IBS-M: The Swift Shift from IBS-C to IBS-D

By Amy Dodd Pilkington

2 min read

Once again, an episode of constipation has ended. It was quickly replaced by a bout of diarrhea. Quite often this change happens during the same bathroom visit. It doesn’t matter how many times I have experienced this quick change. It is still a surprise almost every time it happens.

Constipation changes to diarrhea

The entire week had been a guessing game of when I would find relief. I had been unable to fully evacuate my bowels, and I was becoming quite miserable. This episode had continued long enough that I was anxiously awaiting the change so I would have some relief.

The bout of IBS-C did indeed end in a flash, and the result was a terribly severe episode of IBS-D. The initial feeling of relief was soon replaced by regret as wave after wave of cramping and an urgent need to go kept me running back and forth to the bathroom for 2 full days.

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Severe diarrhea after constipation

I refer to these awful episodes as correction days. It’s the end of a bout of IBS-C, and a cleansing of all that has accumulated during that time with a bout of IBS-D. It does provide relief from the ridiculous amount of bloating caused by constipation, but it changes to a different set of symptoms.

It does not end with emptying the contents. It continues to flush out everything I eat so quickly that I sometimes do not finish a meal before I have the urge to go. The pain is sudden and sharp and unrelenting. It is frustrating.

Dealing with changing flare types in IBS-M

After a couple of days of dealing with the cramping, sharp pains, and running back and forth to the bathroom hoping to avoid an accident, I often begin to hope for a bout of IBS-C. I tend to forget it is equally awful. I’m just desperate for an end to the horrible diarrhea caused by an IBS-D flare. It’s the same when I have an IBS-C flare.

Trying to treat an IBS-M flare is equally frustrating. There is no medication to treat IBS-M. We can only treat the symptoms of a flare and hope it doesn’t trigger a flare of the opposite type. It has been my experience that treatment of any symptom triggers the opposite symptoms. Because of this, I avoid treating symptoms unless it is absolutely necessary.

Living with unpredictable flares and flare types

IBS-M is frustrating in part because you cannot predict when a flare will happen. You also cannot predict which type of flare it will be, and this is maddening. You figure it out once a flare begins.

Sometimes I hope for the opposing type of flare to end a flare that has plagued me for too long. Sometimes the change is welcome for a short time, but that sense of relief never lasts. One type of flare is no better than the other. Neither is preferable, but I wish every bout of IBS-C didn’t end with an IBS-D flare.

Do you have IBS-M? How do you cope with the unpredictable flare types and sudden changes? I would love to hear about your experience.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The IrritableBowelSyndrome.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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Wordsmithlynn Member
Mine used to be IBS-D that occurred occasionally after eating certain foods (esp dairy or very spicy). But in the last several years it has become more random and has shifted to IBS-M. I pretty much go from one extreme to the other, like you. It’s very tiring and hard to plan around. My sympathies!
Kim Dolce Moderator & Contributor
 Amy, I experienced IBS-M exactly as you described it. Although I sometimes experienced constipation without it flipping 180 degrees to explosive diarrhea. I too experienced a severe effect after taking medication to treat one or the other, so I stopped and let my body naturally cycle through C and D, with better results. But after a 28-lbs weight loss this year, it has changed yet again, for the better. I can't remember the last time I had a bout of urgent diarrhea. I evacuate naturally after 2 or 3 days, and it can go from hard little rocks to a bit loose during one sitting, but still be solid, well-formed logs. What's more, urgency while I'm out and about doesn't feel dangerous anymore, I can hold it until I get home. I think I can give credit to my diet regimen of calorie reduction and intermittent fasting for the past year. The less I ate, the quieter my IBS symptoms. I now eat 500-900 calories a day and feel strong and alert. I am 65, and we seniors don't need as many calories as we did in our younger years. So I'm double-pumped that I had two successes: weight loss and improved IBS symptoms. Who knew? I've tried everything I can think of, and this reaped the best results thus far. And I live with multiple sclerosis too, which itself can cause the IBS-like symptom of delayed emptying. So my diet regimen has cut across IBS and MS in good ways. Thank you Amy for sharing your experience. I can't be the only other IBS-sufferer who has found something that improved their symptoms. I hope others will chime in. Cheers, Kim, moderator
DEATHDARKBITCH Member
I have just discovered this the last couple of days. Especially when you go to Tescos and discover that the toilets are out of action and you are told to go to the public toilets that by a miracle are actually open. By which time I was in a mess up to my eyeballs. Going back to Tescos and it's a complete nightmare. The whole world and his wife are in my way and I have to rush back to the loo for the usual false alarm. Having to come back home to have a bath to clean up the you know what only for it to continue all day. Not eaten anything I shouldn't. Just another day in the life of IBS changing the goal post and saying. "try this bitch" 
1. DEATHDARKBITCH Member
 Back to usual IBS C but the same thing happened in Aldis in the town centre on Saturday. I was in a panic committed the crime of the century by going in through the exit. Only to find that their toilets were out of order. What is going on out there lately with public toilets. 
2. Karina Moderator & Contributor
 <inline-mention username="DEATHDARKBITCH" user-id="4250368"/> So sorry to hear that. I have no idea, we don't usually have toilets in supermarkets where I live, unless they're really big, but I have often seen toilets at a doctor's office be out of order and that's also extremely frustrating. I wish there was a law about that or something. 🙁 Karina (team member)
Ladybug53 Member
This is my life exactly! Teaching school makes it really interesting! I run to the bathroom…nothing. Then, finally it breaks loose and it’s a waterfall! So very frustrating. 
1. Karina Moderator & Contributor
 <inline-mention username="Ladybug53" user-id="2327277"/> Teaching must make this very hard, I'm sorry you have to deal with this. 🙁 How have you been feeling lately? Karina (team member)
2. Karina Moderator & Contributor
 <inline-mention username="babsmurdock" user-id="2272085"/> I'm so sorry that you weren't able to continue working with students, that's so tough. Maybe one day you'll feel good enough to do it again? One of our contributors recently went back to professional dancing after having to stop due to health issues: <a href='https://irritablebowelsyndrome.net/living/dancing-with-ibs' target='_blank'>https://irritablebowelsyndrome.net/living/dancing-with-ibs</a>. Wishing you all the best, Karina (team member)
lisaw Member
Research psyllium husk not the powder form though. It works much better than Metamucil. It bulks the stool and makes a person more regular so you don’t have the urgency and cramping. Or the constipation. I had this very scenario with the not going for 3-4 days then next day was toilet bounds. Not anymore with psyllium husk taken one teaspoon every evening before dinner. Good luck 
1. Karina Moderator & Contributor
 <inline-mention username="lisaw" user-id="2312744"/> I'm so glad that psyllium husk has helped you, thank you so much for sharing! Karina (team member)
2. Karina Moderator & Contributor
 <inline-mention username="babsmurdock" user-id="2272085"/> Thanks for sharing, I'm glad this works for you! All the best, Karina (team member)
rosie Member
How much water do you require taking psyllium husk?
1. lisaw Member
 I started with maybe small (half)teaspoon (mixed with grape crystal light)of psyllium on a Friday evening as I am off for weekends to test the waters. I bought from Amazon. I tried the psyllium powder and that’s a no for me. Has to be the whole husk psyllium. Also, if anxiety is the struggle research Nerva a hypnotherapy to retrain the gut brain pathway. An app that has 15 minutes of breathing exercises and relaxation exercises to break the cycle of that fight or flight we have which affects our bowels. For me, meh, I tried it for a couple months and pulled what thought helped. It does have a cost but you can cancel after a month or so. Good luck y’all and God Bless! 
2. Karina Moderator & Contributor
 <inline-mention username="lisaw" user-id="2312744"/> I liked Nerva, too, although I found it too expensive to continue after the initial 3 months subscription. It offers good techniques for dealing with the anxiety around IBS though. Karina (team member)
SirIsaac Member
I too suffer from IBS-M. It used to be more D than anything. The need to use the toilet 5-10 times a day was exhausting. For a while I was living on imodium. I cannot tolerate high amounts of fiber so I had no choice. Couldn't go out for dinner if I wasn't going right home after. Always needing to know where the bathroom is everywhere I go. But what not everyone knows is IBS is a functional and motility disorder. It's not seen on colonoscopy nor in a tissue biopsy. It's linked to our nervous system. Specifically the fight or flight pathway. That Brain-Gut pathway needs to be disrupted or broken in order to stop our symptoms. A lot of research has been done on IBS and some good information is coming out. One thing we all need is support. Finding a Gastroenterologist who specializes in motility and dysfunctional issues is key. There are medications that can help. Having said that, we also need to be mindful of the foods we eat and managing stress. I'm doing much better since finding the right doctor and practicing mindfulness.
1. Karina Moderator & Contributor
 <inline-mention username="SirIsaac" user-id="4263153"/> Thank you so much for sharing these insights, I'm so glad that you're doing better since your found the right doctor. Can I ask what they suggested to manage your symptoms? I never found a good gastroenterologist, so I'm just wondering what the approach might be. Karina (team member)
2415 Member
I too have IBS M and understand completely your account . When my IBSC is bad I have to manually evacuate my bowels--not pleasant but relieves that awful feeling . Mostly wakes me up 2am and continual pain through to 8 am when I go normally.I have tried everything for my IBS nothing works I use Buscopan which does help to relieve the spasms . Have tried every Laxative know to man increases the pain and causes awful D . Have done the diet etc etc nothing is a fix .
1. Njf0618 Member
 I finally bought finger cots so I don’t have a mess when I have to manually help myself. Yes, it seems gross but it helps get pas the jam up and gets me going quicker and with less pain and strain and ending up with hemorrhoids instead
abbie Member
I have IBS-M and I'm in the middle of a flare up now. I'm on day four. So frustrating. I usually try to limit what I eat during a flare. I was constipated all last week and sure enough on Monday morning when I finally started to go the diarrhea hit. The problem is, when I don't eat then I go back into the constipation. I've been limiting my eating but every morning I wake up with cramping. Why is it that it hits in the morning so much? People don't understand when you need to be someplace. I'm dealing with other medical issues and I am just exhausted. I don't have a suggestion but if anyone else out there does I'd be happy to listen
1. lisaw Member
 Same. I don’t schedule any appoints in the morning and I go to work very early but I work 12 min from home 
2. Karina Moderator & Contributor
 <inline-mention username="abbie" user-id="2323323"/> So sorry to hear that you're in a flare now, I hope you'll start feeling better very soon. We have several articles about IBS in the morning, I'm going to link a couple of them here: <a href='https://irritablebowelsyndrome.net/living/hate-mornings' target='_blank'>https://irritablebowelsyndrome.net/living/hate-mornings</a>, <a href='https://irritablebowelsyndrome.net/video/ibs-worse-morning' target='_blank'>https://irritablebowelsyndrome.net/video/ibs-worse-morning</a>, <a href='https://irritablebowelsyndrome.net/living/morning-routines' target='_blank'>https://irritablebowelsyndrome.net/living/morning-routines</a>. The only solution I have found is to get up earlier in the morning so I could deal with my morning flare at home. Wishing you quick relief, Karina (team member)
stuckey17 Member
I went into the hospital for something else and thought I was having diarrhea. But after I went for a CT scan. I was told "I was full of it" I had constipation with Diarrhea around the outside of the colon. so i was referred to a gastro doctor. Before i even knew I had IBS I was told the tail end of my colon has lost its tone. I found it helpful to pray on the way to the bathroom. I was taking along a bottle of water in case I couldn't quite get it out. After several months I switched to IBS- c.
1. stuckey17 Member
 I am doing good now on Linzess. Though I hear it does not work for some
2. Karina Moderator & Contributor
 <inline-mention username="stuckey17" user-id="4361959"/> Glad to hear that it works for you! 😀 Wishing you a symptom-free day, Karina (team member)
CommunityMember386 Member
I have had IBSM since I was 35. I am 73 now, so definitely a veteran of this very unwelcome malady. I completely understand everything in this article as I have felt it all myself. In 2017, I developed my worst symptoms yet: diarrhea so bad that I could not walk across the room to make it to my bathroom. After having a biopsy during a colonoscopy, my gastro doc confirmed his diagnosis that I had microscopic colitis. MC is a type of Inflammatory Bowel Disease that there is no cure from. This diagnosis sent me on a new journey to understand again what was happening to my digestive system. With microscopic colitis, I took Budesonide which is a corticosteroid three times a day for years, and Atropine and Bentyl for cramping. Seldom did I get into remission, which is usually short-lived, then back to the meds. I can actually go from IBS to MC over a month or two. Last Fall of 2022, I found a wonderful Hypnosis practitioner in my hometown with whom I took a stress management hypnosis course. I 100% know that my digestive problems are made worse by stress. After the hypnosis, I was unsure if the MC was better but almost a year later, I notice that the MC is better but I now am back to dealing with IBSM on a daily basis. To say it all has affected my life is a huge understatement. I usually will not plan anything in the mornings; I have to see what kind of day I will have. I lose sleep often due to the terrible cramping. I have never been able to see a pattern in what I can and can't eat. I also lose time when I am feeling too bad to do things I want or need to do. I am grateful that my health otherwise is good. We need to push more research on IBS and MC. We patients feel like we are walking in the wilderness trying to get better. 
1. Karina Moderator & Contributor
 <inline-mention username="CommunityMember386" user-id="4729008"/> I'm so sorry that you are dealing with MC and IBS-M, that sounds so tough. I hope that one day there will be better treatments for these illnesses. Do you have a supportive people in your life who help you get through all of that? Seeing hugs, Karina (team member)
lucy33 Member
I also have IBS-M. Since my IBS-C symptoms are much worse than my IBS-D symptoms, I stick to a high fiber, low fat diet no matter what. I take probiotics and avoid my trigger foods: anything fatty or fried and raw vegetables are the worst for me. I don't eat large portions. I exercise a lot! Unfortunately, stress is probably the greatest trigger and in the modern world, stress is practically unavoidable. I have been swinging back and forth between the two extremes for weeks now; fortunately, the constipation hasn't been the very worst I have had. I generally need to leave early, which is frequently when the worst bouts of diarrhea hit. Of course, they can also hit in the afternoon or evening. What I hate the most is when I then switch right back to IBS-C on the same day! I suppose I should consider myself fortunate that my IBS-D symptoms are not so bad that I've ever been house bound, although I have been late for appointments on occasion. It is so tiresome!
1. Karina Moderator & Contributor
 <inline-mention username="lucy33" user-id="2315452"/> I really hope that your IBS-M flares will ease soon and you'll start feeling better again. It really is very tiresome and frustrating. Sending big hugs, Karina (team member)
hateibs Member
 Amy I feel for you as this is so difficult to navigate isn't it? I have IBS-D mainly, but most of the time recently it only results in too-soft stool, some air-like gas in the mornings, and some lower tummy discomfort, not literally diarrhea, for no apparent reason, and not TOO frequently a full blown flare-up. Fingers crossed anyway! I have to be careful of my fibre intake though or the precarious balance is tipped too far. But just on the odd occasion I have random constipation. That's quite rare but can happen (again for no discernable reason!) Just. Can't. Go. !! I have learned that the only way for me is to treat it very gently indeed, to avoid a flare up of the dreaded D. I think it must be quite mild as it will only last maximum 24-48 hours. The way I have learned to handle it is not by medication (any laxatives) but just with foods. But I know of course that wouldn't work for everyone with IBS M. I just include a carrot with my dinner, or half a boiled beetroot, or a couple of tablespoons of brown basmati rice, and the problem resolves itself the next morning. There have been times when I knew using a glycerin suppository was a good idea, so I did use one, and find those quite gentle in effect too if needed. Strangely, I feel so much more well in myself, full of energy and happier too (very odd!!) when I swing a bit more towards constipation.
1. Karina Moderator & Contributor
 <inline-mention username="hateibs" user-id="4146293"/> Treating the occasional constipation very gently is a must for me, too, otherwise I also go straight into an IBS-D flare. Most of the time, I just do nothing at all and it goes away but itself. But I also have IBS-D, not IBS-M, so it's very different, like you said. I'm glad you haven't had too many bad flares lately. Karina (team member)
June6 Member
I have IBS-M just as you described and it takes several days to be able to eat- I stick with low FODMAPs. I’m exhausted 😩. I am trying to get off the Imodium and laxatives, trying more natural remedies like kiwi , and trying to walk more 
1. Karina Moderator & Contributor
 <inline-mention username="June6" user-id="2331831"/> That's so tough, I'm so sorry you're dealing with this. 🙁 We recently had an article about prunes and dates as well here: <a href='https://irritablebowelsyndrome.net/living/prunes-dates-constipation' target='_blank'>https://irritablebowelsyndrome.net/living/prunes-dates-constipation</a>, maybe those could help? Wishing you relief, Karina (team member)
babsmurdock Member
I can relate! I am also IBS M and fluctuated from one to the other often until my last colonoscopy. Since then, I've been regular but have lots of pain & cramping and the urgency is still there. I started eating Greek yogurt which has helped and doesn't cause the trigger that regular yogurt does. It also helps with my acid reflux as well. I also take magnesium, probiotics, stool softeners, dicyclomine, and Benefiber. I cut way back on my caffeine, drink lots of water, and drink ginger and peppermint herbal teas. The ginger one has probiotics in it and I drink my peppermint one with Benefiber in it. I haven't found anything that really helps during a flare except for Advil Dual Action and when it is really bad, oxycodone which I have from a kidney stone I had to have removed. I have started menopause and it has made the pain worse!
1. Karina Moderator & Contributor
 <inline-mention username="babsmurdock" user-id="2272085"/> It's good that you've been more regular lately, but I imagine the symptoms you still have are still really tough to deal with. Thanks so much for sharing what has worked for you! I can imagine how menopause would make everything worse, hormones can have that effect: <a href='https://irritablebowelsyndrome.net/triggers/can-hormones-trigger-ibs' target='_blank'>https://irritablebowelsyndrome.net/triggers/can-hormones-trigger-ibs</a>. I hope you'll start feeling better once they stabilize again. Wishing you all the best, Karina (team member)
Njf0618 Member
My transition from the one type to the other isn;t for as long a period of time most of the time and until I started Ozempic for my diabetes I hadn’t really experienced much constipation. All in all my current situation is easier to deal with most of the time as always being diarrhea was so unpredictable. I usually have some periods of regularity followed by the constipation changing to a pretty much full emptying of my bowels - for me meaning within an hour or less multiple trips to the bathroom until I’m flushed out. Awful to deal with when I’m out and about but some Imodium usually slows it if I feel it coming on although I really hate to do that. I prefer to let it run its course and thankfully I don’t have the pain many talk about. Once in a while some bad cramps especially if the constipation has gone on for more than 2-3 days. That seems to be my max until I get even sick to my stomach over it all. The doctor gave me a very mild laxative to try and I need to use it and see if it helps - I’m not where I can look up the name of it but am going to take a week or so when I have no major plans to try it. I’m getting used to this newer IBS-M from being all IBS-D for so many years and am glad I found this group and read most of the articles to see what others are experiencing and share what works. For many/most of my adult life I thought it was just me and suffered with what I thought was no hope of any change. I especially find that I have to not get worried or stressed about it or it gets much worse. Learning how to deal with the IBS-C has been new for me - only a couple years and even if that seems like a long time I’m just figuring out and trying different things to learn what might help. This is not an easy disease to deal with. 
1. Karina Moderator & Contributor
 <inline-mention username="Njf0618" user-id="4832334"/> It's definitely not an easy disease to deal with. We really appreciate having you as part of this community, and I'm glad that it makes you feel less alone. I hope managing your new IBS-C symptoms will get easier with time. My flares are often similar to what you describe, multiple bathroom trips one after the other until my bowels feel empty again. The only upside to this is that it usually doesn't last very long, unless it's a very bad flare. Sending hugs, Karina (team member)
Swimfan Member
 Hey there 😀 I most likely have developed IBS-M after dealing with IBS-D for years. At first I thought that I might have developed SIBO or something because the switch to a constipation-based problem felt so alien to me ... if it wasn't for the sudden dirrhea as soon as I eat anything my stomach doesn't agree with (which is almost anything these days). It's really frustrating and it takes up all my goodwill towards my body not to talk myself into a real dark place/self-hate once this shift happens. 
1. Swimfan Member
 Hey Chris, thanks a lot for taking the time and posting those but I already tried that and it didn't really help me. At this point my doctors are basically out of ideas/my diet has manoeuvered me into a corner and my symptoms are piling up. I recently developed inflammation in my prostate as well so now I have pain in my stomach/intestines AND in the urinal tract region. Nothing that people on those help-hotlines can tell me could/would change anything. I have tried to meditate/stay positive and it helped for a while but not nearly long enough. I'm at my wits end for nearly 1 month now because I'm actually out of things to try. I also know that it all could be worse and some people handle worse but I'm just not that kind of person. I can't live with the constant pain/dirrhea-constipation mix/skin&joint problems for much longer. 
2. Karina Moderator & Contributor
 <inline-mention username="Swimfan" user-id="6641984"/> I hear you, this is so hard. Could it possibly be that your issues come from emotional stress rather than from a physical cause? I had the same experience with treatments, nothing I ever tried helped at all and it seemed to only be getting worse and my diet more restricted. This lasted for 2 years and I remember thinking that I didn't want to live the rest of my life like that, it just wasn't worth it. In the end, just taking a break from everything (work, my busy life, anything that caused stress) helped me get a lot better. I know now that my symptoms are almost 100% caused by anxiety and past traumatic experiences though. I've found approaches like EFT or hypnotherapy to be helpful with that. Especially with EFT tapping, it starts by acknowledging what you're going through and then reframing that, which works really well for me personally. It helped me realize that my body actually wanted to heal and that I wasn't doomed to live like that forever. Simply "staying positive" never worked for me either because it just caused me to try to suppress those issues even further, not actually deal with them. You might have read <inline-mention username="explodingguts" user-id="2321200"/>' comments who has had a similar experience (no treatment helped for very long, but dealing with trauma did) but with a different approach. I know that this sounds a bit wishy-washy, which is why it took me years to even consider this... I'm just trying to say that sometimes, some of us might not need yet another pill, probiotic, diet change or doctor's appointment because it causes even more stress, but addressing the nervous system can help a lot. https://www.everydayhealth.com/wellness/united-states-of-stress/link-between-stress-inflammation/ If you're interested at all, I'd be happy to link the exact resources I found helpful (they're all free). Karina (team member)
explodingguts Member
This last one put the icing on the cake for me. I'm now 8 days w/o explosion or Immodium or any of it. Holosync Centerpointe, Sedona, Learning Strategies recordings have all helped me realize how terribly stressed we all are - how out of touch with our own inner natural peace and joy. I thought I was so chill. Ha. Thought the only thing causing stress was my mysteriously broken body exploding in diarrhea for no apparent reason. Over a few mths of daily recordings I began to feel old, painful memories clenched deep in my guts begin to unlock and move as I examined them and let them go. I am so much lighter and happier. While they don't improve the sensibility of the reptile curmugeon I married, they do help me create a less penetrable aura of peace and security. He, too, has started listening to help him sleep better and is mellowing. A bit. My son was the genius who found these things. He also found this prayer from Joseph Murphy, who studied scripture and found the most helpful lessons in it. I am praying this one for all of us. Say it with me for yourselves. <img src="/content/images/2023/08/31/94bbae1fa2075c7c139cec226689d824_medium.png" alt="Perfect Image Prayer" class="uploaded-image"/>
Karina Moderator & Contributor
<inline-mention username="explodingguts" user-id="2321200"/> It's so great that your son found these things for you, and thank you for sharing this prayer. I hope the recordings will help your spouse as well. All the best, Karina (team member)
prim808 Member
I could have written this post!
1. prim808 Member
 It never ends, does it. My PCP, called me out for not getting to appointments. I guess she has no idea how IBS-M affects us.
2. Karina Moderator & Contributor
 <inline-mention username="prim808" user-id="8674223"/> I feel you, it's hard to make appointments when you don't know how you'll be feeling that day and if you'll be able to make it. is your PCP helpful with your IBS at all, or do you have another provider who is able to understand what you're going through? Unfortunately, finding a good doctor is really hard. 🙁 This article summarizes is really well, if you're interested in reading it: <a href='https://irritablebowelsyndrome.net/living/good-doctor-please' target='_blank'>https://irritablebowelsyndrome.net/living/good-doctor-please</a>. Karina (team member)