Diarrhoea and constipation : Hi there I’ve had... - IBS Network

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Diarrhoea and constipation

Mearnsmum1 profile image
5 Replies

Hi there

I’ve had diarrhoea for a week with upper left near centre pain. Now today I’ve still got the same pain but I seem to be constipated. I haven’t eaten anything with fibre (except porridge) to try and stop diarrhoea. I’ve had an endoscopy and a QFit test in the past month and both were fine. Has anyone else found that their symptoms changed like this? I’ve had a lot of anxiety in the last year. Many thanks.

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Mearnsmum1 profile image
Mearnsmum1
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Maureen1958 profile image
Maureen1958

Hi, it sounds like classic IBS to me. Yes, it can flip flop from diarrhoea to constipation. In order to stop the diarrhoea/consitpation you may take medications or change your diet and then it goes the other way and then you may take medications or change your diet again and you're back to where you started. It's the nature of the beast I'm afraid!

Mearnsmum1 profile image
Mearnsmum1 in reply to Maureen1958

Thank you Maureen, it’s very frustrating!

Maureen1958 profile image
Maureen1958 in reply to Mearnsmum1

You're telling me! 35 years and I still can't work it out.

xjrs profile image
xjrs

IBS can certainly get worse with anxiety.

Here is some information about IBS that I have shared with others in this group in case any of these tips are of interest to you:

IBS can be due to a number or combination of factors - these can be stress (including stress from early life experiences) which impacts the communication between the brain and the digestive system. There are lots of free webinars online at the moment regarding mindfulness meditation which might help. Plus you can ask to be referred for CBT or something similar to reduce anxiety - I would have thought online appointments are available. Exercise can play a major role in IBS in terms of reducing stress, helping your gut microbiome and regulating bowel movements.

There is also not absorbing certain types of carbohydrates called FODMAPs very well, the residue ending up in the colon and bacteria feeding off them causing symptoms. Ordinarily feeding gut bacteria is a really good thing - when you feed good gut bacteria these produce by-products that have great health effects in the gut and throughout the body. However, in some people with IBS bad bugs might have the upper hand over good - these bad bugs may cause symptoms such as excess gas, pain or disordered bowel movements. There is an interesting infographic on this here:

gutmicrobiotaforhealth.com/....

This is why it’s worth trying probiotics such as Alflorex (which has been scientifically studied for IBS) or Symprove to crowd out the bad bugs and make their numbers die down. If that doesn't work you can try the FODMAP elimination and reintroduction diet. This is normally under the guidance of a nutritionist via GP referral - this may not be possible at the moment so you can read about it online. If you download the Monash University FODMAP app and Kings College fodmap apps, they will tell you which foods contain FODMAPs and in what quantities. You can eliminate all FODMAPs for 2 weeks and then introduce each type of FODMAP one at a time starting in small quantities, increasing over a 3 day period and wait up to 4 days for symptoms. I go much slower than this - only introducing a small amount (1/4 to 1/3 of a normal portion size) of the same food for 3 days and then increase if tolerable or no symptoms and cut back to the previous amount if symptoms for longer and then try to increment again . I've read your microbiome can adapt to handling a new food if introduced very slowly and your bad bugs are under control with a good probiotic. Ideally you want to eat as many FODMAPs as you can since they are good for your health. Many people with IBS don't have diverse gut bacteria - it has been found that people who lack a diverse microbiome are more prone to diseases in general. In the long run, if you can get your symptoms under control, the ideal situation is to have a very varied diet - lots of different coloured fruits and vegetables, a variety of protein and carbohydrate sources including cereal fibres. This may seem a long way off, but with the right treatment all of this is possible. Last year all I could consume to control my IBS was white rice, protein and limited low fodmap veg. Using the approach above (particularly introducing Alflorex) I am now able to consume far more foods - more than I've ever dreamed of including wholewheat bread which is unheard of for me.

If you are also suffering from pain, you may be suffering from visceral hypersensitivity (functional abdominal pain) - there is info about it here:

iffgd.org/lower-gi-disorder...

It is where the brain interprets the normal activity of the bowel as pain - this is due to a wearing down of neurons in pain control centres of the brain which can be caused by PTSD, neglect or abuse in childhood, extreme stressful events etc. The first line treatment is nerve pain agents such as low dose amitriptyline. There is a theory that being on something like amitriptyline for 6-12 months can help the pain control centre neurons to regenerate. Note that amitriptyline can cause constipation, but this can be helpful in people who are diarrhea dominant. Unfortunately I couldn't tolerate these. Linaclotide (for IBS-C only) & Alflorex have helped me with this intestinal pain.

You may also find assistance with anti-spasmodic medication such as mebeverine (Colofac) or enteric coated peppermint.

You can find some info on self management here:

theibsnetwork.org/the-self-...

If all of the usual IBS remedies fail and you are experiencing diarrhea, it is worth getting tested for BAM (Bile Acid Malabsorption), which can cause constant diarrhea - there is a separate test and treatment for that. Good luck.

Superzob profile image
Superzob

Going through that myself at the moment, but in reverse. Thought I might have eaten something which disagreed with me, but I’m a pretty conservative eater and haven’t changed my diet. Also, I’ve hardly been out and, when I have, been taking COVID precautions, so I find it difficult to believe I picked something up.

I tend to not get a bowel movement for a week after a bout of diarrhoea, and any pain might be caused by residual inflammation. Pain in the corners of the abdomen is pretty common as these are right-angled bends in the colon, trapping points for food and gas. Hopefully, this will correct itself in a few days but, if the pain lingers for more than 3 weeks, it might be a good idea to contact your GP.

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