If you haven’t had a bowel movement in days and then suddenly find yourself dealing with frequent watery diarrhoea, it can feel confusing and unexpected. While many would assume it points to an upset stomach or infection, experts say the reason behind it may be something entirely different. It’s a gut health symptom that often goes overlooked, but one that may need medical attention rather than waiting for it to pass on its own.
Also Read | The surgery costs $82,000! Gastroenterologist warns this bad habit can raise haemorrhoids risk
Joseph Salhab, a Florida-based gastroenterologist and health content creator who focuses on digestive, liver, pancreas, and nutrition health, is highlighting a lesser-known gut health symptom: it’s possible to be severely constipated and still experience watery diarrhoea. In an Instagram video shared on May 25, he explains why this happens, how it is typically treated, and why it’s important not to ignore the signs.
What is overflow diarrhoea?
According to Dr Salhab, it’s possible to have diarrhoea while actually being severely constipated. This is known as overflow diarrhoea. It happens when a large amount of hard, impacted stool becomes stuck in the colon and doesn’t move. With the blockage in place, only liquid stool or water is able to pass around it and leak out. As a result, you may experience frequent or persistent diarrhoea after several days without a proper bowel movement, when the underlying issue is actually constipation.
The gastroenterologist explains, “Overflow diarrhoea can happen when hard stool becomes impacted in the colon, and loose liquid stool leaks around the blockage. Many people think they have nonstop diarrhoea, when in reality they may be severely constipated underneath. Symptoms can include abdominal pain, bloating, nausea, leakage, and frequent loose stools.”
How is this treated?
Dr Salhab emphasises that this condition needs medical evaluation and should not be treated aggressively at home without proper guidance. Management usually begins with diagnostic tests to assess the severity of the blockage and identify any underlying risk factors. Once confirmed, treatment focuses on safely clearing the impacted stool from the colon. After that, the goal is to restore regular bowel movements through long-term measures such as increasing fibre intake, staying well hydrated, and building a bowel routine that supports healthy digestion.
The gastroenterologist explains, “This often requires medical evaluation because severe stool buildup may need treatment under supervision. In some cases, people require hospital evaluation, physical examination, abdominal X-rays, CT scans, bloodwork, enemas, bowel regimens, or even manual disimpaction depending on severity and risk factors. What this is going to entail is to clear out your colon of impacted stool with either some enemas or laxatives. And then you have to get on a bowel regimen which includes a high-fibre diet of about 25 to 30 grams a day, supplements like psyllium that can promote bowel movements, and scheduled toilet time.”
The risk of colon cancer
The gastroenterologist also warns that, in some cases, colon cancer can present as constipation or overflow diarrhoea by creating a blockage in the colon, which is why these symptoms should never be ignored. Persistent changes in bowel habits – especially when accompanied by other symptoms – may point to something more serious than routine constipation or diarrhoea and should be medically evaluated.
Dr Salhab highlights, “Very importantly: colon cancer can sometimes masquerade as constipation or overflow diarrhoea by causing narrowing or blockage within the colon. That’s why persistent symptoms, weight loss, blood in the stool, anaemia, severe pain, vomiting, or worsening constipation should never be ignored.”
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. It is based on user-generated content from social media. HT.com has not independently verified the claims and does not endorse them.
