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Relieving Chronic Constipation

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IBS-C: What to Know about IBS with Constipation

Medically Reviewed By Youssef (Joe) Soliman, MD

Irritable bowel syndrome with constipation (IBS-C) refers to IBS that occurs with hard or difficult-to-pass stools. Doctors may recommend dietary changes, medications, and more to relieve the symptoms. People assigned female at birth are more likely to experience IBS symptoms. Some people with IBS experience constipation, others experience diarrhea (IBS-D), and some people experience a mixture of both (IBS-M).

Read on to learn more about IBS-C and its causes, symptoms, diagnosis, and treatments.

What causes IBS-C?

A woman holding her hands to her stomach
Luciano Spinelli/Stocksy United

The exact cause of IBS-C and the other forms of IBS is unknown. Experts believe that specific factors or a combination of factors may contribute.

Your brain and gut are connected physically and chemically. The disruption of this connection can affect how your body functions and may cause IBS symptoms. For example, an altered brain-gut connection may cause food to travel slower or faster than usual through the gastrointestinal tract.

Other factors that may influence the development of IBS include:

  • bacterial infections
  • a disruption of the bacteria in your small intestine
  • stress
  • anxiety or depression
  • food sensitivities or intolerances
  • a family history of IBS

What are the symptoms of IBS-C?

IBS is the presence of digestive or abdominal symptoms for 3 months or more Trusted Source Office on Women's Health Governmental authority Go to source . IBS-C occurs when more than 25% of your stools are lumpy or hard.

While IBS-C symptoms may vary from person to person, you may experience:

  • cramps or pain in the stomach area
  • infrequent stools that may be hard, dry, or lumpy
  • mucus in the stool
  • a feeling that you haven’t finished a bowel movement 
  • abdominal swelling or bloating
  • gas
  • discomfort or feeling unusually full or nauseous after eating a typical meal

How do doctors diagnose IBS-C?

Your doctor will assess your symptoms and medical history and perform a physical exam. There is no specific test for IBS, but your doctor may run a series of tests to identify or exclude other underlying conditions. These tests may include:

  • Blood: These tests can identify infections, anemia, and other digestive conditions.
  • Stool: Stool tests can detect occult blood, or blood that isn’t visible to the naked eye, which can indicate another underlying condition. They may also help doctors identify signs of infection.
  • Hydrogen breath: These tests, which measure the levels of hydrogen in your breath, can detect conditions like lactose intolerance or bacterial overgrowth.
  • Invasive imaging: Doctors can also perform procedures such as endoscopy and colonoscopy to check for signs of other conditions like celiac disease or inflammatory bowel disease.

If these tests don’t indicate another condition, you may receive an IBS diagnosis based solely on your symptoms.

What are the treatments for IBS-C?

Treatment for IBS-C can involve a combination of lifestyle and dietary changes and medical therapies.

Dietary changes

Your doctor may recommend adding more fiber to your diet through food or supplements to relieve constipation. Probiotics, or live bacteria similar to the ones in your digestive tract, may also help reduce symptoms.

Your care team may also suggest a low FODMAP diet. Some foods contain fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP). Because the body may have difficulty digesting these substances, FODMAP involves removing foods high in FODMAPs, such as:

  • vegetables like cauliflower, mushrooms, and garlic
  • legumes
  • fruits like apples, watermelon, and blackberries
  • some grains, like wheat and rye
  • dairy products like milk, yogurt, and soft cheese

Research from 2021 Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source concluded that, while more research into its long-term effects is necessary, the low FODMAP diet may reduce IBS symptoms.

Learn more about the benefits of the low FODMAP diet.

Lifestyle changes

Getting more exercise may help Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source food move more efficiently through the digestive tract. This, in turn, may reduce IBS symptoms.

Medications

For some people, laxatives may relieve constipation. Your doctor may also prescribe:

  • linaclotide (Linzess)
  • lubiprostone (Amitiza)
  • plecanatide (Trulance)

For people with chronic or severe abdominal pain, some antidepressants or antispasmodics may be beneficial.

Other therapies

Mental health therapies may provide symptom relief, such as:

  • gut-directed hypnotherapy
  • cognitive behavioral therapy
  • relaxation training

Learn more about IBS treatment options.

What is the outlook for people with IBS-C?

IBS-C can be uncomfortable. However, treatment can provide relief and improve your quality of life. Your doctor can help you develop a treatment plan for you.

Read 10 tips for living with IBS.

Other frequently asked questions

Youssef (Joe) Soliman, M.D., reviewed the answers to these common questions about IBS-C.

What causes IBS-C to flare up?

IBS-C may be triggered by many factors, such as stress or bacterial infections. Genetics or food intolerances may also play a role.

Are probiotics good for IBS-C?

Probiotics may help relieve IBS-C symptoms, although more research is needed to fully understand their benefits.

What can be mistaken for IBS-C?

Various other conditions can have symptoms similar to IBS-C, such as diverticular disease or bowel obstruction. Doctors can use several tests to rule out these conditions.

Summary

IBS-C is a form of IBS characterized by frequent constipation. People with IBS-C may also experience abdominal pain, bloating, or gas.

There is no specific test for IBS-C. However, doctors may perform blood, stool, or imaging tests to rule out other conditions. If these tests don’t indicate another condition, your doctor may confirm an IBS-C diagnosis based on your symptoms.

Dietary and lifestyle changes, medications, and mental health therapies may help relieve the symptoms of IBS-C. Talk with your doctor about ways to manage your condition.

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  1. Definition & facts for irritable bowel syndrome. (2017). https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/definition-facts
  2. Irritable bowel syndrome. (2018). https://medlineplus.gov/irritablebowelsyndrome.html
  3. Irritable bowel syndrome. (2021). https://www.womenshealth.gov/a-z-topics/irritable-bowel-syndrome
  4. Patel, N., et al. (2022). Irritable bowel syndrome. https://www.ncbi.nlm.nih.gov/books/NBK534810/
  5. Symptoms & causes of irritable bowel syndrome. (2017). https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/symptoms-causes
  6. Treatment for irritable bowel syndrome. (2017). https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/treatment
  7. van Lanen, A.-S., et al. (2021). Efficacy of a low-FODMAP diet in adult irritable bowel syndrome: a systematic review and meta-analysis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354978/

Medical Reviewer: Youssef (Joe) Soliman, MD
Last Review Date: 2023 Mar 10
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