What Is Paradoxical Diarrhea?

What Is Paradoxical Diarrhea

When loose, watery faeces in your colon manages to get past hardened, impacted stool and escapes via your anus, it results in paradoxical diarrhoea.

It is also known as overflow diarrhoea and is frequently a sign of mixed IBS (IBS-M), a kind of irritable bowel syndrome (IBS).

Usually, hardened faeces prevent other stools from moving through the colon when you're constipated. We refer to this as faecal impaction. However, liquid may begin to seep through and exit the anus when pressure from other stools builds up behind the hardened stool. This results in both constipation and diarrhoea symptoms at the same time.

Continue reading to find out more about paradoxical diarrhea's symptoms, possible causes, and when to seek medical attention.

Paradoxical diarrhea symptoms

The symptoms of paradoxical diarrhoea are comparable to those of constipation.

The following are some of the signs and symptoms you may encounter when constipation first appears:
  • Having less than three bowel motions per week or going several days without having one
  • Extremely dry, hard, and dark stools
  • being unable to pass gas without exerting yourself or pushing
  • not feeling satisfied after using the loo after having a bowel movement
You may begin to notice watery stool after using the restroom for a few days. You might not feel finished even if you pass a lot of watery poo. This diarrhoea is contradictory.

Additional signs and symptoms consist of:
  • feeling nauseated
  • feeling bloated
  • blood in your stool
  • pain in your lower back
  • pain or cramps in your abdomen

Paradoxical diarrhea causes

Having paradoxical diarrhoea is a common IBS-M symptom. IBS-M has no recognised particular aetiology.

Constipation and diarrhoea can be brought on by dietary or lifestyle factors, particularly if you have:
  • allergies to food
  • an imbalance of good bacteria or a deficiency of them in your stomach
  • gastrointestinal problems brought on by stress
Paradoxical diarrhoea can also be caused by bacterial infections.

The overabundance of harmful bacteria can cause diarrhoea and constipation by interfering with your body's food digestion process. It may take months for the restoration of healthy gut flora following this disturbance.

Potential complications of paradoxical diarrhea

If paradoxical diarrhoea is treated or goes away on its own, complications are uncommon.

However, if left untreated, paradoxical diarrhoea might eventually lead to:
  • a high-pressure hole (perforation) in your colon
  • bleeding from applying pressure on the blood vessels surrounding your rectum and anus
  • fistulas that join your intestines to other organs, such as the skin or bladder
  • malnourishment due to inefficient digestion
  • chronic inflammation, which raises the possibility of colon cancer

When to get medical help for paradoxical diarrhea

Constipation and diarrhoea that last for brief periods shouldn't be too concerning.

However, if you experience diarrhoea, constipation, or both for more than a week or if you see any of the following symptoms, you should seek medical attention:
  • dehydration
  • blood or mucus in your stool
  • severe abdominal pain
  • painful gas that doesn’t give you relief
  • fever
  • vomiting
  • losing weight for no reason
  • feeling dizzy
  • fast heartbeat
  • irregular heartbeat

Diagnosing paradoxical diarrhea

To identify paradoxical diarrhoea, a physician could:
  • Do a medical history check to learn more about your general health.
  • perform a physical examination to check for any symptoms of disease
  • do a digital rectal examination to look for a stool that has been affected.
  • recommend getting a CT or X-ray of your abdomen to check for impacted stool.
  • suggest using a contrast-dyed enema to make it easier to see impacted stool or other colon problems.

Treating paradoxical diarrhea

The following are a few ways to manage paradoxical diarrhoea:
  • using digital disimpaction, a physician inserts a finger into your anus using a greased glove to release impacted faeces.
  • an enema that uses liquids to wash away hardened stool
  • laxatives to cause the contraction of your intestinal muscles and the release of impacted stool
Before attempting any of these drugs or procedures for symptom relief, consult a physician.

Paradoxical diarrhea prevention

The best defence against paradoxical diarrhoea is the prevention of constipation.

The following advice can help you avoid constipation:
  • To stay hydrated, make sure you have enough water each day.
  • Consume a lot of fiber-rich foods, such as raw fruits and vegetables or legumes like beans and lentils, to facilitate the easier passage of faeces through your digestive system.
  • Incorporate probiotics into your diet to support the well-being of your gut flora.
  • Alcohol and caffeine can cause dehydration, so cut them back or avoid them.
  • To keep your gut muscles flowing, engage in moderate-intensity aerobic activity for at least 150 minutes every week.

What can cause constipation followed by explosive diarrhea?

Constipation is frequently caused by IBS-M, which is followed by violent diarrhoea.

Other reasons include of:
  • bacterial infections
  • a lack of fiber in your diet
  • dehydration
  • stress


When you have diarrhoea and constipation at the same time, it's called paradoxical diarrhoea. It frequently results from IBS-M or a cause such as stress or a bacterial infection.

If paradoxical diarrhoea subsides after a few days, there's no need to worry; however, if it persists for more than a week, you should get medical attention.


The most common queries regarding paradoxical (overflow) diarrhoea are listed below.

How can I harden my stool?

Smooth peanut butter, potato, pumpkin, yoghurt, pretzels, marshmallows, cheese, white pasta, white bread, banana, white rice, peeled apple, apple sauce, and cheese

Does fiber soften stool?

Dietary fibre softens and makes your faeces heavier and bigger.

Which fruit is best for hard stool?

Blackberries and raspberries

Is Papaya good for diarrhea?

This fruit is well-known for treating upset stomachs and diarrhoea.

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