Diarrhoea and constipation are two different stomach disorders. While these are believed to happen separately, there is a slight risk that both constipation and diarrhoea happen simultaneously. Yes, it is possible to have both the issues at the same time and this condition is called paradoxical diarrhoea. It is a rare condition and only a fraction of people experience it but it can be extremely painful and discomforting. While paradoxical diarrhea is the medical term, it is generally referred to as overflow diarrhoea. Refer to this article to know what causes paradoxical diarrhoea, its causes and what a person can do to prevent this condition.
Diarrhoea Vs. Constipation
Let us begin with the common differences between diarrhoea and constipation as a lot of people do not know what is what.
Diarrhoea is a digestive disorder that causes watery stools and is highly common in people of all age groups. Sometimes, it can go away within a day and sometimes it may take a few days to recover. If someone experiences watery stools more than 3 times a day, he is said to suffering from diarrhea. The possible causes of diarrhoea are:
- Bacterial, viral or parasite infection: In most cases, diarrhoea is caused when these pathogens enter the body and disrupt the digestive system. When someone consumes any food or drink(food poisoning), the parasites enter the body and cause diarrhoea.
- Other than the pathogen invasion, there are an array of conditions and diseases that lead to diarrhoea. These include inflammatory bowel disease(IBD), irritable bowel syndrome(IBS), lactose intolerance or allergy to dairy, celiac disease, to name but a few. These cause chronic diarrhoea that may last for about a week.
- Heavy medications or antibiotics can also cause diarrhoea condition.
As opposed to diarrhoea, constipation, is the condition that causes hard stools. This is when the person is unable to defecate due to stiff and difficult to pass stools. This can also affect people of all age groups. Generally, constipation stays for a couple of days only unless it is chronic constipation that may stay for a long period of time. A lot of people deal with this condition lifelong where they don’t get a bowel movement for days or 2-3 times a week. The stool is hard and defecation is both difficult and painful. One may need to put an extra strain in order to pass the stool. The common causes of constipation are:
- Not eating enough fibre that helps in improving bowel movements.
- Drinking less water(when you don’t stay hydrated, the body absorbs water from the intestine and cause hard stools)
- Poor physical activity
- Stress or travel constipation
- Holding bowel movements for a longer time
- Medications include antacids, antidepressants and antihistamines.
- Medical conditions like irritable bowel syndrome, thyroid, multiple sclerosis, Parkinson's disease, etc.
Paradoxical Diarrhoea Condition and Its Causes
Almost everyone speculates the cause of diarrhoea to be consumption of something that has disturbed the stomach or any pathogenic invasion. Right? But no one considers constipation to be a cause of diarrhoea. This is because it is a rare occurrence that constipation causes diarrhoea. Generally, constipation is transitory and gets better in a couple of days. In the case of chronic constipation where the condition stays for an extended time period, fecal impaction can occur. There are instances where people do not attend to natural bowel movements which cause their faeces to build up in the digestive tract. This further leads to faecal impaction.
What is Fecal Impaction?
This is a condition where a hard mass of faecal matter is accumulated in the intestine. This stool is so hard that it cannot be passed and remain stuck. The other names for faecal impaction are impacted stool, impacted colon, impacted bowel, etc. In such a condition, people get watery stools but they can feel that something is stuck in the digestive tract. While they may not be a passing stool, they may be experiencing bathroom incontinence.
This so happens that the watery stool behind the impaction is leaking out. People assume this to be diarrhoea whereas, it is actually impacted stool that is stuck due to constipation.
Constipation can cause diarrhoea and this condition is termed paradoxical diarrhoea.
If this condition is not treated timely, the rectum enlarges to contain the stool that is continuing to collect in the rectum. The anal relaxes and allows leakage of watery stool, the intestine produces more fluid which leads to more amount of water stools and higher leakage.
Faecal impaction Causes
Here are some common causes of faecal impaction:
- Laxative dependence: people who have chronic constipation issues take laxatives to get bowel movements. This helps them get stools. Laxatives are 100% safe but if you take them regularly, your system becomes dependant on them to have bowel movements. When you stop taking them, you may have to experience diarrhoea along with constipation.
- Taking painkillers often: It is seen that people who take painkillers daily, such as those who are undergoing medical treatment may experience faecal impaction.
- Consumption of fibre supplements such as methylcellulose, calcium polycarbophil or psyllium husk.
There are several ways to get rid of faecal impaction. One should consult a doctor to find out the best possible solution for faecal impaction. There are manual removal options, surgery to fecal impaction removal, an enema can also be given, use of laxatives, etc. are some of the major methods to remove an impaction.
Can Children Get Paradoxical Diarrhea?
This is a digestive disorder that can happen to anyone of any age from children to older adults. However, children experience encopresis which is a condition where they soil their clothes with stools. This is similar to paradoxical diarrhoea where it is caused due to constipation. Children may not be able to hold their stools and therefore leakage may happen.
How to identify if your child is dealing with this condition? As a parent, you need to see if your child is:
- Going to bathroom infrequently
- Having small and hard stools
- Soiling the underwear often
If these symptoms are seen, your child may be dealing with paradoxical diarrhoea. You must consult a doctor to relieve their condition.
How to Prevent Paradoxical Diarrhoea?
Let us put it like this- to prevent paradoxical diarrhoea, you need to prevent constipation. Since this condition is caused due to constipation, you need to avoid that from happening. Here are some recommendations for you:
- You must make dietary and lifestyle changes first. Eat fibre-rich diet to regulate bowel movements.
- Always go to the washroom when you feel the urge to. Delaying may cause constipation.
- Drink a lot of water.
- If you frequently deal with constipation, consume fibre supplements that help in the easy passing of stools. Along with that add foods like whole grains, fruits, vegetables, legumes, etc. to your diet.
- Take laxatives after consulting a doctor to prevent constipation. However, as mentioned earlier, the overuse of laxatives may complicate your health.
Paradoxical diarrhoea is not common because in most cases, constipation is addressed on time. Only when constipation remains for a long time, it can lead to paradoxical diarrhoea. By making simple changes in diet and lifestyle can reduce the risk of this condition. Consulting a doctor is suggested if you experience any chronic symptoms. Never take medication on your own as it may affect your system negatively. If you experience other issues such as blood in the stool, dizziness, blood pressure, etc., you must see a doctor.
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