diarrhea that comes and goes

Overview

Diarrhea that comes and goes means you have loose, watery stools on some days but not others. It may last a few days, then stop, then return weeks or months later. This pattern can happen for many reasons, from a passing infection to a long-term condition like irritable bowel syndrome (IBS).

Yes, intermittent diarrhea is one of the most common digestive complaints. Almost everyone experiences it at some point.

It can affect people of any age, but it is more common in those with sensitive digestive systems, travelers, people taking certain medications, and those with chronic conditions like IBS or inflammatory bowel disease (IBD).

Symptoms

Common symptoms

• Loose, watery stools that come and go
• A sudden urge to use the toilet
• Bloating or gas in the belly
• Cramping or mild belly pain before a bowel movement

Symptoms in children

• Same loose stools but children can get dehydrated more quickly
• Irritability or crying more than usual
• Dry mouth or fewer wet diapers (signs of dehydration)
• Fever may be present

Symptoms in older adults

• Loose stools that come and go, often with less warning
• Higher risk of dehydration because the body's fluid reserves are smaller
• Weakness, dizziness, or confusion if fluid loss is significant

Causes

Main causes

• Infections: viruses (like norovirus), bacteria (like from contaminated food), or parasites
• Food intolerances: trouble digesting lactose, gluten, or certain sugars
• Irritable bowel syndrome (IBS): a common condition where the bowel is extra sensitive
• Medications: antibiotics, some antacids, or laxatives can cause loose stools
• Stress and anxiety: can speed up digestion and cause diarrhea

Risk factors

• Travel to areas with different food and water
• A weakened immune system (from illness or treatments like chemotherapy)
• Taking multiple medications that affect the gut
• Having a chronic digestive condition (IBS, IBD, celiac disease)

When to see a doctor

See a doctor urgently if:

• Diarrhea with blood or black stools
• Severe belly pain that gets worse
• Signs of dehydration that do not improve with drinking fluids
• Diarrhea after returning from a trip abroad, especially if fever is present

Book a routine appointment if:

• Diarrhea that comes and goes for more than 2 weeks
• Unexplained weight loss or tiredness
• Diarrhea that wakes you up from sleep regularly
• You have a family history of bowel cancer or a known bowel condition

Diagnosis

A doctor will ask about your symptoms, how long they last, what triggers them, and any other health conditions. They may also do a physical exam to check your belly and hydration.

Tests that may be done

• Stool sample test to check for infection or blood
• Blood tests to look for signs of inflammation or other problems
• Breath test for lactose or fructose intolerance
• Colonoscopy (a camera inside the bowel) if symptoms are long-term or there is bleeding

What to expect at your appointment

Your doctor will work with you to find the cause. It may take a few visits or tests. Keep a diary of your symptoms, foods, and stress levels to help identify triggers.

Treatment

Treatment depends on the cause. If an infection is the reason, it often clears on its own. For long-term conditions like IBS, treatment focuses on managing symptoms and avoiding triggers.

Self-care at home

• Drink plenty of water or oral rehydration solutions (available at pharmacies) to replace lost fluids
• Avoid foods that can make diarrhea worse, such as fatty, spicy, or very high‑fiber foods
• Try the BRAT diet (bananas, rice, applesauce, toast) during flare‑ups
• Rest as much as you need and avoid strenuous activity until symptoms settle

Medical treatments

Your doctor may recommend medications to slow down diarrhea or to treat an underlying infection. These are only used after a proper diagnosis. Never take anti‑diarrhea medicine if you have a fever or bloody stool unless your doctor says it is safe. Probiotics (friendly bacteria) may help in some cases. For ongoing conditions like IBS, specific treatments like low‑dose antidepressants or gut‑focused therapies may be offered. Always follow your doctor's advice.

When is surgery considered?

Surgery is very rarely needed for diarrhea that comes and goes. It might be considered only if an underlying condition like severe Crohn's disease or a blockage requires it. Your doctor will discuss this if it applies to you.

Living with this condition

Keep a symptom diary to spot patterns. Plan trips knowing where toilets are. Carry a small kit with wipes and a change of underwear for peace of mind. It can help to let close friends or family know so they can support you.

Lifestyle tips

• Manage stress with relaxation techniques like deep breathing, yoga, or gentle exercise
• Avoid known triggers like certain foods, caffeine, or alcohol
• Stay active with low‑impact activities like walking, which can help digestion

Diet and exercise

Eat smaller, more frequent meals rather than large ones. Choose low‑fat, bland foods when symptoms are active. Gradually add fiber (like oats or cooked carrots) as you feel better. Gentle exercise, such as a short walk after meals, can help regulate bowel movements.

Mental health and emotional wellbeing

Living with unpredictable diarrhea can cause anxiety about social situations, work, or travel. It is normal to feel frustrated or embarrassed. Talking to a therapist or joining a support group can help. Your doctor can also point you to resources.

Prevention

You cannot always prevent intermittent diarrhea, but you can lower your risk by washing your hands often, preparing food safely, drinking clean water, and avoiding foods that you know trigger your symptoms. If you have a known condition like IBS, following your management plan helps prevent flare‑ups.

Vaccines

There are vaccines for some causes of diarrhea, such as rotavirus (given to infants) and cholera (for travelers to high‑risk areas). Ask your doctor if any vaccines are right for you.

Screening programmes

If you have long‑term symptoms or risk factors, your doctor may recommend screening tests like a colonoscopy to check for underlying conditions. This is not routine for everyone, but it is important if you have warning signs.

Complications

If left untreated

• Dehydration: the most common risk, especially in children and older adults
• Electrolyte imbalance: loss of salts like sodium and potassium can affect your heart and muscles
• Malnutrition: if diarrhea goes on for weeks, your body may not absorb enough nutrients
• Weight loss and weakness

Long-term outlook

For most people, diarrhea that comes and goes is a temporary nuisance that gets better with simple self‑care. Even if it is linked to a long‑term condition, there are many effective ways to manage symptoms and live a full, active life. With the right support, you can feel in control again.

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