hello I’m posting to this forum once again as my Ibs symptoms continue to worsen. I don’t know if I’m constipated or have diarrhea but simply put, my colon is always filling up with mushy stool containing food fragments. I have 10 to 15 bowel movements every day but never get any feeling of relief just continuous cramping, and the urge to have more bowel movements. I get up at 3am every morning to get rid of as much stool before I start work at 9am. And I’m exhausted from it all throughout the day. I don’t eat very much and try to consume soft foods like eggs, bananas and apple sauce, I’ve tried every diet possible but no matter what I consume my colon fills up with stool. Has anyone experienced similar symptoms and can offer advice on treatments that provided some relief? I have had multiple colonoscopies, endoscopes and stool and blood tests. All appear normal. But this constant pain, bowel movements and feeling constipated just gets worse and worse. I appreciate any responses and suggestions.
thank you
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GKT1969
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You might be suffering from overflow diarrhoea, which is where liquid food gets backed up behind impacted/constipated stool and then seeps around the stool so that it comes out like diarrhoea. The thing to work on is the constipation (if this is the case). Eating soft foods doesn't give your stools enough bulk to help passage through your system. High fibre foods like whole grains, prunes etc. work the best. I have a whole spiel about how to treat constipation. I've posted it many times, but can do this again if this helps. Nevertheless it might be best to ask for a referral to a dietitian via your GP, so they can guide you until your symptoms are under control. I would ask not to be discharged until you can lead more of a normal life. You shouldn't have to put up with this. Good luck.
Thanks for the reply xjrs. I would appreciate any further insight on constipation you can provide, I have considered this to be overflow but the volume and frequency of the bowel movements leads me to believe I’m overproducing stool. But a couple of doctors have suggested overflow diarrhea so I should apply treatments and diets that will help me with that
What is your fibre intake like? To improve constipation in the short term you can try ground flaxseed on your breakfast, starting at 1 teaspoon and increasing at 1 teaspoon every 2-3 days - you'll need to consume extra water with it.
These foods are also high fibre:
8-9 Prunes
2 tablespoon chia seeds (soaked for 10-15 mins in milk or non dairy milk with cereal or water)
Shredded wheat (or if GF: Nutribrex)
60g Quinoa
Wholewheat bread
75g Whole grain pastas (if GF: Buckwheat)
2 Hard pears
5 Dried apricots
90g Raspberries
1 orange (contain a natural laxative)
2 kiwi.
I find that I need to have 1 orange or 2 kiwi a day and then another high fibre fruit later in the day to help with BMs. Introduce new foods and any fibre increases slowly, starting with one new thing at a time, waiting for 2-3 days for a response and keep a food diary. You may not need to consume as much fibre as I do.
For breakfast I make a porridge of 4 tablespoon of oat bran and 4 tablespoon all bran (wheat bran), 2.5 small cups of water and microwave for 10 mins. I then mix in 2 tablespoon of chia seeds and 1 tablespoon ground flaxseed and leave to stand for 15-20 mins since the chia seeds need to form a gel. On top of that I place 8 prunes and eat. The best thing to do is to start with normal oats in similar quantities and, if needed, replace one of the tablespoons of oats with oat bran for a couple of days, carrying on doing this every couple of days until you get to 4 tablespoon of oat bran and 4 tablespoon of oats. Then start replacing with wheat bran in the same manner. You can then add the other ingredients one at a time. You might find you do not need the complete 'recipe' to have a BM. All these individual components are down to tolerance e.g. you may not tolerate wheat (see later about Alflorex), so it is best to keep a food diary (I do this on a spreadsheet) recording symptoms for up to 2-3 days after each change.
I also take 30 drops of ginger extract before bedtime to aid motility. You may need to work up the dose to say 7 drop increments each night.
Exercise can help with BMs. The government recommends 150 mins of moderate exercise (e.g. walking as if you are late for an appointment) or 75 of intense exercise (e.g. jogging) per week. I also have a bit of a walk around straight after breakfast to get things moving.
You need to ensure that you are drinking enough fluids (2 litres of fluid per day).
There is some good advice about constipation here:
There are also medications that help IBS-C (constipation dominant IBS). I suffer from IBS-C and have been prescribed Linaclotide for it. I also take Alflorex probiotic which has made me more tolerant to taking in the extra fibre I need for a BM.
Failing dietary measures, you can try Optifibre, which needs to be worked up to a dose according to instructions. You may not need the full dose - watch out for gas and increment to a level that is acceptable for you.
Some people are more prone to constipation due to their intestinal anatomy. Through colonoscopies I have been told that I have a long loopy (redundant) colon. This means that food takes longer to pass through and in the mean time the intestines have more time to suck out water from the stool, drying them out and causing constipation. I have found that I need to consume much more fibre than other people to have regular BMs.
I have also found useful having most of my food at meal times, leaving 4-5 hours of not eating between meals, eating my fruit snack before a meal. This means that your digestive system has time to process each meal. It also allows something called the MMC (migrating motor complex) to run which sweeps food waste from your small intestine into your large intestine. This only happens when you have an empty stomach. When people snack regularly, it prevents the MMC from working properly. I also find the larger meals help to push things along better than drip feeding through snacking.
this is so helpful thank you so much. I do take fiber supplements and drink nutrition drinks that contain fiber. But I will follow your recommendations to see how I respond. It’s such a dilemma for me as my chart will show constipation because of the amount of stool in my colon. But my symptoms are the opposite as I have 15 substantial bowel movements a day. So one doctor gives me medication and diet advice for constipation and another for diarrhea. There is so much stool I really do not understand where it all comes from. And this is every single day I wake at 3 am and am having bowel movements until I start work at 9am. Then more throughout the day. No wonder I am close to losing my job. My wife already left because it was too much for her. I don’t blame her she deserves better than living with someone who spends half the day on the toilet. I am struggling to cope it’s all getting too much for me. But I am so grateful to you and others who have offered advice and reassurance,. Thanks again my friend
Sorry to hear that. It isn't normal to start pooping at 3am. It sounds like more studies are needed such as some form of transit study, if that is possible.
Also waking up in the night to go to the toilet means its inflammatory cause of some type, according to gastroenterologist on Zoe on youtube... theres quite a few videos on there about diorrhea and constripation... 15 times a day is not normal anyway!
If you had impacted stool wouldn't it have shown up on the colonoscopies? Just asking as my friend has EDS and severely backed up and it showed up on MRI scan! I have heard of that overflow diorrhea but isn't 10-15 times a day classed as chronic diorrhea which should be investigated? Apple sauce is high fodmap also which might not help... Fodmaps give me mushy stool. I also have undigested food in it but read recently that that is completely normal ?
To know for sure if its constipation or diorrhea its easy to test your gut transit time yourself - Zoe did the blue muffin test - you just buy blue food dye and add it to home made cakes and watch out for the blue poo You can also do the same with sweetcorn though as noone can digest sweetcorn skins.
You need more fibre, Soluble Fibre is best, try seeds, like Chia, Sesame, Pumpkin, Sunflower and dried Prunes, fresh fruit daily include pear not too ripe. A good variety of fresh or frozen vegetables as you can tolerate. Steamed or grilled fish, wholemeal bread if you can digest it, I can't but some people can. Oats like porridge and sprinkle seeds on it. Flaxseed is good, I add it to my bread as I make my own. These foods will bulk up your stool. If all fails, you can buy sachets of soluble Fibre to mix with water or try Phsylium Husk. It's not something you can put right overnight, it takes time for your system to adjust but a week or so should bring better results. Good Luck. 🤞
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You can also do the same with sweetcorn though as noone can digest sweetcorn skins. 
I feel so much better
Paler stools and wheat
Good good news I am doing so much better 
Sticky stool problem. 
