Constipation and diarrhea are both troubling issues with bowel movements for many people. Constipation is defined as bowel movement less than three times per week, while diarrhea is when the stools are loose and watery. It is common for many people to have short episodes of constipation or diarrhea, but chronic cases usually indicate an underlying problem. Constipation can be caused by a variety of reasons, simple ones like diet changes, not drinking enough water, or a side effect of medications, or severe reasons like intestinal obstruction, problems with the nervous system, or hormonal imbalances. On the other hand, diarrhea is often caused by an infection by a virus, bacteria, or parasite from contaminated food or water, a side effect of medications, intolerance to certain substances like lactose, or chronic gastrointestinal conditions like inflammatory bowel disease, celiac disease, or irritable bowel syndrome.

Occasionally, you may also experience what is called constipated diarrhea. This occurs when severe constipation causes a blockage in your bowel, resulting in the bowel to leak out watery stools around the blockage. The leak from the bowel can look like diarrhea and is termed as overflow diarrhea. If you have this condition, be sure to talk to your doctor before taking any more medications for constipation or diarrhea as this condition may indicate an underlying disease such as irritable bowel syndrome (IBS). IBS affects between 6-18% of people globally, this condition causes a change in frequency and form of your bowel movements and also lower abdominal pain. Triggers for this condition vary between individuals, some common triggers are diet, stress, poor sleep, or changes in gut bacteria. Researches have also found that food allergies and certain genes that increase the risk of getting allergic diseases play a role in IBS, as allergic asthma, rhinitis, and eczema go hand-in-hand with bad digestive reactions in people with IBS.

If you get both constipation and/or diarrhea often, you may have a type of irritable bowel syndrome (IBS). There are three types of IBS, grouped by the main bowel problem that you are having, namely:

  • IBS-D (diarrhea): over 25% of your stools are watery and loose
  • IBS-C (constipation): over 25% of your stools are lumpy and hard
  • IBS-M (mixed) or IBS-A (alternating): over 25% of your stools are lumpy and hard, and an additional 25% are watery and loose

When you have IBS, you may also experience other digestive problems besides constipation or diarrhea, such as cramping, bloating, or abdominal pain. IBS-M is called mixed as you alternate between constipation and diarrhea pretty quickly, this type affects about 20% of patients with IBS and tends to have more pain or discomfort than the other two types. With IBS, your digestive issues like discomfort and bowel troubles are common and usually go on for months.

There are no tests that can diagnose whether you have IBS, doctors generally rely on the symptoms you described and their experience to make a diagnosis. There is no cure for IBS, the goal of treatment is mainly to ease your symptoms so that you have a better quality of life. If constipation is the major problem, often in people with IBS-M, your doctor may suggest that you take some fiber supplements. Drugs for constipation, diarrhea, pain, and anxiety or depression may also be part of your treatment. However, it is often a challenge to use medications as medicine for constipation may make diarrhea worse, and vice-versa. You may try some diet changes to find out what food makes your symptoms better and which ones make them worse.

If you have any new symptoms, make sure to tell your doctor in charge. Any “red flag” issues such as weight loss, fever, or blood in the stool should prompt a visit to your doctor. If you have diarrhea, watch out for symptoms of dehydration such as dark yellow urine, dry mouth, thirst, or decreased urine output. If you are having severe constipation, look out for any swollen veins around your anus (hemorrhoids), torn anus skin (anal fissure), or part of your intestine sticking out of your anus (rectal prolapse).