Irritable bowel syndrome with diarrhea (IBS‑D) is a common cause of chronic abdominal pain and loose stools, but it must be diagnosed carefully so that other serious conditions are not missed.

IBS‑D care at Sabuche Health

At Sabuche Health, IBS‑D is evaluated and treated through secure, HIPAA‑compliant telehealth visits using video and audio technology. During your visit, your clinician reviews your symptoms, guides you through a focused virtual exam, and helps decide whether IBS‑D or another condition best explains what you are experiencing.

Telehealth visits are delivered on a secure platform that protects your privacy and keeps your health information confidential. Before your visit, you will complete a consent process that explains the benefits and limits of telehealth so you can make an informed choice.

How your symptoms are reviewed

Your clinician will start with a detailed discussion of your symptoms and overall health. This helps determine whether your pattern fits IBS‑D or suggests something else that needs in‑person care.

You may be asked about:

• Abdominal pain or cramping, how often it occurs, and what makes it better or worse.

• Stool frequency and appearance, including watery or mushy stools versus hard or lumpy stools.

• Episodes of diarrhea that wake you from sleep, rectal bleeding, unexplained weight loss, or anemia, which can be warning signs for other diseases.

• Symptoms like indigestion, bloating, fatigue, or thyroid problems, which can point to different diagnoses.

Your clinician also screens for anxiety and other factors that can worsen gut symptoms, while watching your breathing, speech, and general appearance over video to be sure you are not in acute distress.

Diagnostic criteria and ruling out other causes

IBS‑D is a “diagnosis of exclusion,” which means it is diagnosed based on symptoms once other important conditions have been ruled out. Modern guidelines still support a positive, symptom‑based approach, but they emphasize targeted testing so that key diseases are not missed.

Common conditions that can mimic IBS‑D and may need to be ruled out include:

• Celiac disease, an autoimmune reaction to gluten that can cause chronic diarrhea, weight loss, anemia, and nutrient problems.

• Thyroid problems, including hypothyroidism and hyperthyroidism, which can affect bowel habits, energy, and weight.

• Inflammatory bowel disease (such as Crohn disease or ulcerative colitis), which may cause bleeding, weight loss, and more severe inflammation in the gut.

• Infections and other gastrointestinal conditions like microscopic colitis, pancreatic disease, or chronic gastroenteritis, depending on your history and risk factors.

The Rome criteria describe IBS as recurrent abdominal pain, at least one day per week over the past three months, linked to bowel movements and changes in stool form or frequency. The Manning criteria add supportive features such as pain relief after a bowel movement, looser stools when pain starts, bloating, mucus in the stool, and a sense of incomplete evacuation.

Because IBS‑D has no specific blood test or biopsy pattern, colonoscopy and additional testing may be recommended in certain situations, such as concerning symptoms or age‑based screening needs. Testing for celiac disease and selected additional labs or stool tests may help distinguish IBS from inflammatory bowel disease and other disorders.

Treatment options for IBS‑D

Once IBS‑D is the most likely diagnosis, your clinician builds a plan that fits your symptoms, risk factors, and preferences. For many men, this includes both medication and lifestyle changes.

Common elements of an IBS‑D plan can include:

• Loperamide for diarrhea control, which slows gut movement and increases anal sphincter tone. It is typically used as needed, with strict attention to maximum daily doses to reduce the risk of rare but serious heart rhythm problems.

• Rifaximin, a minimally absorbed antibiotic that alters gut bacteria and has been shown to improve symptoms in some patients with IBS‑D.

• Review of other medicines you take, because certain drugs can interact with rifaximin or loperamide or worsen diarrhea.

• Guidance to stop and contact a primary care clinician urgently if symptoms such as bloody diarrhea, severe abdominal pain, fever, or signs of allergic reaction occur.

• Lifestyle steps, including regular exercise and avoiding alcohol and tobacco, which may improve IBS symptoms over time.

Your Sabuche Health clinician will also discuss non‑drug strategies, such as diet changes tailored to triggers, stress management, and making sure you have regular follow‑up if symptoms change.

Why timely evaluation matters

IBS‑D is common, accounts for a large share of gastroenterology visits and missed days of work, and affects many adults in their most productive years. A focused telehealth visit can shorten the time to diagnosis, help avoid unnecessary testing, and get you started sooner on a clear plan.

If your symptoms suggest something more serious, Sabuche Health will guide you toward appropriate in‑person testing or specialist care so that important conditions like celiac disease, inflammatory bowel disease, or significant thyroid disorders are not overlooked.

To learn more or schedule a visit for possible IBS‑D symptoms, you can use the Sabuche Health online booking page to choose a time that works for you.