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Constipation and diarrhoea can be warning signs of IBS.
But if you’ve had a bout of constipation or diarrhoea, don’t be alarmed. It doesn’t mean you have IBS.
It’s very important to know that IBS is a collection of symptoms, not a disease.
If you’ve had diarrhoea or constipation for over around six weeks, a doctor will probably diagnose you with IBS. But because there is no one, definitive way to diagnose IBS, you might get a diagnosis of IBS from one doctor but not from another.
Whether you have a diagnosis of IBS, or you don’t, please don’t worry. IBS symptoms aren’t a life sentence. There are many ways you can beat IBS.
Most people have had constipation or diarrhoea at some point in their lives. That’s all IBS is: constipation or diarrhoea. The only difference between ‘just’ constipation or diarrhoea and IBS is that IBS hangs around for longer.
IBS can get better, just like shorter bouts of constipation or diarrhoea do.
So, if you’re worried that you might have IBS, read on to find out more.
A change in your bowel movements is the most common early warning sign of IBS.
If your bowel movements change, or you develop IBS symptoms like constipation or diarrhoea, you should always tell your doctor. IBS symptoms can be a sign of a huge number of diseases and health conditions, and they may want to run tests to exclude these.
If you’re looking for specific signals that you have IBS—in the way that high blood sugar can be a sign of diabetes, for example—it’s important to know that IBS doesn’t work like that.
There are no official ‘alarm symptoms’ or warning signs for IBS, because it’s generally not considered a serious disease.
At Healthpath, though, we think IBS symptoms are always worth investigating. That’s because every part and system in your body is connected. You can read more about how we view IBS on our conditions page.
If you have IBS symptoms, it’s likely that something isn’t working somewhere else too. For example, people with IBS often have anxiety or depression [Source: PubMed].
Our medical system has separated the body into different categories: you see a gastroenterologist if you have symptoms in your gut, and an endocrinologist if something could be going on with your hormones.
But your gastrointestinal system (gut) and your hormones are intricately connected. That’s why hormonal problems and gut problems are often found together. For instance, women with menstrual problems often suffer from bloating, diarrhoea or constipation too [Source: PubMed].
In short, while IBS symptoms like constipation and diarrhoea appear in your gut, your gut is only one part of the whole IBS picture.
At Healthpath, we look at IBS symptoms as a warning sign that you need to look into the health of your whole body and mind.
There are many studies that show people have successfully addressed their IBS symptoms by supporting the health of their nervous system, for instance with exercise, meditation, breathing and optimising sleep. By finding and tackling the root cause of their symptoms—a disordered nervous system—their IBS disappeared [Source: PubMed].
If you’re getting early warning signs of IBS, like constipation or diarrhoea, you need to take a deep dive into your diet, lifestyle and state of mind.
IBS is different for everyone. Some people with IBS suffer from extreme pain, while others have no pain at all. Some may be incontinent and have no control over their bowels, while others are unable to go to the toilet without special medicine.
Many people with IBS also suffer from nausea. Experts don’t agree on whether or not nausea is a symptom of IBS, but you can read more about the connection between IBS and nausea on our blog post Is nausea a symptom of IBS?
As we mentioned before, the most common IBS symptoms are diarrhoea and constipation.
Diarrhoea is usually defined as having more than three bowel movements a day. However, it’s not that simple!
You could have one or two bowel movements a day, but if they’re watery and you don’t have enough time to search for the toilet when you’re out, we’d call that diarrhoea too.
According to the NHS, you have constipation if you have less than three bowel movements per week. At Healthpath, we say that if you’re straining to have a bowel movement, that’s constipation: it doesn’t matter how often you’re going.
And, even if you’re going twice or more a day, if you feel like you’re ‘not finished’, then you’re constipated.
This is why it’s possible to have constipation and diarrhoea at the same time. It can get a bit confusing, but remember that we ‘should’ ideally be having one to three well-formed bowel movements per day, with ease.
Our bowel habits in the modern western world are very different to how they have been throughout most of our evolution when we ate only whole, natural foods and lived close to the earth. We know from the few hunter-gatherer societies that still exist today that they have an easy bowel movement after every meal [Source: PubMed].
If you’re not having easy bowel movements (as many of us aren’t) then you need to look at your gut health and make some changes the way you eat and live.
Needing to go to the toilet very urgently is a common sign of diarrhoea. However, constipation can also make you feel like you need to poo.
Sometimes, you can have the sensation of needing to poo, when you don’t actually need to. This can happen for a few different reasons. Your rectum could be swollen from an injury, or you could have haemorrhoids (a swelling of the veins in and around your rectum).
It’s also possible that you do need to poo, but for a variety of reasons, you’re having trouble. Some of these could be:
You can suddenly develop IBS symptoms, but they can also creep up on you slowly over a number of years.
Some common reasons for suddenly developing IBS symptoms include:
There are an almost infinite number of reasons why you could suddenly develop IBS symptoms. It’s important to remember that you should always tell your doctor if your bowel movements suddenly change, so they can rule out any serious conditions.
Because IBS is a collection of symptoms, you have it if you have the symptoms: constipation or diarrhoea.
Unfortunately, there is no medically agreed definition of IBS. The NHS currently say that you have IBS if you have “recurrent abdominal pain, on average, at least one day a week in the last three months, associated with two or more of the following criteria:
The criteria must be fulfilled for the last three months, with symptom onset at least six months before diagnosis” [Source: NHS].
At Healthpath, we think that your bowel movements should be easy, well-formed and relatively regular. If they’re not, then you need to find out why. Then you need to make a plan to support not just the health of your gut, but your whole body and mind to get back on track.
We know from a mountain of recent medically-reviewed studies that your microbiome (the communities of bacteria and other microbes in your gut) has a massive impact on IBS symptoms. People with unbalanced microbiomes are a lot more likely to have IBS symptoms than people with healthy, diverse microbiomes [Source: PubMed].
Here are ten signs all might not be well with your gut:
Acne is especially linked to gut health [Source: PubMed].
Food intolerances and allergies can be evidence of a disordered microbiome [Source: PubMed].
Hard stools could mean you’re lacking key species of microbes in your gut [Source: PubMed].
People with acid reflux have been found to have different communities of microbes in their guts when compared to healthy people [Source: PubMed].
Bloating can reflect an overgrowth of certain species of microbes in your gut that love to eat the same foods you do [Source: PubMed].
You need a balanced gut ecosystem for a sound night’s sleep [Source: PubMed].
The link between your gut and your brain goes both ways. For a healthy gut, you need a healthy brain, and vice versa [Source: PubMed].
The guts of people with chronic fatigue syndrome (CFS) have overgrowths and deficiencies of specific types of bacteria [Source: PubMed].
The microbes in your gut interact with your immune system. A disordered microbiome sends out the wrong messages, and your immune system can start to attack your own body [Source: PubMed].
Nearly half of the children with IBS in the UK are obese [Source: PubMed], while one in five of the general population of UK children is obese.
Confusingly, you can have any of the above conditions and not have IBS symptoms, although IBS symptoms are more common in people with those conditions.
We mentioned already that if you have dysbiosis (an imbalance of the communities of microbes in your gut), you’re more likely to have IBS symptoms, but the reverse is also true: if you’ve got chronic disease and/or IBS symptoms, you’re more likely to have dysbiosis [Source: PubMed].
If you have IBS symptoms, it’s important to remember that there’s a lot you can do to tackle them. You certainly don’t have to put up with diarrhoea or constipation forever.
Alexandra Falconer MA (Dist) DipCNM mBANT is a Registered Nutritional Therapist specialising in IBS and related conditions. A graduate of Brighton’s College of Naturopathic Medicine, she is committed to fighting the root causes of chronic illness and bringing functional medicine to everyone who needs it.
Before her natural health career, Alex was a journalist and copywriter. She continues to write for magazines and media agencies, and now combines her two great passions—writing and health—by creating content that empowers people to claim their right to a healthy body and mind.
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