Can a person have “constipated diarrhea”?
Question – Has anyone else experienced ‘constipated diarrhea’? I have been dealing with IBS for about 10 years. My symptoms are constant and occur daily and include bloating, gas, and constipation. Strangely enough, more times than not I experience what I refer to as ‘constipated diarrhea.’ I found it disturbing that the doctors I visited wanted to know if I was either constipated or if I experienced diarrhea. My IBS (as I’m sure is most of yours) cannot be so easily classified as one or the other. [Taken from ‘Personal Stories,’ a feature on IFFGD’s web sites; this question and story appeared on www.aboutIBS.org.]
Answer – “Pain and/or discomfort related to a change in bowel habits are the main symptoms of irritable bowel syndrome (IBS). These changes are described by the terms “diarrhea” and “constipation”. The commonly used terms diarrhea and constipation mean different things to different people and this applies to healthcare providers as well. However, bowel symptoms affect treatment choices. It is important that you and your healthcare provider communicate clearly about your symptoms and how they affect your life.”
– Douglas A. Drossman, MD
How do we ‘translate’ bowel symptoms in a meaningful way?
Constipation is a cluster of symptoms which can mean having infrequent stools of any kind. Constipation is commonly described by the passing of hard pellet-like stools.
This can also include bowel movements (BMs) that happen less often, or three or fewer times in a week. People often have difficulty or straining when passing a BM, feel unable to completely empty during a BM, or they feel that they need to go but are not able to have a BM. The rectum is the final section of the large intestine where BMs are stored before being emptied.
Diarrhea is defined as loose, watery, or frequent bowel movements. Everyone has had experience with diarrhea, the passage of liquid stools. For most people, it is a symptom that lasts for a couple days, then resolves suddenly, typically within one week. These acute episodes usually are due to infections resulting from consuming contaminated food or drink. The average American has an episode of acute diarrhea every few years. For other people, diarrhea may be a more chronic problem, occurring for months to years. About 5% of the population has diarrhea lasting more than a month in any year
So, while it may seem strange to have “constipated diarrhea,” it is not that uncommon. If you have loose stools, but also have difficulty having a BM or feel you have trouble completely emptying, then it makes sense.
It is important to note that some people will experience “constipated diarrhea” due solely to constipation. “Loose stool overflow” occurs when hard stool becomes impacted (stuck) in the rectum and is not easily passed. The stool in the higher portion of the colon remains soft and leaks around the hard stool. The person experiences what they recognize as diarrhea since the stools are loose.
It is also important to remember that your bowel patterns may change over time. One person’s IBS might be different from another individual’s IBS. It is always important to maintain a working relationship with medical and support teams to obtain help when symptoms change.
Adapted from IFFGD Publication #265 “Constipated Diarrhea” By: Douglas A. Drossman, M.D., Drossman Gastroenterology PLLC, Chapel Hill, NC; Updated by: Eric D. Shah, MD, MBA Assistant Professor of Medicine, Geisel School of Medicine, Dartmouth, Lebanon, NH; Edited by: Darren Brenner, MD, Associate Professor of Medicine and Surgery, Northwestern University, Chicago, IL