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Published on: 1/29/2026

Why do I have abdominal pain and diarrhea — could it be IBD?

Abdominal pain with diarrhea is most often due to temporary causes like infection, food intolerance, or IBS, but if it keeps coming back, lasts more than 2 to 3 weeks, or is severe, it could be inflammatory bowel disease. There are several factors to consider, including red flags like blood in stool, weight loss, fever, or nighttime diarrhea; see below for key differences between IBS and IBD, how IBD is diagnosed, and the next steps to take.

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Explanation

Why Do I Have Abdominal Pain and Diarrhea — Could It Be IBD?

Abdominal pain and diarrhea are common symptoms that many people experience at some point in life. They can happen after a stomach bug, food poisoning, stress, or eating something that didn't agree with you. However, when these symptoms keep coming back, last for weeks, or interfere with daily life, it's reasonable to wonder whether something more serious—such as inflammatory bowel disease (IBD)—could be the cause.

This article explains what IBD is, how it differs from other causes of abdominal pain and diarrhea, and when it's important to speak to a doctor. The goal is to inform you clearly and calmly, without unnecessary alarm.


Understanding Abdominal Pain and Diarrhea

Abdominal pain is a broad symptom that can range from mild cramping to severe discomfort. Diarrhea is typically defined as loose or watery stools occurring more frequently than usual. Together, these symptoms can arise from many conditions, including:

  • Viral or bacterial infections
  • Food intolerances (such as lactose intolerance)
  • Stress or anxiety affecting the gut
  • Medication side effects (including antibiotics)
  • Digestive disorders like irritable bowel syndrome (IBS) or IBD

Most causes are temporary and improve on their own. However, ongoing or worsening symptoms should not be ignored.


What Is Inflammatory Bowel Disease (IBD)?

Inflammatory bowel disease (IBD) is a term used for chronic conditions that cause ongoing inflammation in the digestive tract. The two main types are:

  • Crohn's disease – can affect any part of the digestive tract, from mouth to anus
  • Ulcerative colitis – affects the colon (large intestine) and rectum

IBD is different from IBS. While IBS causes digestive symptoms, it does not cause inflammation or damage to the intestines. IBD, on the other hand, involves immune system–driven inflammation that can lead to tissue injury over time.

Medical understanding of IBD is based on decades of research from gastroenterology specialists and major health institutions. While the exact cause is unknown, it is thought to involve a mix of immune system dysfunction, genetics, and environmental factors.


Common IBD Symptoms

IBD symptoms can vary widely from person to person. Some people have mild symptoms, while others experience more severe flare-ups.

Common signs include:

  • Ongoing abdominal pain or cramping
  • Chronic or recurring diarrhea
  • Blood or mucus in the stool
  • Urgent need to have a bowel movement
  • Fatigue or low energy
  • Unintended weight loss
  • Reduced appetite

Symptoms often come and go, with periods of relative calm (remission) followed by flare-ups.


How Abdominal Pain in IBD Often Feels

In IBD, abdominal pain is usually linked to inflammation in the intestines. People often describe it as:

  • Cramping or aching pain
  • Pain that improves after a bowel movement
  • Discomfort located in the lower abdomen (ulcerative colitis)
  • Pain anywhere in the abdomen (Crohn's disease)

That said, abdominal pain alone does not mean you have IBD. Many non-inflammatory conditions can cause similar discomfort.


Other Conditions That Can Cause Similar Symptoms

Before assuming IBD, it's important to know that many other conditions can cause abdominal pain and diarrhea, including:

  • Gastroenteritis (stomach flu)
  • Food intolerances or sensitivities
  • Celiac disease
  • Irritable bowel syndrome (IBS)
  • Stress-related digestive issues
  • Thyroid disorders

IBS, in particular, is very common and often confused with IBD. IBS does not cause bleeding, inflammation, or long-term damage, even though symptoms can be uncomfortable.


When Should You Be More Concerned?

While it's important not to panic, certain symptoms should prompt you to speak to a doctor as soon as possible, as they may indicate something more serious.

Seek medical advice if you have:

  • Abdominal pain that is severe, persistent, or worsening
  • Diarrhea lasting more than 2–3 weeks
  • Blood in your stool
  • Unexplained weight loss
  • Fever along with digestive symptoms
  • Nighttime diarrhea that wakes you from sleep
  • Signs of dehydration (dizziness, dark urine, dry mouth)

These symptoms don't automatically mean IBD, but they do require proper medical evaluation.


How IBD Is Diagnosed

There is no single test that confirms IBD. Doctors use a combination of tools to understand what's causing your abdominal pain and diarrhea, such as:

  • Detailed medical history and symptom review
  • Blood tests to check for inflammation or anemia
  • Stool tests to rule out infection
  • Imaging studies (such as CT or MRI scans)
  • Endoscopy or colonoscopy to look directly at the intestines

A gastroenterologist usually makes the diagnosis based on the full picture, not just one test result.


Treatment Options for IBD

If IBD is diagnosed, treatment focuses on reducing inflammation, managing symptoms, and preventing flare-ups. While IBD is a chronic condition, many people live full, active lives with proper care.

Treatment may include:

  • Anti-inflammatory medications
  • Immune-modulating drugs
  • Biologic therapies
  • Nutritional support
  • In some cases, surgery

Treatment plans are individualized and adjusted over time.


What You Can Do Right Now

If you're experiencing abdominal pain and diarrhea and are unsure what's going on, consider taking a structured approach:

  • Track your symptoms (frequency, severity, triggers)
  • Use a free AI-powered abdominal pain symptom checker to help identify possible causes and understand when to seek care
  • Stay hydrated, especially if you have diarrhea
  • Avoid self-diagnosing without medical input

Taking these steps can help you better understand your symptoms and what actions to take next.


The Importance of Speaking to a Doctor

Any ongoing abdominal pain, especially when paired with diarrhea, deserves attention. While many causes are not life-threatening, some conditions—including IBD—can become serious if left untreated.

Speak to a doctor promptly if your symptoms are persistent, worsening, or interfering with your quality of life. Seek urgent medical care if symptoms are severe, sudden, or associated with bleeding, high fever, or dehydration.


Key Takeaway

Abdominal pain and diarrhea are common symptoms with many possible explanations. IBD is one possibility, but not the most common one. Understanding your symptoms, watching for warning signs, and seeking medical advice when needed can help ensure you get the right diagnosis and care—without unnecessary fear.

Listening to your body and getting expert guidance is always the safest path forward.

(References)

  • * Agostini, L., Tursi, A., Scagnolari, C., D'Incà, R., Stasi, E., Felice, C., & Torsoli, A. (2020). Inflammatory Bowel Disease: A Review for the Primary Care Physician. *Current Therapeutic Research, 92*, 100585. DOI: 10.1016/j.curtheres.2020.100585. PMID: 32426210.

  • * Ungaro, R., & Peyrin-Biroulet, L. (2022). Diagnosis and Management of Crohn's Disease. *JAMA, 328*(18), 1851–1852. DOI: 10.1001/jama.2022.19393. PMID: 36365922.

  • * Huang, H., Wang, W., Hu, C., & Xiao, Y. (2023). Ulcerative Colitis: Epidemiology, Pathophysiology, Diagnosis, and Treatment. *Journal of Clinical Medicine, 12*(17), 5707. DOI: 10.3390/jcm12175707. PMID: 37626947.

  • * Schiller, L. R., & Pardi, D. S. (2021). Differential Diagnosis of Chronic Diarrhea in Adults: A Review. *JAMA, 325*(23), 2384–2399. DOI: 10.1001/jama.2021.5710. PMID: 33949826.

  • * Kaser, A., & Tilg, H. (2016). Inflammatory bowel disease: epidemiology, aetiology and management. *Nature Reviews Nephrology, 12*(5), 323–323. DOI: 10.1038/nrneph.2016.51. PMID: 27040446.

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