IBD in Remission: Why Do Diarrhoea and Bloating Continue?

Author : Vikrant Kale | Published On : 04 Nov 2026

Many people with Inflammatory Bowel Disease (IBD) feel better after starting treatment. Their stomach pain reduces, bowel movements become normal, and inflammation comes under control. This stage is called remission.

However, some patients still experience diarrhoea, bloating, gas and stomach discomfort even during remission. This can be confusing. If the inflammation is under control, why do these problems continue?

There can be several reasons. Food intolerance, changes in gut bacteria, IBS-like symptoms and other digestive problems may cause these symptoms. Understanding the reason is important for proper IBD management.

Why Do Diarrhoea and Bloating Continue During IBD Remission?

IBD mainly includes Crohn's disease and ulcerative colitis. Both conditions cause inflammation in the digestive system. With proper treatment, patients can achieve remission and feel better.

However, remission does not always mean that every digestive problem has disappeared. Some patients may continue to experience the following problems.

1. IBS-Like Symptoms

Some IBD patients experience symptoms similar to Irritable Bowel Syndrome (IBS), even when their inflammation is under control.

These symptoms may include:

• Frequent loose stools

• Stomach pain or cramps

• Gas and bloating

• Sudden urge to pass stools

• Discomfort after eating

This happens because the digestive system may remain sensitive even after inflammation has improved. These symptoms do not always mean that IBD is active again.

2. Changes in Gut Bacteria

Our intestines contain good bacteria that help with digestion and maintain gut health. Sometimes, IBD, medicines or changes in diet can affect the balance of these bacteria.

When this balance changes, patients may experience:

• Excessive gas

• Stomach bloating

• Loose motions

• Discomfort after meals

• Changes in bowel movements

These changes may contribute to digestive problems even during IBD remission.

3. Small Intestinal Bacterial Overgrowth (SIBO)

SIBO is a condition in which too many bacteria grow in the small intestine. It can affect digestion and cause discomfort.

Some Crohn's disease patients may have a higher risk of developing SIBO, especially if they have had intestinal surgery or changes in their intestine.

Common symptoms include:

• Frequent bloating

• Excessive gas

• Loose stools

• Stomach discomfort

• Feeling full after eating

A doctor may suggest a breath test to check for SIBO if the symptoms indicate bacterial overgrowth.

4. Food Intolerance

Some patients notice that certain foods cause bloating, gas or diarrhoea, even when their IBD is under control.

Common food triggers include:

• Milk and dairy products

• Fried and oily foods

• Onions and garlic

• Certain high-fibre foods

• Carbonated drinks

• Artificial sweeteners

Every patient's body responds differently to food. Keeping a food diary can help identify which foods cause discomfort.

Avoiding too many foods without medical advice is not recommended, as it may lead to nutritional deficiencies.

5. Bile Acid Diarrhoea

Bile helps the body digest fats. It is produced by the liver and normally absorbed in the small intestine.

In some patients with Crohn's disease, especially those with problems in the last part of the small intestine, bile acids may not be absorbed properly.

Extra bile acids can enter the large intestine and cause watery diarrhoea.

Common symptoms include:

• Frequent watery stools

• Sudden need to use the toilet

• Loose motions after meals

• Stomach discomfort

A gastroenterologist can evaluate whether bile acid diarrhoea is responsible for these symptoms.

6. Side Effects of Medicines and Other Digestive Problems

Sometimes, medicines used for other health conditions can cause loose stools or stomach discomfort. Antibiotics can also change the balance of gut bacteria.

Other conditions, such as intestinal infections, lactose intolerance and digestive enzyme problems, may also cause similar symptoms.

Therefore, it is important to identify the actual cause instead of assuming that every episode of diarrhoea is an IBD flare-up.

Patients should not stop their prescribed IBD medicines without consulting their doctor.

How Can Doctors Find the Cause of These Symptoms?

If diarrhoea and bloating continue during remission, a doctor may recommend some tests to understand the reason.

The tests depend on the patient's symptoms, medical history and previous treatment.

Not every patient needs all these tests. The doctor decides which investigations are necessary after evaluating the patient.

When Should You Consult a Gastroenterologist?

Occasional bloating or loose stools may happen due to food habits. However, frequent or long-lasting symptoms should not be ignored, especially if you already have Crohn's disease or ulcerative colitis.

Consult a gastroenterologist if you experience:

• Diarrhoea that continues for several days

• Blood in stools

• Frequent stomach pain

• Unexplained weight loss

• Loose motions during the night

• Fever or unusual weakness

• Frequent bloating and gas

Severe stomach pain, heavy bleeding or signs of dehydration need urgent medical attention.

An experienced Stomach Specialist can help identify whether these symptoms are related to IBD or another digestive problem.

Frequently Asked Questions

1. Can diarrhoea continue even when IBD is in remission?

Yes. Some patients continue to experience diarrhoea even when their IBD inflammation is under control. IBS-like symptoms, food intolerance, SIBO and bile acid diarrhoea can be possible reasons.

2. Does bloating mean that my IBD is active again?

No. Bloating does not always mean that IBD has become active. Gas, food intolerance and changes in gut bacteria can also cause bloating. However, persistent symptoms need proper evaluation.

3. How can I know whether my IBD is in remission?

Your doctor may check your symptoms, blood reports, stool tests and colonoscopy findings. These help understand whether inflammation is under control.

4. Can IBS and IBD occur together?

Yes. Some people with Crohn's disease or ulcerative colitis experience IBS-like symptoms even during remission. These may include gas, bloating, stomach cramps and changes in bowel movements.

5. Which foods should I avoid during IBD remission?

There is no single diet that suits every IBD patient. Milk, fried foods, onions, garlic and some high-fibre foods may cause problems in certain people. It is better to identify your food triggers with proper dietary guidance.

6. Can SIBO cause bloating and diarrhoea?

Yes. SIBO can cause excessive gas, bloating, stomach discomfort and loose stools. A doctor may suggest a breath test if SIBO is suspected.

7. Should I stop my IBD medicines after feeling better?

No. Do not stop your prescribed medicines just because your symptoms have improved. Stopping treatment without medical advice may increase the risk of an IBD flare-up.

Conclusion

Diarrhoea and bloating can continue even when Crohn's disease or ulcerative colitis is in remission. These symptoms do not always mean that inflammation has returned. Problems such as IBS-like symptoms, SIBO, food intolerance and bile acid diarrhoea may also be responsible.

The most important thing is to understand why these symptoms are happening. Do not ignore frequent digestive problems or change your medicines without medical advice.

Dr. Vikrant Kale is a Consultant Gastroenterologist, Hepatologist and Interventional Endoscopist at Kaizen Gastro Care, Wakad, Pune. He has 18+ years of experience in managing digestive disorders, liver diseases and inflammatory bowel disease (IBD). He has completed fellowships in Upper and Lower GI Endoscopy and Inflammatory Bowel Disease from Oxford University, UK.

Patients experiencing ongoing digestive problems should seek medical advice for proper evaluation and suitable management.