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Understanding Paradoxical Diarrhea
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Have you ever experienced a peculiar mix of constipation and diarrhea at the same time? This unusual phenomenon, known as paradoxical diarrhea or overflow diarrhea, can be both confusing and uncomfortable. Here’s what you need to know about this condition:

What is Paradoxical Diarrhea?

Paradoxical diarrhea occurs when liquid stool leaks around impacted, hardened stool in the colon. This leakage leads to symptoms of both constipation and diarrhea simultaneously. It’s often associated with conditions like mixed irritable bowel syndrome (IBS-M).1

Symptoms may include:

  • Infrequent bowel movements or difficulty passing stool
  • Dark, hard, dry stools
  • Watery stool that doesn’t provide relief
  • Nausea, abdominal pain, bloating, and sometimes blood in the stool
  • Causes and Risk Factors

Paradoxical diarrhea is commonly linked to:

  • Mixed IBS (IBS-M)
  • Dietary triggers or lifestyle factors like stress
  • Bacterial infections affecting gut health
  • Complications

Untreated paradoxical diarrhea can lead to:

  • Colon perforation or hemorrhoids
  • Fistulas connecting intestines to other organs
  • Malnutrition and increased risk of colon cancer1

Doctors diagnose paradoxical diarrhea through:

  • Medical history review
  • Physical exams and digital rectal exams
  • Imaging tests like X-rays or CT scans

Treatment options include:

  • Digital disimpaction
  • Enemas to flush out impacted stool
  • Laxatives to stimulate bowel movements
  • Prevention

Preventing constipation is key:

  • Stay hydrated and consume fiber-rich foods
  • Manage stress and incorporate probiotics into your diet
  • Limit caffeine and alcohol
  • Engage in regular aerobic exercise

Pelvic floor physical therapists can play a crucial role in managing paradoxical diarrhea by addressing the underlying pelvic floor dysfunction that often contributes to this condition. These specialists use techniques such as biofeedback, manual therapy, and targeted exercises to strengthen and coordinate the muscles of the pelvic floor, which can help improve bowel function and reduce symptoms of both constipation and diarrhea3. By teaching patients how to properly engage and relax their pelvic floor muscles, physical therapists can help alleviate the strain and pressure that lead to fecal (bowel) impaction and overflow diarrhea. Additionally, they can provide patient education on dietary modifications, hydration, and bowel habits to support overall digestive health and prevent future episodes of paradoxical diarrhea. Through a comprehensive and individualized approach, pelvic floor physical therapists help patients regain control over their bowel function, enhancing their quality of life.

While short episodes of paradoxical diarrhea may resolve on their own, persistent symptoms warrant medical attention to prevent complications. Understanding the causes and managing symptoms effectively can significantly improve quality of life. If you are experiencing symptoms of chronic constipation, diarrhea/loose stools, and/or paradoxical diarrhea; reach out to your physician. 

For more detailed information and updates on health topics, stay tuned to our blog. Stay informed, stay healthy! If you’d like to visit us, schedule your appointment here. We hope to meet you soon!

 

References

  1. Whitehead WE. Functional anorectal disorders. Seminars in gastrointestinal disease. 1996;7(4):230-236.
  2. Cohen RA, Pops MA. Paradoxical diarrhea with opiates. JAMA : the journal of the American Medical Association. 1968;205(11):802-803.
  3. Camilleri M. Diagnosis and Treatment of Irritable Bowel Syndrome: A Review [published correction appears in JAMA. 2021 Apr 20;325(15):1568. doi: 10.1001/jama.2021.4833]. JAMA. 2021;325(9):865-877. doi:10.1001/jama.2020.22532

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Testimonial by S.B.

As someone who suffered the debilitating physical and emotional effects of vaginismus (as well as a complicated history of back injuries) for more than 15 years, I thought a "normal" life was just a fantasy. Then I found Heather.

Read more: Testimonial by S.B.

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

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Testimonial by R.S.

I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

-- R.S.

Testimonial by S.P., Age 26

I would like to start off by thanking Heather Jeffcoat for educating me and curing me of Vaginismus. I had been married for almost three years before I was referred to Heather. I never knew about Vaginismus until almost three years into my marriage. I knew something was wrong when I went on my honeymoon and came back a Virgin. I had always imagined how magical my first night would be but boy was I wrong.

Read more: Testimonial by S.P., Age 26

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

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