Here’s the Poop on Managing Loose Bowels with IBD

Diarrhea and urgency are common symptoms of Crohn’s disease and ulcerative colitis. You can wipe them away with diet, probiotics, and stress management.

If you have Crohn’s disease or ulcerative colitis, loose bowels are probably a fact of life for you. Regardless of which form of irritable bowel disease (IBD) you have, you’ve probably seen everything from watery diarrhea to semi-formed stool.

You’re may also be familiar with the need to go NOW — a symptom known as bowel urgency. This can make having loose bowels emotionally stressful in addition to the physical discomfort it causes.

While experiencing loose bowels is common with IBD, that doesn’t mean it’s normal. It’s a sign that your digestive system is stressed and needs some support. Some lifestyle changes can lessen the severity and frequency of your loose bowels.

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Making dietary changes

One diet change you can make to improve loose bowels is to lower your fiber intake. That’s because the insoluble fiber in foods such as raw vegetables and fruits doesn’t get digested but instead passes through the digestive tract. This intact fiber can cause more irritation to a digestive system that’s already sensitive.

To support your body’s ability to digest fruits and vegetables during this time, consider trying to:

• peel the skin
• cook them until they’re soft
• blend them into a veggie soup with broth

Other dietary changes that may help include:

• Lowering how much sugar you consume: While natural sugars from fruit may not be a problem, sugar is a sneaky ingredient that you may find added to more than just sweet treats. Check the labels on products like pasta sauce, yogurt, salad dressing, canned soups, and other packaged foods.
• Removing any known triggers: If you don’t know your triggers, some of the most common ones are dairy, gluten, fatty foods, spicy foods, and nuts.
• Prioritizing broth, soups, stews, and slow-cooked meats: Since the longer cooking time breaks down the foods, it gives your gut some digestive assistance.
• Eating more “bulking” foods: “Bulking” foods are like those in the BRAT diet (bananas, rice, applesauce, toast).

Once your bowel movements begin to pass normally again, you can slowly reintroduce foods from your usual diet as tolerated.

Adding probiotics

Probiotics are known as “good” bacteria because they help us maintain a balanced and healthy gut microbiome.

When bowel movements are loose, an overabundance of opportunistic or “bad” microorganisms may be to blame. Thus, taking probiotics may help restore balance.

Fermented foods contain naturally occurring probiotics, which may also help your gut health and improve the quality of your stools.

One type of probiotic yeast called Saccharomyces boulardii has been shown to be helpful for loose bowels with varying causes.

A 2020 research review suggests that S. boulardii is effective in several gastrointestinal issues, including:

• reducing the incidence of traveler’s diarrhea
• reducing the duration of diarrhea and the length of hospital stays that result from antibiotic use
• reducing inflammation and promoting the growth of helpful bacteria in the intestines of mice that were induced with colitis

If you’re interested in supplementing with S. boulardii, reach out to a healthcare professional to see if it makes sense for you.

Getting adequate hydration

Since loose stools contain more water than normally formed bowel movements, you lose water at a quicker rate when you have diarrhea. This can lead to dehydration if you don’t replace the fluid.

Signs of dehydration can be mild at first but become more serious if not addressed.

While drinking water is the first step to replenishing fluids, consider some additional strategies to maintain hydration:

• Supplement your water with electrolytes: Electrolytes are minerals that are responsible for regulating fluid balance and blood pressure, supporting nerve function, muscle contractions, and more. They’re present in bodily fluids, but when you lose these fluids, you lose electrolytes as well, leading to fatigue, headaches, muscle cramps, and other signs and symptoms of dehydration.
• Get electrolytes through your food: Add salt (either when cooking or at the table). Many water-rich fruits and vegetables also contain electrolytes, so incorporate them into your diet as tolerated.
• Increase other types of liquids in your diet: Add in more broths, soups, and stews. As noted earlier, these foods are easier to digest, so this is another benefit to consuming them.

Dehydration can escalate quickly with chronically loose bowels, so it’s important to be hydrating regularly. If your dehydration becomes severe, talk with your doctor. They may recommend that you receive intravenous (IV) fluids at a hospital or IV therapy location.

Managing stress

Digestion and the nervous system are closely linked, so if you experience loose bowels frequently, you may want to take a closer look at your stress levels.

Digestion is regulated through the parasympathetic nervous system (also known as the state of “rest and digest”). When the body is stressed, it operates predominantly from the sympathetic nervous system (also known as the state of “fight or flight”).

In “fight or flight,” energy, blood, and other resources go to the parts of the body needed for in-the-moment survival — like the muscles, heart, and lungs — and away from digestion. This can contribute to digestive symptoms, including loose bowels.

A simple way to get into your parasympathetic state is by regulating your breath before eating. Cycle through a few rounds of breathwork until you feel calmer and more relaxed. This is a great sign you’re shifting into the right state to properly digest food.

The takeaway

With IBD, you may have changes in your bowel movements and have loose bowels from time to time. Trying some simple changes in your diet and lifestyle may help normalize your bowels.

Be sure to talk with a healthcare professional if your symptoms don’t improve.