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Digestive Symptom

Diarrhoea

Chronic or recurring diarrhoea — frequent, loose or watery stools persisting beyond a few days — can significantly affect quality of life and daily functioning. While acute diarrhoea is usually viral and self-limiting, persistent diarrhoea warrants investigation. For many people with functional diarrhoea or diarrhoea-predominant IBS, the gut-brain connection is central, and complementary therapies offer meaningful support alongside dietary management.

What is Diarrhoea?

Diarrhoea is defined as passing loose or watery stools more than three times per day. Acute diarrhoea (lasting less than two weeks) is usually caused by viral gastroenteritis, food poisoning or traveller's diarrhoea. Chronic diarrhoea (persisting beyond four weeks) may indicate an underlying condition.

Common causes of chronic diarrhoea include irritable bowel syndrome (IBS-D), inflammatory bowel disease (Crohn's disease, ulcerative colitis), coeliac disease, bile acid malabsorption, and microscopic colitis. Stress and anxiety are significant functional contributors to diarrhoea-predominant presentations.

For functional diarrhoea and IBS-D, where investigation has not revealed a structural cause, the gut-brain axis plays a central role — the enteric nervous system is hypersensitive to stress signals from the brain, increasing gut motility and urgency.

Signs and symptoms

Symptoms associated with chronic or recurrent diarrhoea include:

  • Loose or watery stools three or more times per day
  • Urgency — needing to rush to the toilet
  • Abdominal cramping or pain before or during defecation
  • Bloating and wind
  • Feeling of incomplete emptying
  • Symptoms that worsen with stress or anxiety

Always seek medical assessment if diarrhoea is bloody, persistent beyond two weeks, associated with unexplained weight loss or fever, or occurs with nocturnal symptoms that wake you from sleep.

How therapy can help

Once underlying conditions have been assessed medically, the following approaches can help manage functional or stress-related diarrhoea:

  • Gut-directed hypnotherapy — strong evidence for diarrhoea-predominant IBS, reducing gut hypersensitivity and urgency
  • CBT for IBS — addresses the anxiety-gut feedback loop that drives urgency and frequency
  • Dietary management — the low FODMAP diet, supervised by a dietitian, can identify dietary triggers; soluble fibre can help regulate stool consistency
  • Mindfulness-based approaches — reducing the stress reactivity that drives functional diarrhoea
  • Acupuncture — some evidence for reducing urgency and improving stool consistency in functional bowel disorders

Seeking help

Persistent diarrhoea (more than 2–4 weeks) should be assessed by a GP to rule out underlying conditions. Once these are excluded or managed, a gastroenterology dietitian and a therapist with experience in functional gut disorders can provide effective support.

Therapies that may help with Diarrhoea

We don't currently have any therapies mapped to this condition.

Frequently asked questions

Can anxiety cause diarrhoea?

Yes — anxiety activates the sympathetic nervous system and the gut-brain axis in ways that increase gut motility and reduce transit time, causing urgency and loose stools. This is why diarrhoea is extremely common before stressful events and is a prominent feature of anxiety disorders and IBS.

What is the difference between IBS and inflammatory bowel disease?

IBS is a functional disorder — the bowel looks normal but functions abnormally, and there is no inflammation or structural damage. Inflammatory bowel disease (IBD — Crohn's and ulcerative colitis) involves actual inflammation and structural changes in the bowel. IBD typically causes blood in the stool, nocturnal symptoms and weight loss, which are unusual in IBS. IBD requires specific medical treatment.

Does diet affect diarrhoea?

Yes significantly. High-fat foods, caffeine, alcohol, artificial sweeteners, and high-FODMAP foods are common triggers for functional diarrhoea. Identifying personal dietary triggers through a food diary and supervised elimination protocols can make a meaningful difference.

Can probiotics help with diarrhoea?

Some probiotics have evidence for specific types of diarrhoea — particularly antibiotic-associated diarrhoea and some forms of IBS. Evidence quality varies by strain and condition. They are generally safe and worth trying, though they work best as part of a broader management approach.

Is it normal to have diarrhoea when anxious?

It is very common — the gut-brain connection means anxiety directly affects gut function in most people to some degree. For some people this produces constipation; for others, urgency and loose stools. When this pattern becomes a significant part of daily life, psychological therapy — particularly gut-directed hypnotherapy or CBT — can produce meaningful improvement.