# Confused by Alternating-Type IBS



## iPhoneGamer (Aug 15, 2011)

Hi all,My first time here, and although the diagnosis isn't 100% official yet (pending some tests to rule out other things), both my gastroenterologist and I think I have IBS, alternating between constipation and diarrhea. I don't see a forum for this particular kind of IBS, so I'm posting here as I feel the diarrhea is interfering with my life more than the constipation is.But it's the presence of both that is really throwing me for a loop. I'm still not sure exactly what "alternating" means in this context, so I'll start with that as my first question: does it mean that I truly alternate between being constipated on some days and having diarrhea on others, or does it mean that I can be constipated and having diarrhea on the same day? The latter is what I seem to be getting from my doctor, but as I say, I may be confused about what she was telling me. Anybody out there with Alternating type IBS that can explain what's going on?Thanks!


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## Kathleen M. (Nov 16, 1999)

Most commonly what happens is you are constipated for awhile, but then go into "flush mode" to get things moving which tips over to diarrhea. So often you pass a constipated stool followed by increasingly softer/looser stools. This set you up for the next round of constipation if you get too emptied out and the cycle repeats. Some people may have bouts of being pretty normal but then will have a cycle pop up and may cycle for awhile before having "good days" again.We don't have a special forum for alternating, as they don't have separate treatments from the C or D anyone who tends to be mostly one way uses.However even someone who tends to be mostly C or D may occasionally flip to the other direction. Either from overdoing a treatment, or just because IBS isn't noted for being consistent.While the diarrhea part of the cycle is usually much more disruptive, often the key to breaking the cycle is preventing the constipation. Even if it feels like a relief to have a break from BMs for a couple of days that backing up tends to set off the flushing out so if you can keep things more regular (with diet, fiber supplements or a mild osmotic laxative as soon as you start backing up, like a magnesium supplement) you can usually avoid most of the diarrhea.


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## iPhoneGamer (Aug 15, 2011)

Thank you for that explanation, which I understood better than anything my doctors have told me so far!In late June, I went to the ER with severe D and abdominal pain, and a clammy sweaty sensation. X-rays showed three impactions, so I was constipated even tho' I was experiencing such extreme diarrhea. I guess that was the beginning of the "flushing out" you speak of.I think you already answered my next question, which was to be: can I take Immodium from time to time? Am I correct in assuming your answer would be "only when the D is active, and even then as rarely as possible"?Also, do you happen to know how long a single dose of Immodium is likely to last? In other words, am I causing several days worth of constipation by taking Immodium just once?Thanks again for your help!


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## Kathleen M. (Nov 16, 1999)

Sound like you may have had some paradoxical diarrhea which is when the body is trying to flush out an impaction.I'd try to limit Imodium use to when you really need it as you don't want to set up the next bout of constipation. It does have a half life of about 10 hours (so 50% is gone in 10 hours, 75% is gone in 20 yours 87% gone in 30 hours) so it can sometimes hang around for a bit and it depends how sensitive you are to it.


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## iPhoneGamer (Aug 15, 2011)

You're tops Kathleen, thanks!


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## rellybelly17 (Jun 10, 2011)

it just means that sometimes you get constipated, and sometimes get diarrhea. Some people only get one or the other. Im an IBS-A, it sucks lol but you will learn how to manage it better every day, it gets better i promise


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