# Constipation Immediately Followed By Diarrhea



## Jessi No More Martini

Hello everyone. I hate to go into such detail, but I will anyway. As of the past couple of months, I've been feeling extremely constipated. I either make less frequent bowel movements, or make much more painful and difficult ones. The thing that seems weird to me is immediately following constipation, I have diarrhea. And I mean quite literally, I can be constipated and have diarrhea in the same bowel movement. Does this happen to anyone else?I always thought I was IBS-D. I'd be constipated two or three times a year at most. Lately I feel like I've been alternating and it's driving me insane. The stomach cramps and bloating seem to be even worse now that I'm often constipated. I suffer from GERD, but the nausea seems even worse when I'm constipated.It's driving me crazy. I have an appointment with the gastro in a couple of months. It's the earliest one I could get. My Librax just seems utterly pointless now, and I haven't seen the doctor in nearly 2 years. Hoping the next 2 months will produce some miracle drug, or at least a prescription for Nexium.


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## Kathleen M.

That alternating is quite common. The body (even in people without IBS) will sometimes use loose or watery stools to "flush" out constipated, hard to pass stools.Usually for a lot of people if they can prevent the constipation you also prevent the "flush". You might see if playing with fiber/water consumption helps keeps the stools moving, and if not usually the next step is adding a bit of an osmotic laxative like magnesium supplements or miralax, or a stool softener as wet "soft" stools are easier to keep moving than hard dry ones.


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## thePIXEL

I have this every so often, like the D was hiding behind the formed stool. Strange. I have no explanation though, just know that you're not the only one. However the last time it happened to me was today after 4 days of nothing at all (I assumed due to the amount of pain killers and other drugs I was given as I was in hosp since last Sunday for surgery on appendix). So the explanation given above makes sense to me here. Especially as the D was much worse than I usually have.


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## Jeffrey Roberts

I completely understand the D following C as I too have this sometimes.I hope knowing that others go through the same thing offers you some level of comfort.Jeff


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## Jessi No More Martini

I'm glad there's so many other who can understand this. For the past 5 days I was horribly constipated. Last night after being constipated I suffered two horrible diarrhea IBS attacks. This sucks. I guess I won't be eating much for the holiday besides tea, toast, and bananas.


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## debbyk

This is exactly the kind of IBS I have - so do I have IBS C or IBS D? Or is it called IBS-A?? I am now having a new symptom of excessive pressure in my upper abdomen and trying to figure out what to take. I am nervous to add a fiber supplement as I don't want to have diarrhea but am thinking the bloating must be from constipation.


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## Jay Colon Hydrotherapist

Jessi No More Martini said:


> I'm glad there's so many other who can understand this. For the past 5 days I was horribly constipated. Last night after being constipated I suffered two horrible diarrhea IBS attacks. This sucks. I guess I won't be eating much for the holiday besides tea, toast, and bananas.


Unfortunatly tea, toast and bananas will cause the constipation to re occur and then you will be back where you started, sorry to tell you, instead try lots of nuts, seeds, dried and fresh fruit, but only fresh fruit you can eat the skin of.


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## What is a display name?

Damn, over 5,000 views and only 6 people reply? I have the same problem and the first thing that comes to my mind when this happens is the ileo cecal valve might play a factor.


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## SarahLund

No matter which type of i.b.s someone has, i still always think dehydration causes it in the first place. Fluids always seem to ease everything up. Whereas, sometimes food can put you right back there again. This is why i hardly eat when i get constipated. Also. Over-eating/binging/purging can cause it. Bread may be a culprit. Most carbs seem to be, with i.b.s. Not sure tea would harm, as it's only a fluid. Banana's i'm not sure about. Bread can cause more abdominal pain than you started with. I'd stay away from it. Whether it's white, whole-grain, wholemealm, or any bread for that matter. When i crave a certain food i can't eat, i think of the pain it put me through, and then i don't crave it much after that. lol


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## windemere

I actually just had this happen to me. I haven't been able to go then when I had to yesterday i was at work and couldn't. So today I had 4 bms in 2 hours..starting with excruciating cramping and then a small amount of formed stool then the last bm was diarrhea. I'm hoping that its the end of it..but everytime im constipated i'll get horrible cramps and some sort of diarrhea. Seems to be pretty common among people here.


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## member2012

Hello everyone,

This is the first time I take part to this forum and I would like to share my thoughts.

I have been having various symptoms (reflux, bloating, stomach pain, nausea, cramps, diarrhoea and constipation) for years until 2005 when my GP named it 'IBS'. I have been on various types of medication to treat the symptoms. Last year I went to GP and demanded further investigation as my IBS-D turned into IBS-C and it was now unmanageable for me. After 6 months I was put in touch with the dietitian at the hospital and September 2012 I went on 1/2 the low FODMAP diet (wheat free, some fruit and veg free) and on November 2012 on the the other half (lactose free and low fructose). I FEEL FANTASTIC.

I have too experienced exactly what you are all describing here. In a period of constipation for example, suddenly I will have abdominal cramps, will go to the toilet and in one bowel movement, I will pass stools across the Bristol chart (usually 1-6). It is very uncomfortable. It feels like the body its trying to reject, discharge the cause of pain as I feel relieved and a bit sore immediately afterwards.

My dietician explained the follow up of diarrhoea in the same bowel movement, an indication of 'built-up' for IBS individuals. Today I just had an episode (the second and only one since September 2012) and this is why I search for this forum. I think my IBS episode (expressed via cramps and bowel movement of this nature) today was caused by stress as this afternoon I experienced a very stressful situation whilst still on 100% low FODMAP. I think I can control my IBS, medication free, with low FODMAP (80%) and the rest may just be stress.

best of luck to all and thank you for sharing your thoughts.


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## Ari_g

Hi...this has also happened to me!i had 5day of no bowel movements....i had tummy cramps and when I did finally struggle to go it was hard(sorry if tmi)....so I took some lactulose....an hour later I was the complete opposite with diarrhoea!!i did notice the lactulose was 10months out of date...but didn't think that would of done it??i have been stressed recently and had bad anxiety so im not sure weather its this also!x


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## Kathleen M.

It is really common for the body to use diarrhea/loose stools to push the constipated stool out. So going from constipation with diarrhea right after it is pretty common in IBS.

You can usually avoid the diarrhea if you do things more regularly to keep from getting too backed up. After 5 days of no BM you could get diarrhea pushing it out even if you didn't take anything.


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## GenieG

I was so glad to come across this discussion on alternating IBS "C & D", for in the past several months this is what I have been experiencing when for over 30 years I was always IBS"D". I was a frequent poster on the "D" forum, many, many times it was severe and could last for months, Tried so many of the suggestions from the forum and some helped, like Linda's Calcium regime, probiotics, Heather's products, etc. Stress and Anxiety seemed to be the biggest trigger, I'd always followed a pretty, healthy food diet, avoiding sodas, fast foods, etc.. Constipation was never a factor, never took a laxative

Then C"& D" happened after a year of very stressful, anxiety times, family illnesses, loss of close family members and friends, lots of Out of State and Out of the Country travelling often in bad weather conditions. I started just over a year ago with the "C& D" episodes, the first one happened while I was on one of these.upsetting trips. Other than giving birth, I had never experienced such awful pain in my lower abdomen,almost passed out from the pain, I was given a fleet enema to use from a relative who regularly dealt with "C", I had not had a BM in about 4 days. For months my diet had been all over the place, snatching meals at airports or in hospital cafeterias, it was impossible to follow the eating routine that I usually followed and helped keep the "D" at bay. I was stressed big time, not getting enough rest not eating or drinking properly. Since then, I've tried to avoid getting constipated for when I do, inevitably the explosive "D" often follows making me feel nauseous, weak and shaky with no energy.was I still have anxiety for I still have stressful situations to deal with, the loss of a daughter still in shock over that, the worst nightmare ever, my husband's poor health and depression, etc. any wonder I ended up in the ER after one particular bad anxiety attack. I was prescribed Ativan for the anxiety and told to eat regularly, (my appetite has diminished) told I should learn to relax more, I've always been somewhat hyper active. and full of energy. The "C&D" attacks seem to hit when my stress level goes up, the situations that cause them aren't getting any better. I think too a past problem has returned, Hypoglacemia, I was diagnosed years ago as being borderline this and warned it may worsen as I get older. Over the last 2 weeks I've had "C&D" attacks, and after them I feel so weak and shaky, I have to sit down, I get a sensation in my legs of the blood surging through them, I feel better when the sensation passes.. I also get cramping in my gut when after an attack I eat a light meal.As well as the "C&D" issues, my chronic allergy sinus problems have developed, difficulty breathing through my nose, the off balance feeling from Stenosis of my neck, I've had Mri's, Ultrasounds, etc, just have to deal with it, a few months back I was diagnosed with a torn Meniscus in my right knee, babying that along. Why getting older is called "The Golden Years", I'll never understand., everything slows down, breaks down, I rarely went to the Dr. always been relatively healthy, except when the IBS flares happened.

I'm sorry this is so lengthy, it feels good to unload even if no-one reads it, I do know how many out there are suffering big time from all of the IBS problems, my sympathy and best wishes for feeling better are with you. I was enlightened at reading the "C&D" posts, I never realized it was so widespread, possibly this condition could use it's own Forum! Having IBS of any sort, is no way to have to live. I hate myself for feeling so sorry for myself, so many out there are much worse off than I. If you have read this, Thank You!


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## jdinvirginia

Jessi,

I sympathize with your problems as I share the constipation-diarrhea portion. I am fecal incontinent due to a serious accident which damaged my pelvic nerves, causing me to lose much sphincter control and most of my ability to sense the presence of stool in the rectum, or an approaching BM. As I became older my problems evolved into bowel incontinence, a problem with which I have to cope daily.

I suffer from severe chronic constipation, which, if not caught in time, causes overflow diarrhea. I also have a defecation disorder. Under the supervision of my gastroenterologists I take daily morning enemas to control the incontinence and prevent later fecal accidents during the day. I wear diapers 24/7.

Overflow incontinence, often called overflow constipation or overflow diarrhea is nonintuitive and confusing as the underlying cause is the constipation while the very obvious symptom is the diarrhea. You generally treat for the constipation, not the diarrhea.

If you wish to learn more, you can Google the various terms.

Best wishes,

--JD


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## tummyrumbles

It could be bypass diarrhea but I can't find much information on this.

http://www.netdoctor.co.uk/diseases/facts/constipation.htm

What are the symptoms of constipation?

Diarrhoea: constipation is one of the most common causes of diarrhoea, especially in the elderly in care. Diarrhoea caused by constipation is known as bypass diarrhoea.

There is also a condition called overflow diarrhea:

http://pallipedia.org/term.php?id=878

Overflow diarrhea (spurious diarrhea)

One of the most typical symptoms of constipation is overflow diarrhoea, it occurs when the faeces become so hard that they cannot be expelled and faecal fluid will flow around the block.

There are a number of features that clinically characterize overflow diarrhoea (spurious diarrhoea):
1. It is only fluids that are expelled
2. It most often has the colour of faeces
3. It is not accompanied by abdominal pain
4. It is often difficult for the patient to reach the toilet before it is expelled
5. If a gloved finger is put down into the fluid it will feel threadlike due to the mucus in the stool
6. The patient does not have fever

This is an IBS forums discussion on it:

 http://www.ibsgroup.org/forums/topic/133306-constipation-immediately-followed-by-diarrhea/

It's possible a dietary cure would be to not eat constipating foods at all but defining these accurately is difficult. White, refined flours/breads and white rice are traditionally constipating foods but maybe high FODMAPs, wholemeal bread , brown rice and non-gluten grains could be considered as constipating as well if they cause malabsorption.

It would be interesting to know how exactly constipation works in the case of malabsorption and whether it's possible that foods that are constipating for you can actually cause cramping or spasm in the bowel as well.


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## Beth1980

I've to have beens having trouble like this. I've had IBS D for several years since I was a child and over time it has gradually gotten worse. Things really came to a head last year when I was experiencing a lot of pain when visiting the loo, I had a pain in my right hand side that wouldn't go away and completely lost my appetite.

After about a week I called my doctors who suspected I had appendicitis and sent me up to the hospital. I stayed in for about a week and was fed several types of antibiotics, I still didn't eat. They gave me an ultrasound but couldn't see any inflammation and decided I was well enough to return home.

The symptoms and pain continued to get worse, I tried to change my diet, cutting out wheat and eating more fibre, I found the fibre made me feel a lot worse and started to feel very unwell again. Still I kept on getting diarreah all the time. On several occasions I found that my faeces was completely black and sticky and on other occasions I found great amounts of blood down the loo and have had a colonoscopy to try and find out what was wrong.

Despite being ill for well over a year the hospital is unable to find anything and make me feel like I am wasting their time.

Today I had constipation followed by Diarrhea and was stuck on the loo for about an hour, I think that its all over only to have to keep rushing back as soon as I've washed my hands. Sometimes it can get better, my quality of life seems to get better then I can feel it going down gradually over time. There was however a difference after I took Moviprep in preperation for my examination - each time I took it I have felt better for about 2-3 months following the treatment. My specialist has prescribed Laxido to drink as he thinks that I may have some sort of constipation blockage going on - I think he is just guessing. My GP has been really helpful with this but at the hospital, it feels like they really don't want to know.


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## Grace_M

It's such a relief that others experience what i've been going through for a few years now. I'm a young woman (22) and I find it near to impossible to talk to anyone about the pain, the inconvenience and horribleness of this type of condition. I work somewhere that is otherwise very understanding, but I missed a shift or two at one point a year and a half ago (because of this very thing) and was told naively 'well, everybody goes to the toilet'...since then i've felt I have to ride through it on my own and keep it to myself.


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## PD85

I think of it just like "breaking the seal" when you are drinking alcohol.

After that first pee you just gotta pee every 1/2 hour from then on out!

Same thing happens to me after my first poo of the day.


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## pandash

It makes me feel so much better being able to see so many people exactly in my position. I have IBS-D and I feel like I constantly need to go so to help this I take Imodium every day. For the past two weeks I was on holiday and constantly terrified I would have an accident so took more than normal and ended up being constipated the entire trip. Now i'm home I took over the counter laxatives to help move myself and now I have terrible D!!

I'm only 19 and it feels like it's ruining my life! My university is affected and I just never want to go out because i'm too scared. I feel like i've tried everything


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## tummyrumbles

Is it possible that most people with IBS-diarrhea are constipated as well? It could be that IBS-D is a form of constipation. I've often wondered that but haven't come across any studies to support this. Most references to constipation still classify it as being related to difficult to pass, hard stool but my BMs are always mushy and seem to be filled with gas and I think that's very common here. I'm wondering too if most of us move our bowels daily. We know that IBS-D is fast transit but maybe IBS-C can be fast transit as well. I classify my IBS constipation type as a sluggish colon, meaning that it's sluggish in the tail end of things. Because I go every day I doubt I have slow transit constipation but you can't rule that out either. It seems to be generally accepted in the medical world that methane is associated with constipation and hydrogen with diarrhea and that the makeup of our gas depends on the microbiota inhabiting our gut. Is this theory independent of the SIBO theory though? Methane like other gases can behave like a neurotransmitter. The proper name is gasotransmitter I believe. So methane producers have more methanogens than say hydrogen producers, who have a different bacterial makeup. Methane can be converted from hydrogen so I don't know if that's meaningful in any way. IBS-D has more of an inflammatory element than IBS-C. Could this difference be related to gas as well? At what stage would methane be converted from hydrogen and would this have any bearing on IBS symptoms?


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## ergjam

I have had gut pain, constipation followed by painful diahhrea, then getting watery, lasting hours, for 50 years, mainly due to incontenance because of my Spina Bifida (L5).

I have tried many diets, treatments and alternatives. All to no avail.

Pro-Biotics are good for a few hours, then followed by painful diarrhea. Enemas were as painful as the diarrhea. Too many carbs, too much protien, just vegs, they're all just fad diets.

I have found the best lifestyle is; exercise, weights and aerobic (exercise will regulate your metabolism), normal meals, with meat and vegs. Eat semi-mature cheese when I have diarrhea, and oranges, plums and corn when I have constipation. Lots and lots of water, 6 litres a day, no coffee (coffee will give you diarrhea), no alcohol, no drugs (illegal drugs, and pain killers will make you constipated).

The more medication, and alternatives I use, then more I problems I would have. That means when I stopped using medication, some days I just have to stay home and ride it out. However, they became less often, and less painful, especially as I lost the weight.


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## IndianRopeTrick

Yes, it used to happen to me some times. You are not alone. Some people just have C or D.


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## darylhd

Hi everyone,

I have IBS but for the last three years, I was always constipated taking colace every night as directed by my gastro. Now all of sudden, more often than not, I get a day of explosive diarrhea or many loose bowel movements in one day. Then I go back to constipated for awhile and then to diarrhea. Seems to be happening more and more. Just saw my gastro dr and he didn't order any tests because he said my colonoscopy from 2 1/2 years ago is fine and just sent me on my way saying IBS can go back and forth. My concern is why all of a sudden am I having loose stools and diarrhea.


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