Alternating constipation and diarrhoea – What Does it Mean?

Experiencing alternating bouts of constipation and diarrhoea can be worrying and uncomfortable. If you don’t know what your digestive system will throw at you next, managing symptoms can be tricky.

This article explores the possible cause of having alternating constipation and diarrhoea. It should be used as a reference only, and you should consult a healthcare professional if you experience ongoing episodes of alternating constipation with diarrhoea.

What Can Cause Alternating Constipation and Diarrhoea?

Constipation and diarrhoea are common conditions, but they don’t usually occur simultaneously. However, there are instances where they can occur in alternating cycles.

Irritable Bowel Syndrome (IBS)

If you have fluctuations between constipation and diarrhoea, it may be a sign of a digestive tract issue called irritable bowel syndrome (IBS).

The cause of this condition is complex and not fully understood but is likely to involve several factors.

Common IBS symptoms may include:

• Diarrhoea
• Feeling bloated
• Constipation
• Abdominal pain or cramps

You might experience days when your symptoms improve and days when they worsen. These flare-ups may happen without any clear cause, but they can sometimes be triggered by certain foods or beverages.

What is IBS-M?

IBS-M (Mixed Type) is a subtype of IBS where symptoms of constipation and diarrhoea can alternate quickly. A person with IBS-M may experience both lumpy and hard bowel movements, as well as loose and watery movements.

See your GP if you think you might have IBS, so they can run tests to rule out other conditions

Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease (IBD) is a different type of bowel condition. However, the symptoms may sometimes be similar. This condition needs to be diagnosed by a healthcare professional, following tests and consultations.

Faecal Impaction (Overflow Diarrhoea)

This can happen due to long-term (chronic) constipation. Stools (faeces) can build up in the last part of the intestine (rectum), and become too hard to push out. This can lead to watery stools leaking out when they pass around the blockage of hard stools in the rectum. The leakage may look like diarrhoea. The causes of faecal impaction may similar to constipation, including:

• Side effects of painkiller medicines
• Being inactive or not doing exercise for a long time
• Not eating enough fibre containing foods
• Using laxatives for a long time
• Depression and anxiety

Treatment options may include softening the stool with enemas or suppositories or manual removal by a trained medical professional or prescribed laxatives. If you’ve had long-term constipation and then develop diarrhoea, you should speak to a healthcare professional before trying any anti-diarrhoea medicines.

Other possible causes

For some people, other causes of unpredictable bowel movements may include:

• Food Intolerances, where they have difficulty digesting certain foods or food ingredients. Common symptoms include diarrhoea but there are also other possible symptoms like constipation.
• Menstrual Periods where for some women, their bowel movements become altered at certain times of their menstrual cycle. Hormonal changes during the menstrual period may cause diarrhoea in some, while others may experience constipation.

Relieving Constipation and Diarrhoea at Home

Managing symptoms effectively depends on the underlying causes. Initial steps typically include dietary and lifestyle modifications, although medication may be necessary in more severe instances. Consultation with a healthcare professional is advised.

Relieving Diarrhoea

• Stay at home and get plenty of rest
• Drink enough fluids like water or squash, to maintain hydration
• Eat when you’re able to
• Reduce high-fibre foods like wholegrains (for example, brown bread and brown rice), nuts and seeds
• avoid products containing a sweetener called sorbitol
• ask a pharmacist about medicines that can help

Relieving Constipation

• Avoid alcohol
• Be physically active and establish a regular bowel routine
• Drink plenty of water to help soften your stools
• Eat a healthy balanced diet
• Increase your fibre intake gradually – you could include foods like oats, pulses, carrots, peeled potatoes and linseeds (whole or ground) and also include fruits that contain sorbitol, such as apples, apricots or grapes (however, be aware of the risk of diarrhoea if you have IBS-M)
• Ask a pharmacist about medicines that can help
• If you think you may have faecal impaction don’t take laxatives before speaking to a healthcare professional.

If these measures don’t work, consult a medical professional to advise you on the appropriate options.

When Should You Contact a Healthcare Professional?

Diarrhoea

Speak to a medical professional straight away if:

• you still have signs of dehydration after using oral rehydration sachets
• you have bloody diarrhoea or bleeding from the bottom
• you have diarrhoea for more than 7 days

Constipation

Please reach out to a healthcare professional if you:

• Experience frequent constipation
• Have constipation that continues despite treatment
• Have lost weight without trying
• Often feel bloated
• See blood in your stool
• Are on medications that may lead to constipation, such as painkillers
• Experience sudden changes in your bowel habits
• Have abdominal discomfort

This article is for general information only and not intended as a substitute for medical advice. All information presented on these web pages is not meant to diagnose or prescribe. In all health-related matters, always consult your healthcare professional. Always read the product label. Use only as directed. Incorrect use could be harmful. If symptoms persist consult your healthcare professional.