year it’s gotten cronic no pain just pours out of me no warning I haven’t been to my dr in 5 yrs since no ins I finally made an appt nov 12 I haven’t been watching my diet so I’m sure that’s the culprit after today I was out to lunch with a friend and it hit me poured out like a faucet how much more embarrassed could I be Imodium does help I really need help this can’t happen again


Mariel Heiss October 27, 2015 at 4:31 pm

Hi Judy – I’m so sorry you’re going through this.

Eating the foods you can tolerate is so important when you have IBS, and eating right can control your symptoms 100%. However, it’s hard to know what to eat when everything seems to make you sick.

The SCD diet can heal your gut and help you figure out your “food safe zone” so you don’t have embarrassing flare-ups.

The best place to start is with our Free quick start guide here: http://scdlifestyle.com/scd-quick-start-guide/

From here, we highly recommend following the directions in the eBook for best results: http://scdlifestylebook.com/

I hope this helps and that you’re feeling much better very soon!

P.S. we’re glad to hear you’re going back to your doctor – it is always good idea to have a check-up when your symptoms change drastically


Barnie November 1, 2015 at 10:12 am

Hi all of you guys. I have IBS (or so I’m told) since 1986. I use to be able to control it by elimination of trigger foods, but since the beginning of this year (after a stomach bug, treated with antibiotics) it became increasingly worse. I’m now at a critical point wereby the doctors start treating me for Crohn’s discease without any success. My colon spasm is so bad that they call it the lead pipe syndrome, with severe pain where it turns in on the left side below the bladder. My stool is really hard and at stages cause some rectal bleeding.

I used to take Scopex Co. (normally for a day or two) with great success and without IBS for 4 to 6 months. But Scopex Co. was only taken of the market in South Africa in 2014. Apparently someone in Germany died of anaphylactic shock in the 1980’s, but so does a lot of people from penicillin allergy, scalefish, nut allergy etc. Sometimes I am thinking that we are at the mercy of these pharmaceutical companies. If someting as cheap as Scopex co. and it works then there must be something worng with it, treating IBS Crohn’s with success? (http://mg.co.za/article/1997-10-17-killer-drug-is-sold-in-south-africa) The active ingredient (Dipyrone 250mg) was taken out and is now only left with Hyoscine-N and Butylbromide and marketed as Scopex, Hyospasmol, Buscopam etc. with no effect what-so-ever.

To treat Crohn’s is a very expensive protocol, and there is 5 protocol regimes of medication the last is so expensive that no Medical Aid plan will cover it. And then there is the final invasive colostomy surgery.

There is virtually no food that I can eat without reaction. Is there anyone with advice? And if, where could you find Scopex Co.


Mariel Heiss November 2, 2015 at 3:56 pm

Hi Barnie, thanks for reaching out to us here! We’re really sorry your symptoms have gotten so bad.

We suggest you start by addressing your diet, as that is the real foundation of health :)

The best place to start is with our Free quick start guide here: http://scdlifestyle.com/scd-quick-start-guide/

From here, we highly recommend following the directions in the eBook for best results: http://scdlifestylebook.com/

We aren’t familiar with the drug you’re discussing. However, you might be interested in this article: http://scdlifestyle.com/2009/11/the-scd-diets-tag-team-partner/


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