HomeAnswersMedical Gastroenterologyirritable bowel syndromeI have been having diarrhea and constipation for about four weeks now. Can you please help me?

What causes diarrhea and constipation in a stressed individual for several weeks?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At April 27, 2022
Reviewed AtDecember 13, 2022

Patient's Query

Hello doctor,

I have been under stress lately and have been having diarrhea and constipation for about four weeks now. I am under investigation for IBS and will have a colonoscopy in a few weeks. I have gallstones and a cyst in my ovaries. Blood tests on kidneys and liver are normal. I do not have celiac disease, and I have not lost any weight or no blood in my stool. I am just wondering what this could be. My doctor is also testing for ovarian cancer. I experienced some nausea and vomiting yesterday, but that appears to be settled now. My doctor seems to think that the vomiting could be related to being so constipated she has prescribed a Psyllium husk supplement. Would this medication cause initial diarrhea? Also, the consistency of the stool changes occasionally. Is there any difference between diarrhea with IBS or diarrhea with cancers? I have heard in diarrhea with cancer that sometimes the stool can be pencil-thin. The doctor checked for infections and performed an amylase test to see if there were any problems with my pancreas. My diet has been poor lately. I have also heard that IBS does not respond to treatment. Is this correct? I have tried a few laxatives, and they all seem to run through me. Can cancers respond initially to laxatives?

Hi,

Welcome to icliniq.com.

I can understand your concern.

It looks like Irritable bowel syndrome (diarrhea-predominant subtype). I would recommend you discuss with your doctor to prescribe you Mebeverine, which helps smooth muscles relaxation and reduces diarrhea. It usually gives good results. Exercise and meditation help in reducing stress and controls IBS symptoms very well. Avoiding dairy products also helps in controlling diarrhea. The husk is unlikely the cause of diarrhea as it helps bind stools and reduces diarrhea. I hope this answers your questions. If you have any further queries, please ask me. Thank you.

Patient's Query

Thanks for you reply just a few other things. I was prescribed a laxative for colonscopy which has not given me the bowel movement. I have been drinking a lot of water lately so maybe my bowels are cleaared this is worrysome. Is one big mushy bowel movement enough to classify diarrahoe as I read somewhere that you need three runny stools to be classified as diarrhoea. Although I have noticed over the last few days a bit more pain in the stomach however on some occasions the pain would reduce with a bowel movement. Are big bowel movements like overflow diarrahoe a cause for concern as I read sometwhere these can be associated with cancer. Also can flautence be associated with IBS.
Theoritical things are different from practical ones. Based on my experience in Internal Medicine, you have Irritatable bowel syndrome Unlikely to be IBD (Inflammatory bowel disease). Whenever you have stools they are in bout of diarrhoea. So, I feel it's IBS. Did you get your biopsy done during colonoscopy? If yes please share with me the report.. Try isabgol husk. It will surely help you.

Patient's Query

Colonscopy is not done yet. Due next week. However I was just wondering when this started about 7 weeks ago they put on me on cosmicol it is a laxative it give me loose watery stools but did not ease the constipation issue my GP suggested to try this again however I did not get loose watery stools this is a cause of concern or could it be that the body has got used to this. I have also be prescribed other laxatives such as dulocax and laxido. Also my stool consistency has changed for going about 4 times a day and the start of this to just having 1 large bowel movement today does this indicate anything serious.
I don't think this is serious. It happens. Infact you are passing one large bowel movement then it's absolutely normal. Let's wait for colonoscopy.

Patient's Query

I just want to check something I did a stool test and it did show up hidden blood however it this only four days since my period finished could this still be causing some hidden blood. Also I have anemia could this cause it as well. Also the fact that I have had constipation for a number of weeks could this cause hidden blood as I have to strain to pass bowel movements.
I am not getting that what do you mean by hidden blood? Have you seen it or you are talking about a laboratory test, that is called as STOOL FOR OCCULT BLOOD. If your lab says that your stool for occult blood is positive, then it can be a reason for anemia.

Patient's Query

Yes that was what I meant could anemia cause hidden blood in stool. Also could the long term constipation cause hidden blood. If it is IBS the diarrhoea sub type can you still have the constipation with it. Can you feel stomach pain intermettiely but gets worse when a bowel movement is coming and gets easier after you go. Can you feel a bowel movement is due and not go for hours. Also can you have just one big bowel movement a day. I was prescribed cosmol a laxative about six weeks ago I worked in that if gave me diarrhoea it did not give my diarrhoea this time around but has eased the constipation a bit. Could this be that the body has got used to laxatives as I have been tried on a number of these. Could it indicate that there could be some damage to bowels. Do you think that this is anything to be worried about. Thanks again for your help. I tend to get a lot better at night.
If you have blood in stools I'll describe it to you: 1. Fresh Red Blood - Piles 2. Black Tarry Stool - Melena due to upper gastrointestinal tract bleeding. 3. Occult blood means, blood not visible with naked eyes. Yes body gets used to laxatives. Since there is time in your colonoscopy, I would suggest you to read about Irritable Bowel Syndrome and see, you have it or not. And discuss with me.

Patient's Query

I think that it is best to wait to colonscopy and take it from there. I am very worried now. Hopefully if it is colon cancer that it has not spread as I have had CEA, CA19.9 and CA 125 done and I think they are used for progress and these were all in limits . It is just the fear and worring and due to high levels of anxiety I do not need this. I have to take some of the blame for this as the first test I did on the stool some of it had got into the toilet bowl so obviously as effecting the result and feel I could of got to see a consultant a bit sooner which may have speeded up thing a bit but I do not think that 4 weeks would make much difference to cancer treatment. Due to anxiety I possibly was not thinking about this. Could there be other reasons for the hidden blood, have already discussed amenia. Could long time constipation cause this. In relation to IBS I could have this I am not sure as I have alternating constipation and Diarrhoea, big bowel movements, adminonal pain which gets worse when a bowel movement is coming and gets better once passed. Feeling not emptied bowels. Also could the use of laxatives cause these symptoms of constipation with Diarrhoea. I had seen a doctor in the Emergency Department of the hosptial and he wrongly diganosed me with Stomach inflammation which held be back for about 2 weeks as I was content this was what it was but it did not get any better.
I feel you have IBS and anxiety provokes it. You will absolutely fine once you have in your hands absolutely normal report of Colonoscopy. Good Luck.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Anshul Varshney
Dr. Anshul Varshney

Internal Medicine

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