Can I stop recording on good days?

You must record good days as well to compare what was different regarding sleep, diet, and medication.

Is it IBS even if I only have diarrhea without abdominal pain?

Since the connection between abdominal pain and bowel changes is key, if only diarrhea is present, other causes of diarrhea and functional diarrhea are evaluated together.

Is it the same condition even if constipation and diarrhea alternate?

This can occur in the mixed type. Instead of looking at only one day's bowel movement, record the recurring patterns of abdominal pain, stool shape, and frequency.

Baekrokdam Care Guide

What should I record for a week when alternating between diarrhea and constipation?

Name: What should I record for a week when diarrhea and constipation alternate?
Published: 2026-08-26

Rather than recording only the food you ate, record the time of bowel movements, Bristol Stool Chart, please record the abdominal pain before and after bowel movements and the level of urgency on the same line. You should also record days when you feel well to compare what was different; if you have bloody stools, black stools, dehydration, or a high fever, do not wait until you finish the records.

Click on unfamiliar terms to see their meanings immediately.

Reviewed by Korean Medicine Doctor Yeon-seung Choi · Last updated 2026-08-26

Record both the frequency of bowel movements and the stool shape

Record how many times you had a bowel movement per day along with the Bristol Stool Scale number for each. Recording frequency alone may cause you to miss changes in hardness and looseness.

Observe how abdominal pain changes before and after bowel movements

Record the time and location where the pain started, and whether it decreased or remained after the bowel movement. tenesmusAlso note the level of urgency in needing to find a restroom.

Record the amount and timing of medications and food

laxatives· Mark the date and time you took antidiarrheals or probiotics, and any meals that were larger than usual or skipped. A single overlapping food item is not determined to be the sole cause.

Do not wait if there is bleeding or dehydration

Bright red bloody stools, black stools, or repeated diarrheadiarrhea or vomiting to the point where you cannot even drink water, high fever, and severe abdominal pain mean that a medical evaluation is prioritized over a week of records.

Check once more before your appointment

Preparing this much before your appointment is sufficient

Rather than looking at a single symptom in isolation, observing when it started, what it changed with, and how much it has disrupted your daily life helps in determining the direction of treatment.

Irritable Bowel Syndrome: Details to be confirmed during the medical evaluation

IBSis not caused by your mind, but is a condition where abdominal pain, bowel movements, intestinal sensation, and motility are repeatedly disrupted. Within the diarrhea-predominant, constipation-predominant, and mixed types, Korean herbal medicine is prescribed by differentiating between tension, coldness, damp-heat, dryness, and deficiency of energy.

Stool form over 7 days and abdominal pain·changes before and after bowel movements

Chronic constipation: Details to be confirmed during the medical evaluation

For chronic constipation, we must look at stool hardness, straining, the feeling of blockage, and incomplete evacuation, not just how many days pass between movements. We perform Byeonjeung (pattern identification)to determine if the intestines are dry, if Qi is blocked, if the pushing force is weak, or if the body is cold and motility is slow.

Stool shape, frequency, and straining time for 7 days

Chronic diarrhea, details to be confirmed during medical evaluation

After ruling out infection, inflammation, medication, or intolerance, if diarrhea persists, we prescribe herbal medicine by analyzing the absorption capacity of the spleen and stomach, coldness in the lower abdomen, tension-induced bowel movements, damp-heat, and food reactions.

Time of bowel movement, shape, and whether it occurred at night

Information that is helpful to write down before your visit

Changes in stool form, abdominal pain, and bowel movements over 7 days
Urgency, feeling of incomplete evacuation, and the number of times outings were avoided
Sleep, tension, cold sensation, menstruation, diet, and medications
Stool shape, frequency, and straining time over 7 days.
Feeling of blockage, feeling of incomplete evacuation, abdominal pain, and bloating.
Response to laxatives and probiotics, as well as hydration, cold sensations, and activity levels.

Gastrointestinal Glossary

Terms to know in this text

You can proceed to a detailed explanation after confirming the simple meaning.

Bristol Stool ScaleThe Bristol Stool Chart is a recording method that classifies stool shape into Types 1 through 7, ranging from hard lumps to watery stools.LaxativesLaxatives is a general term for medications that make bowel movements easier by softening the stool or aiding intestinal motility.UrgencyBowel urgency refers to a state where the urge to have a bowel movement comes on suddenly and strongly, making it difficult to hold until reaching a restroom. Separate from the frequency of diarrhea, this can place a significant burden on daily life.TenesmusA feeling of incomplete evacuation is the sensation that stool remains in the rectum or anus after a bowel movement, leaving one feeling unsatisfied. This does not always correlate with the actual amount of stool.Irritable Bowel SyndromeIrritable Bowel Syndrome is a gut-brain interaction disorder characterized by recurrent abdominal pain related to bowel movements, accompanied by changes in stool frequency or form.Pelvic floor outlet obstructionPelvic floor dyssynergia refers to a condition where bowel movements are difficult because the muscles around the rectum and anus do not relax properly or fail to coordinate strength when passing stool. Even if the stool is soft or occurs daily, there may be a severe feeling of blockage or a sensation of incomplete evacuation.Lactose IntoleranceLactose intolerance is a condition where the body cannot sufficiently digest lactose, the sugar found in milk and dairy products, leading to symptoms such as abdominal bloating, gas, abdominal pain, and diarrhea. The degree of discomfort may vary depending on the amount consumed and the individual's digestive capacity.Inflammatory Bowel DiseaseInflammatory Bowel Disease (IBD) is a group of disorders characterized by chronic inflammation of the intestines related to immune responses, with Crohn's disease and ulcerative colitis being representative examples. Symptoms may include abdominal pain, diarrhea, bloody stools, and weight loss; it is a different condition from Irritable Bowel Syndrome (IBS).

Details confirmed in Korean medicine treatment

We review test results and your current discomfort together

IBS is not caused by your mind, but is a condition where abdominal pain, bowel movements, intestinal sensation, and motility repeatedly fluctuate. Depending on whether it is diarrhea-predominant,constipationconstipation-predominant, or mixed-type, Korean herbal medicine is prescribed by differentiating between tension, coldness, damp-heat, dryness, and decreased energy.

Points to be examined during the medical evaluation

Examining the relationship between abdominal pain and bowel movements rather than stool frequency

We check whether there is pain before bowel movements that eases afterward, or if a feeling of incomplete evacuation and urgency remains.

Points to be examined during the medical evaluation

Why we look at both the frequency and quality of bowel movements

Even if you go every day, if you strain for a long time and do not feel relieved, treatment goals remain.

Points to be examined during the medical evaluation

Distinguish between morning, post-meal, and nighttime diarrhea

The approach differs depending on whether the urgency occurs upon waking, immediately after eating, or wakes you from sleep.

Diarrhea alone is not enough to diagnose IBS-D. The core of IBS is the connection between recurring abdominal pain and changes in bowel movements; if abdominal pain is not prominent, other causes such as functional diarrhea, medication, infection, or absorption issues are checked.

How to discuss my symptoms during the medical evaluation

Discomfort that persists after tests and treatment

What should I record for a week when diarrhea and constipation alternate?

Rather than just recording the food eaten, write the time of bowel movement, the Bristol Stool Scale, and the level of abdominal pain and urgency before and after bowel movements on the same line. Recording 'good days' allows for comparison of what was different. If you have bloody stools, black stools, dehydration, or high fever, do not wait until the record is complete.

We establish a recovery sequence by dividing the roles of existing treatments and Korean herbal medicine treatment. If there is a cause that requires priority treatment, that treatment will be continued. For Korean herbal medicine treatment, we determine the primary goal and progress criteria by examining the remaining symptoms, their impact on daily life, and the patterns of sleep, digestion, body heat, and fatigue. The sequence of combining this with existing treatments is adjusted based on actual responses, and lifestyle management is tailored to support the treatment goals.

Frequently Asked Questions

Frequently Asked Questions Before Your Visit

Do I need to take photos every day?

It is not necessary to take photos. It is helpful just to record the Bristol Stool Scale number, frequency, and level of urgency using the same criteria.

Can I stop recording on days when I feel well?

Recording your good days as well allows you to compare what was different regarding sleep, diet, and medication.

Is it IBS if I only have diarrhea without abdominal pain?

Since the connection between abdominal pain and changes in bowel movements is key, if only diarrhea is present, other causes of diarrhea and functional diarrhea are evaluated together.

Is it the same disease if constipation and diarrhea alternate?

This can occur in the mixed type. Rather than looking at a single day's bowel movement, record the recurring patterns of abdominal pain, stool consistency, and frequency.

Guidance related to my symptoms

Condition GuidanceIrritable Bowel SyndromeThe core of Irritable Bowel Syndrome (IBS) symptoms is the simultaneous occurrence of recurrent abdominal pain associated with bowel movements and changes in the frequency or form of stool. There are three types: diarrhea-predominant, characterized by loose stools and a sudden urgent need to defecate; constipation-predominant, characterized by hard stools, straining, and a strong feeling of incomplete evacuation; and mixed-type, where both patterns alternate. Abdominal bloating and white mucus may accompany these, and symptoms may fluctuate after meals, in the morning, during sleep, or due to stress, but diarrhea or gas alone is not diagnosed as IBS. Inflammatory Bowel Disease (IBD) is a different condition where intestinal inflammation and damage are confirmed; therefore, if there is bloody stool, black stool, anemia, unexplained weight loss, fever, or diarrhea that wakes you up at night, it is not treated as IBS. Severe dehydration or persistent vomiting requires prompt gastrointestinal or emergency evaluation first.Condition GuidanceChronic ConstipationChronic constipation is not judged by the number of bowel movements per week alone. We also look for recurring states such as hard, dry, or lumpy stools; bowel movements that require prolonged straining or are painful; a feeling of incomplete evacuation; a sensation of blockage at the anus; and difficulty evacuating without the help of fingers or perineal pressure. If you feel a blockage at the exit despite loose stools and repeatedly require manual manipulation, we also check for issues in the evacuation process, such as pelvic floor outlet obstruction. Even if you go to the bathroom every day, an evaluation is necessary if these symptoms cause you to sit for a long time and disrupt your work, outings, or sleep. If you experience sudden severe abdominal pain, abdominal bloating, vomiting, a total absence of stool or gas, bloody stools, rectal bleeding, fever, or unintended weight loss, do not take more laxatives and seek prompt medical evaluation.Condition GuidanceChronic DiarrheaIf loose stools continue for more than 4 weeks or fluctuate between improving and worsening, it is time to analyze the cause rather than simply reducing the frequency with antidiarrheals. Organizing the start date, whether you wake up at night, food and medications taken, weight changes, and stool shape helps determine whether to first check for food intolerance, medication side effects, infection, inflammatory diseases, or functional diarrhea.Condition GuidanceAbdominal PainFor abdominal pain, we first rule out suddenly worsening pain and acute dangerous symptoms such as bleeding, fainting, or persistent vomiting. If these causes are absent and tests show no major abnormalities, but the same pain repeats over a long period depending on meals, bowel movements, sleep, or stress, it is time to examine not only the location of the pain but also bowel motility, sensory hypersensitivity, and overall body temperature and energy levels.Digestive Health ColumnWhen diarrhea and constipation alternate, how can the rhythm of the bowel be restored?If you hold in hard stools for several days and then suddenly have loose stools, or have diarrhea in the morning and a feeling of incomplete evacuation in the afternoon, you should view this as a single cycle rather than treating diarrhea and constipation separately.Digestive Health ColumnDiarrhea-predominant, constipation-predominant, and mixed-type Irritable Bowel Syndrome: What are the differences?While Irritable Bowel Syndrome (IBS) commonly involves recurring abdominal pain and changes in bowel movements, the treatment differs for those with urgent diarrhea, those blocked by constipation, or those who alternate between both states.

Evidence and Update Information

The following materials were referenced for definitions, criteria for distinguishing similar symptoms, and safety standards. These are applied together with medical interviews and pattern identification (Byeonjeung) to determine the direction of Korean herbal medicine and acupuncture treatments and the sequence for integrating them with existing treatments.

NIDDK: Irritable Bowel Syndrome
NIDDK: Symptoms & Causes of Crohn’s Disease
NIDDK: IBS symptoms and causesRecurring abdominal pain associated with bowel movements, changes in bowel habits (diarrhea, constipation, or mixed), bloating, and a feeling of incomplete evacuation