If you haven’t pooped in days, you might find yourself praying for any sort of bowel movement—well, except diarrhea. And if you’re dealing with a seemingly unending flow of shitty lava, you’re probably wishing you could just stop pooping. So it’s easy to see why getting stuck in a cycle of constipation and diarrhea is a special kind of hell.
Experiencing such a worst-of-both-worlds poop scenario is a classic marker of irritable bowel syndrome (IBS), a commonly diagnosed GI condition that can be pretty unpredictable, says Mark Pimentel, MD, a gastroenterologist at Cedars-Sinai in Los Angeles and the director of the Medically Associated Science and Technology (MAST) program, which focuses on IBS. There’s a constipation-predominant (IBS-C), diarrhea-predominant (IBS-D), and mixed version (IBS-M) of the condition, and all of these types can come with some degree of both bowel extremes, which can be tough to manage, Dr. Pimentel tells SELF.
In fact, yo-yoing between constipation and diarrhea can actually be the result of treating either symptom, whether or not you’ve been formally diagnosed with IBS. Read on to learn how the vicious constipation-diarrhea cycle typically starts, and how to get yourself off the GI seesaw.
What’s causing me to swing between constipation and diarrhea?
Technically speaking, you’re constipated if you’re pooping fewer than three times a week, whereas diarrhea means you’re letting out loose or watery poops three or more times a day. Simply dealing with a combination of the above on a regular basis and experiencing discomfort with either may be enough for a doctor to diagnose you with IBS. (After all, the condition is technically defined by a set of GI-related symptoms, like abdominal pain and changes in poop frequency and consistency, that have gone on consistently for at least three months.)
The problem is, experts don’t fully understand what leads to these symptoms in the first place. One of the primary theories is that there’s a breakdown in communication between your gut and your brain, leading the former to become hypersensitive to nerve signals from the latter—but again, we don’t know why that might happen to certain people (factors like genetics, a mental health issue, or a bacterial imbalance are all potential culprits). As a result, the drugs we have for IBS just treat individual symptoms, Dr. Pimentel says, which, in itself, can cause a flip-flopping effect between bowel problems.
Take constipation: A doctor will typically recommend trying a stool softener or a laxative, which either makes your poop wetter or bulkier, or stimulates the nerves in your gut to push things along—and all of this can inadvertently cause loose poops. And for diarrhea, you’d likely take loperamide (a.k.a. Imodium), which slows the movement of your intestines, potentially triggering constipation. So in either case, you might knock out one symptom only to end up with the opposite one—cue the GI whack-a-mole!
But you could certainly get milder versions of constipation and diarrhea—say, struggling to poop for a couple days or getting the runs every so often—or some occasional switching between the two for a few one-off reasons as well.