Constipation and diarrhea are at the opposite ends of the spectrum of abnormal bowel habit. After a bout of diarrhea, constipation may seem like a welcomed relief from the frequent trips to the toilet, loose or watery stool, excessive gas and sometimes abdominal pains. But constipation can end up being as distressing as diarrhea itself. And it can occur soon after you get over the diarrhea.
So what causes constipation after diarrhea? Many people who have just overcome a bout of diarrhea find it strange that they are constipated, but it is a common phenomenon and occurs for several reasons. One of the most important points to consider when trying to understand the cause of constipation after diarrhea is to look at the type of diarrhea and the type of bowel movement.
Causes of Constipation After Diarrhea
The causes of diarrhea itself can vary but involves one or more of the following mechanisms.
- Osmotic diarrhea where water is drawn out into the bowels due to a large concentration of solutes within the bowel lumen (cavity).
- Secretory diarrhea where the water passed out from the bowel wall into the lumen is more than the water being absorbed.
- Abnormal bowel motility where the movement through the bowels due to muscle contractions are abnormally fast (hypermotility).
- Inflammatory/infectious diarrhea where the bowel walls are inflamed or infected by microbes like viruses or bacteria like viral gastroenteritis.
The constipation that then follows could be due to one or more of the following reasons:
- Excessive use of anti-diarrheal drugs like loperamide.
- Dehydration with inadequate water content within the bowels.
- Poor nutrition during diarrhea leading to a lack of bulk within the bowels/stool.
- Secondary “slowness” of the bowels (hypomotility) as a reaction to the period of hypermotility in diarrhea.
- Disturbances in the normal intestinal flora (microbes that normally live in the bowels).
- Severe illness (stress) that upsets the normal bowel habit.
- Use of opioid painkillers to ease the abdominal pain/discomfort during diarrhea.
- Episodes of constipation that occurs in certain bowel disorders like inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS).
There may be other reasons why constipation occurs and it is therefore important to see a doctor if the constipation persists. Here are some simple diet and lifestyle tips to help ease constipation after diarrhea.
Walk Around After Meals
Physical activity is one of the lifestyle remedies advised for constipation in general. Constipation is often more seen among people with a sedentary lifestyle. After days of lying in bed and feeling drained from diarrhea, even mild physical activity like walking a few blocks can be helpful. The movement can “kickstart” the slow bowel motility.
It also aids with digestion if you walk around after a meal, or at the very least stand. Only take on the physical activity that you can manage. Remember that your body is likely to be dehydrated and still overcoming the stress of the diarrheal illness and straining yourself further with exercise can do more harm than good.
Drink ORS And Water
Oral rehydrating solutions are the fluids of choice when you have diarrhea. The optimally balanced solution containing essential minerals and electrolytes ensures that you body gets what it needs. ORS also does not contribute to diarrhea (osmotic and secretory types). But the ORS should not stop when the diarrhea comes to the end.
Continue with ORS for a few days after. It helps counteract the dehydration that may have set in with diarrhea. Also increase your water intake between the ORS drinks. It will help give bulk to your stool and aid with relieving constipation.
Restore Normal Eating Patterns
Medical guidelines for managing diarrhea states that you should not stop eating solid foods if you have diarrhea. It is only if you are vomiting, whether diarrhea is present or not, that you should avoid solid foods for a little while. However, when you do have diarrhea you often will not have your regular appetite and may be averse to certain foods that you otherwise enjoy.
You should continue eating bland and balanced meals. Try to return to your normal eating patterns as soon as possible once the diarrhea stops. Avoid spicy foods, alcohol and caffeine for a while but eat as much and as frequently as your normally would.
Eat Yogurt Or Take Probiotics
Your bowels contain a variety of different species of bacteria which play an important role in bowel health. It is known as the normal intestinal flora. However, diarrhea can affect this microbial population. Even if you do overcome the diarrhea, the normal intestinal flora can take days to weeks to restore.
For some people there may be ongoing digestive symptoms while others may barely notice it. Live culture yogurt and probiotic supplements containing certain species of Lactobacilli and Saccharomyces boulardii can expedite the restoration of the normal intestinal flora. This may help to relieve the constipation that follows.
Stay Away From Unnecessary Medication
The purpose of an antidiarrheal drug like loperamide is to stop bowel movements or at least reduce the frequency when you have diarrhea. But if you continue to use these drugs once the diarrhea resolves then it will cause constipation. Antidiarrheal drugs is not always recommended for diarrhea as it can worsen the situation but if you are using it then take it as prescribed and know when to stop.
Painkillers used during diarrheal illnesses can also cause constipation. Even if you are a little sore after overcoming the illness, try to avoid the painkillers unless it is really necessary. Constipation can occur with many other types of drugs but never stop prescribed medication unless you first speak to your doctor.
Up Your Fiber Intake With Food
Drinking water helps with counteracting dehydration, bulking up your stool and easing diarrhea. However, it is not as effective if you are not eating enough fiber. It is advisable to increase your dietary fiber intake before turning to fiber supplements. Fiber cannot be digested in the gut, absorbs water and bulks up the stool.
Cereals, grains, fruit and vegetables are some of the main sources of dietary fiber. Remember that fiber should be a part of your daily diet and not an add-on only when your bowels are giving you a problem. However, fiber supplements are helpful when constipation is a problem.
Stop Stressing About Your Bowel Habit
Worrying about your bowel movements can alter bowel habit as much as any disorder, disease , diet or lifestyle factor. Have you passed too much or too little stool? Did you go out enough times for the day? These are common concerns after a a diarrheal illness or other bowel upset. Diarrhea is a worrying symptom and can also cause a great deal of inconvenience in your normal life.
Most cases are short-lived and your bowel habit should quickly return to normal in most cases. Anxiety about whether you will get another bout of diarrhea or worrying about whether you are not going out enough can cause changes in normal bowel habit. The same applies for other psychological stresses in life.
Reviewed and updated on 10 August 2018.