# Sudden diarrhoea without pain. Why? And how to cope? Please advice.



## pepperidge

[Sorry it's so long. I needed to rant even if nobody was going to read it. If you want to know just my question, you could read just the first and last portion]

I soiled myself again today - 4th time since Feb. Thankfully I was at home so I managed alright, but I live in dread of sudden diarrhoea in a public place, and worse having it in a situation where I am unable to excuse myself.

Usually, I get pain preceding diarrhea and during it. Though the cramps can be excruciating, at least then I get the signal to rush to the privacy of a toilet.

But sometimes, and lately too often, I get sudden diarrhoea that is not preceded by not even the slightest discomfort or foreboding. I literally haven't a clue that I'm about to have it! Like a bolt out of the blue, I know about it only when it's begun and then I can't stop the flow (sorry for being gross) however hard I try to, so that I've usually made a big mess before I get to the toilet.

It's the most distressing thing about IBS for me. I'd gladly have much more bloating/pain than go through the humiliation of soiling myself again. I feel stupid, dirty and generally wretched when I do. In fact it's the main reason I finally decided to join this forum - Just three weeks ago, my worst nightmare came true when I soiled myself in public for the first time: I was in the middle of a quarterfinal round, in a chess competition when - again without pain or any discomfort whatsoever - I just suddenly had diarrhoea, and a lot of it. Despite the smell and some stares, I really wanted to/had to finish the game because I was in a team representing my university and we had a real chance of winning it. I lost the round in the end, partly because I was too distracted thinking "Why?! Why now? Why me?!" I felt betrayed by my own gut. Because I didn't even make it to the semi-finals, my team lost out to Imperial eventually and placed second in the competition. I had to explain that it was because of IBS, which I had till then kept secret. They were nice about it, but I could tell they were sorely disappointed. I'm usually a tough guy and haven't cried since my granddad's funeral years ago, but that day I just broke down in the toilet while cleaning up. That's when I decided to join this forum to rant/get help.

It's especially unnerving because it happens for no apparent reason, so I don't know when it will next happen or how I can prevent it. Was it nerves? I doubt it. I was quite relaxed today when it happened and not particularly nervous during the chess competition. Yes, I was keen to do well because it was a competition but I find playing chess calming. In fact I usually play chess online to settle my stomach when cramps get so bad I can't do work. Chess helps to take my mind off symptoms. Playing a good game, makes me happy and proud and for those few moments, I lose a bit of the sense of helplessness from IBS. Also, anxiety-triggered episodes usually begin with cramps. Was it trigger foods or just the act of eating/drinking? I doubt it's this either. I've kept to a FODMAP diet for nearly half a year now. And though eating/drinking itself can sometimes give me diarrhoea, that sort of diarrhoea is always accompanied by cramping. Also, I wasn't eating/drinking during/immediately before the chess game.

How are those "attacks" physiologically possible in the first place? It's always entirely liquid so why has it, on several occasions, happened shortly after I've been to the toilet? Surely it would have exited then? Also, if there were no cramps, why were they moving?

This has happened even after preemptively taking 2 immodium tablets.

I don't go out much as it is and since the public incident, am gripped by fear when I do. I feel like I absolutely HAVE to sit on the toilet, and strain and wait for a bit before I leave the house, just in case; and I've been so anxious shortly after stepping out of the house that I get cramps and need the toilet immediately. Does anyone have the same issue and know how to deal with it and/or know what's causing the painless diarrhea attacks?


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## urbanfresh

I can't say that I have the same issue but I know where you're coming from. I suffer from 'urgency' which you will see other members discussing. Urgency can be a life impeding and stressful symptom. I am suffering from urgency just now in a way that I never have before so I am ALWAYS near a toilet after I eat.

In terms of painless diarrhoea, I wouldn't worry too much about that. If I eat a meal, I can feel absolutely fine for 10 minutes after then BAM I get that awful dropping feeling in my stomach and can feel the D down below, so I run to the toilet and voila, liquid D. No matter how many times I get liquid D it always stresses me out in the same way and I find it very depressing. This can reoccur sometimes for up to an hour (with or without spasms). Also, I get this when I am completely calm but I think the initial trigger happens at a point of stress which irritates your gut and will hence take time to heal and recover.

Personally, I would go back to your GP and push them. I am from the UK too and know how hesitant the NHS are to speak or care for IBS sufferers (I understand they are overcrowded but this does not help us!) but you need to probe them. I am going to probe for some Cognitive Behaviour Therapy - what about that? I am on amitriptellene 15mgs a day, Imodium, a probiotic pill and Zantac which I am experimenting with for the first time.


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## pepperidge

Thanks Urbanfresh! Yeah I've followed a fair few threads on "urgency" but they seem to be centred around having not enough time to find a toilet when D is approaching. It's comforting to know I'm not alone in suffering from incontinence (hate the word) but everyone else seems to get some warning of sorts whereas mine feels like someone's flipped a switch and suddenly the D is happening.

I sometimes get that "awful dropping feeling in the stomach" too (you've described it quite accurately) where I can literally feel D travelling very rapidly down, accompanied by some cramps. With this sort of D with prior warning, I get some time to run to the nearest toilet.

But more often lately, I've had the sort of D without any warning, it just seems to flow out (sorry). My mum, who's had to buy me new clothes, finds it incredulous that I had no idea at all before it happened. It's made me even more anxious because I've had it even while feeling fine.

You're exactly right about my GP. I went to him about 2 weeks ago (shortly after the first public accident) and he essentially said there was nothing much that could be done about it except take immodium preemptively, check food diary for intolerances, eat small meals blah blah blah... the same stock standard answer. I'm having my finals in a month's time and am seriously considering wearing adult diapers in my exams


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## BQ

Have you considered trying the calcium carbonate in addition to the preventative imodium? See the 1st page of the "Linda's Calcium" thread for the instructions. Also ask the Dr about using a bile salt binder like Questran or Colestid.


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## pepperidge

Hi BQ, thanks for the advice! I'll try both and update you guys on whether it helps. I've never heard of bile salts before so I googled it and it seems plausible as the underlying problem or contributing factor.

I've been on this forum for less than a month but I notice you're a veteran of sorts, giving advice on all sorts of things. You and some others who contribute loads to this supportive network are wonderful. Thank you!


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## looby_loo

Sorry to hear about the soiling incident, I too turned up here after something similar (namely having had to get off a bus to poo in a bush on the South Bank of the Thames!)

I don't think I can offer much advice but just wanted to say too I don't get as much stomach cramping as others seem to, in fact for a while I wondered if it was IBS I had as that seemed to be the 'main' symptom that I read about everywhere. I get a little pain but just a 'need the loo' pain or the odd twinge that's really painful but passes in seconds.

I too do that business where you try to go before leaving the safety of a toilet and can't and then find you need to go 10 minutes later. I think, for me, I am too impatient, especially at work where I want to be in and out as quick as possible before anyone realises the foul smell is down to me  I find at the weekend, left to my own devices in my own toilet, if I just sit there then there will be a second BM a few minutes afterwards (I take the crossword in with me!) but, if i'd rushed it that would be another completely separate incident half an hour later and somewhere more inconvenient.

I also think sometimes those attempts to go (when we don't yet need to) trigger something in the brain to get things moving and then, lo and behold, 10 minutes later it's all happening.


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## pepperidge

I have had trouble with public transport too! And yeah, it's like my bowels are out to sabotage me. I could be in the toilet trying to fully empty myself and have nothing and then 10 minutes after leaving the house, BAM - I have to go immediately!


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## Christena Kuck

I have the same issue you do. I have learned that if I'm going to go out and about for the day I don't eat anything. No breakfast, nothing.... I can even be 2 feet from a toilet and not make it. Very depressing and stressful. My husband wants to drive out west for vacation and all I can think about is "will I have issus??" All my doctor says is younger people are getting this IBS but my problems could be from my meds I take for RA or the RA it self.....


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## momofcats

I was interested to see if this was happening to others after a distressing experience over the weekend. As I rose to go to the bathroom just because I might have to urinate, my bowels just let loose and there was nothing I could do to stop it. Of course I was in a restaurant with my family, out of town I might add, and spent an awfully long time in the restroom trying to clean up and conceal the mess and odor. With panties wrapped in toilet paper and stashed in my bag, I walked out with wet jeans and thankfully a long sweater. Even more thankfully, had my suitcase in my rental and had already indicated I'd packed hastily and would need to rearrange the whole thing so there was no suspicion when we got to the guest home and I hauled in my suitcase, changing to something more comfortable for the flight home. But this has never happened in public before and had me very concerned as a European trip is forthcoming and I'm not going to be this lucky again.

Now, I've discovered gluten intolerance a year and a half ago, and had the genetic test for celiac which I carry. Initially, avoiding gluten was the key to my diarrhea problems. But since then I have discovered I can also count on diarrhea if I eat: oats, quinoa. This last incident occurred after having gluten free black bean soup in a restaurant. As mentioned by others, about 10 minutes after eating, without warning or pain, just a shift in my position from sitting to rising caused this flood of bowel contents into my unsuspecting pants.

I have long been interested in the paleo diet and used some of the recipes the bloggers and websites use. Now I'm beginning to wonder if I will react this way to all grains and all beans (both of which are off the paleo diet).

The immune system is a funny thing, and when it's provoked, can jump into action with much greater enthusiasm than we'd ever imagined. I'm wondering if any of you have noticed a food correlation with your sudden diarrhea as well? I used to think it had to be 12 hours later as food takes that long or longer to go through the digestive system, however with the immune system kicking in, it seems this problem is much more immediate than I had thought.

As background, I have achieved my first year certification as a holistic nutritionist and am convinced my next class must be a concentrated digestion class.


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## BQ

Well the BM isn't the food you just ate though unless you were sitting for a few hours after eating.

Is that the 1st time you have ever eaten black beans? If so.. might not be a good idea to try things for the 1st time at a restaurant.

I have found restaurant meals can be heavier (more fat) and usually way out of normal proportions. So those two things alone can activate the gastro/colonic 'over' response you experienced. You might consider taking imodium with you on trips and use it preventatively.. taking it *with* meals or even before. If one tablet is too much.. try breaking it in half. Also some folks do really well with calcium carbonate supplements. (See the 1st page of the "Linda's Calcium" thread pinned above us here for the instructions).

So try ordering as lightly as you can and also ask for gluten free options. Also I find It's best to eat about half of what they give you.

Sometimes it isn't what we eat.... it is simply THAT we eat.

I find preparing for the worst but expecting the best serves me well.

Edited to Add: I have trouble processing beans too. But I can eat lentils without any problems.. so you might want to give them a try. They are also high in protein.


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## Lisa Atkinson

Hi There,
I realise this was a few years ago now, but I was wondering if it ever improved for you, and if you might have any advise? It has happened to me, EXACTLY, word for word how you described it (absolutely NO warning) a few times, and as recent as yesterday. It is really getting me down. I live in fear that I will fart loudly or worse, poop myself in public.
I may never recover 

Regards

Lise


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