Table of ContentsView AllTable of ContentsSymptomsCausesComplicationsWhen to See a ProviderTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Complications
When to See a Provider
Treatment
Prevention
Paradoxical diarrhea (overflow diarrhea) occurs when watery stools gush around a solid stool and leak out of the anus. It happens when you are constipated and water accumulates behind the blockage. The mounting pressure causes the fluids to leak out.
Paradoxical diarrhea looks a lot like regular diarrhea, often happening suddenly and explosively. It can also cause abdominal pain, cramping, and rectal pain or bleeding. It can be an isolated incident, or it can occur with chronic conditions like irritable bowel syndrome (IBS).
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Paradoxical diarrhea may begin after a few days ofconstipation. Symptoms of constipation include:
Symptoms of paradoxical diarrhea include:
When you have constipation and don’t pass stool for a long time, the hardened stools may accumulate and get “stuck” in thecolon. This isfecal impaction.
When this happens, fluids can start to build behind the obstruction, eventually seeping out around the hardened mass. This liquid stool is often gritty and foul-smelling.When the impaction eventually becomes “unstuck,” it can come gushing out uncontrollably in a combination of diarrhea and hardened stools.
IBS
One condition for which constipation anddiarrheaare characteristic ismixed-type irritable bowel syndrome (IBS-M). IBS-M is one of three subtypes ofirritable bowel syndromewhere constipation and diarrhea frequently alternate, sometimes over a period of hours or days.IBS-M can even cause extreme changes in stool consistencies within the same bowel movement.
IBS-M can be persistent or occur in episodes. By definition, a person has IBS-M if they experience hard, lumpy stools for at least 25% of bowel movements and loose, mushy stools for at least another 25% of bowel movements during periods of disease activity.
Laxatives
The chronic use of medications that cause constipation can lead to fecal impaction. At the same time,laxativesused to relieve constipation can also contribute to fecal impaction if overused.
The overuse of certain laxatives, particularlystimulant laxatives, can lead tolaxative dependence. This happens when you have to take more and more of the drug to get the desired effect. Over time, the body will become less responsive to the laxative, and gut motility will slow, leading to constipation.
Non-stimulant laxatives and bulk-forming laxatives are safer for long-term use, provided they are used correctly. These include:
Stimulant laxatives and stool softeners aren’t recommended for long-term use.
Children sometimes hold in bowel movements, a practice that can lead to constipation. In turn, when children are constipated, they may also hold bowel movements to avoid pain—leading to even more constipation.
Encopresishappens when children have bathroom accidents and soil their underwear. It occurs when impacted stools cause liquids to seep around the stool, staining underwear.
To avoid this, make sure your child:
If your child is regularly soiling their underwear, call your pediatrician. They can work with you to find safe and effective treatments.
Other Causes
Common causes of constipation include not eating enough fiber, notdrinking enough water, and being physically inactive. Travel and stress can also cause some people to become constipated.
Medications are also a major cause of constipation, including drugs like:
Health conditions that can also cause constipation include:
Fecal impaction is a significant problem for people who are bedridden due to chronic disease.
If constipation is chronic, it can lead torectal distention(in which the lower part of the colon is enlarged) and laxity (loosening) of theanal sphincter musclewhich controls bowel evacuations. This can lead to the loss of bowel control, also known asfecal incontinence.
Fecal impaction may also lead to a serious condition called peritonitis, which is an inflammation or infection of the tissue lining the abdomen.
When to See a Healthcare Provider
Diarrhea and constipation that comes and goes aren’t usually cause for concern. However, you should see a healthcare provider if they occur with any of these symptoms:
There are several different treatments that can be used to remove impacted stool:
On rare occasions, surgery may be considered. This is usually reserved for people who develop peritonitis or perforation of the bowel.
Drinking more water can help keep your stools soft. You should also aim to get more fiber in your diet, eating fiber-dense foods such as:
Fiber supplementsare bulk-forming laxatives that can be taken regularly to ensure normal bowel movement. These draw water into stools to keep them soft so they can pass easily.
Summary
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Serrano Falcón B, Barceló López M, Mateos Muñoz B, Álvarez Sánchez A, Rey E.Fecal impaction: a systematic review of its medical complications.BMC Geriatr. 2016;16(1):4. doi:10.1186/s12877-015-0162-5Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol.2021;116(1):17-44. doi:10.14309/ajg.0000000000001036Cornell Health.Laxative use.Harvard Medical School.Constipation and impaction.American Academy of Pediatrics.Soiling (encopresis).Larach S, Martin-Perez B.Management of fecal impaction. In: Fazio VW, Church JM, Delaney CP, Kiran RP, eds.Current Therapy in Colon and Rectal Surgery. Elsevier; 2017:102-106.Larach S, Martin-Perez B.Faecal impaction of the elderly: a review of the existing literature.Indian J Surg. 2024;86(3):509-13. doi:10.1007/s12262-023-03870-5National Institute of Diabetes and Digestive and Kidney Diseases.Eating, diet, & nutrition for constipation.Additional ReadingHarvard Health Publishing.Don’t bomb the bowel with laxatives.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Serrano Falcón B, Barceló López M, Mateos Muñoz B, Álvarez Sánchez A, Rey E.Fecal impaction: a systematic review of its medical complications.BMC Geriatr. 2016;16(1):4. doi:10.1186/s12877-015-0162-5Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol.2021;116(1):17-44. doi:10.14309/ajg.0000000000001036Cornell Health.Laxative use.Harvard Medical School.Constipation and impaction.American Academy of Pediatrics.Soiling (encopresis).Larach S, Martin-Perez B.Management of fecal impaction. In: Fazio VW, Church JM, Delaney CP, Kiran RP, eds.Current Therapy in Colon and Rectal Surgery. Elsevier; 2017:102-106.Larach S, Martin-Perez B.Faecal impaction of the elderly: a review of the existing literature.Indian J Surg. 2024;86(3):509-13. doi:10.1007/s12262-023-03870-5National Institute of Diabetes and Digestive and Kidney Diseases.Eating, diet, & nutrition for constipation.Additional ReadingHarvard Health Publishing.Don’t bomb the bowel with laxatives.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Serrano Falcón B, Barceló López M, Mateos Muñoz B, Álvarez Sánchez A, Rey E.Fecal impaction: a systematic review of its medical complications.BMC Geriatr. 2016;16(1):4. doi:10.1186/s12877-015-0162-5Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol.2021;116(1):17-44. doi:10.14309/ajg.0000000000001036Cornell Health.Laxative use.Harvard Medical School.Constipation and impaction.American Academy of Pediatrics.Soiling (encopresis).Larach S, Martin-Perez B.Management of fecal impaction. In: Fazio VW, Church JM, Delaney CP, Kiran RP, eds.Current Therapy in Colon and Rectal Surgery. Elsevier; 2017:102-106.Larach S, Martin-Perez B.Faecal impaction of the elderly: a review of the existing literature.Indian J Surg. 2024;86(3):509-13. doi:10.1007/s12262-023-03870-5National Institute of Diabetes and Digestive and Kidney Diseases.Eating, diet, & nutrition for constipation.
Serrano Falcón B, Barceló López M, Mateos Muñoz B, Álvarez Sánchez A, Rey E.Fecal impaction: a systematic review of its medical complications.BMC Geriatr. 2016;16(1):4. doi:10.1186/s12877-015-0162-5
Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol.2021;116(1):17-44. doi:10.14309/ajg.0000000000001036
Cornell Health.Laxative use.
Harvard Medical School.Constipation and impaction.
American Academy of Pediatrics.Soiling (encopresis).
Larach S, Martin-Perez B.Management of fecal impaction. In: Fazio VW, Church JM, Delaney CP, Kiran RP, eds.Current Therapy in Colon and Rectal Surgery. Elsevier; 2017:102-106.
Larach S, Martin-Perez B.Faecal impaction of the elderly: a review of the existing literature.Indian J Surg. 2024;86(3):509-13. doi:10.1007/s12262-023-03870-5
National Institute of Diabetes and Digestive and Kidney Diseases.Eating, diet, & nutrition for constipation.
Harvard Health Publishing.Don’t bomb the bowel with laxatives.
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