When Irritable Bowel Syndrome and Constipation Interact

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Coping With IBS and Constipation

Let’s face it — any type of condition of the gastrointestinal (GI) tract is uncomfortable. We’ve all experienced an occasional bout of diarrhea or constipation, but what if this was our daily lives?

In a 2005 research study, it is estimated that 14.1 percent of the US population suffers from some form of irritable bowel syndrome (IBS), with only 3.3 percent having a medical diagnosis. Comparable is an 11.5 percent prevalence rate in Europe.

That’s a whole lot of people with upset stomachs.

What Is IBS?

IBS is characterized by frequent diarrhea, abdominal pain, constipation, flatulence and bloating. It often has flare-ups, meaning that the symptoms come and go.

IBS-C is constipation — these people have constipation that is related to their IBS.

IBS-D is diarrhea — these people have diarrhea that is related to their IBS.

What Causes IBS?

There is not a clear-cut cause of IBS, but there are several theories. Some of the more popular theories:

  • The majority of IBS sufferers are women — it stands to reason, then, that hormonal changes may trigger IBS.
  • The neurotransmitter serotonin, which is produced in the gut, may act on the digestive tract nerves. Increased serotonin may cause diarrhea, while decreased serotonin may cause constipation.
  • An immune system response to stress and infection may cause IBS.
  • For people with IBS, contractions in the gut may be felt more acutely than for non-IBS sufferers.
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Diagnosis of IBS With Constipation

To obtain a diagnosis of IBS, multiple different items must be checked in order to arrive at the diagnosis:

  • Symptoms must be ongoing for a period of six months or more.
  • Symptoms must occur at least three times per month in the last three months.
  • Pain and discomfort must be experienced, and the pain must have two out of the three following characteristics:
  1. Relieved with defecation
  2. Change in frequency of stool
  3. Change in appearance of stool

Once a diagnosis of IBS (either IBS-C or IBS-D) is made, a treatment plan can be made.

Treatment of IBS and Constipation

There is, unfortunately, no cure for IBS. Treatment is aimed at reducing symptoms.

If symptoms are mild to moderate, the treatment plan revolves around decreasing stress and other lifestyle modifications. If symptoms are more severe, medications may be indicated.

Both types of IBS can benefit from dietary changes such as reducing the amount of gaseous foods (broccoli, cabbage, raw fruits, carbonated beverages), eliminating gluten, and following a low-FODMAP diet.

FODMAPs are fermentable oligo-, di-, and monosaccharides and polyols — a complicated term for a type of carbohydrate that may be difficult for some people to digest. Eliminating these carbohydrates, found in foods such as grains, dairy products and fruits, can reduce symptoms.

Over-the-counter medications can easily be added, such as fiber supplements. Fiber supplements are known to reduce constipation. In addition, laxatives may be prescribed if fiber supplements do not work for constipation.

Anti-diarrheals can also be purchased over the counter. There are also bile acid binders that are prescription medications — these can reduce diarrhea. However, they are actually known to cause diarrhea.

Anticholinergic and antispasmodic medications can be prescribed, which reduce bowel spasms. They should be used with caution — they are effective, but have unpleasant side effects, such as difficulty urinating.

There are also several medications that are specific to IBS. However, they are both indicated only in women and they have a large list of side effects, so they are only prescribed when other treatment options have failed.

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