IBS Constipation

By Dr. Vik, MBBS, MRCP(GB), PhD

IBS constipation, also known as constipation-predominant IBS, is irritable bowel syndrome with constipation symptoms. Typically, the symptom of IBS is either diarrhea or constipation.

Irritable bowel syndrome has been described as an alteration of normal bowel function. It is a clinical condition that affects millions of individuals across the globe.

IBS patients generally have infrequent bowel movements, difficulty passing stools and a feeling of incomplete emptying of the bowels.

In this article, we will take a look at constipation and IBS (irritable bowel information) and how it can be successfully managed.

Do I Have IBS Constipation

In the medical world, constipation is defined by the following:

Having less than three bowel movements per week
Passing hard lumpy stools
A difficulty in passing stools

Patients with IBS constipation tend to pass hard stools at least 25% of the times they have a bowel movement.

They also tend to pass loose or watery stools less than 25% of the time (this differentiates these patients from those with IBS diarrhea).

Some patients with hard to pass, infrequent stools may actually just be constipated, and not have IBS constipation.

Two distinguishing marks of IBS

• Abdominal pain is more often a sign of IBS

• Having periods of diarrhea in between periods of constipation is a sign of IBS

Clinical symptoms

The classic symptom is a reduction in the frequency of bowel movements.

IBS patients tend to develop abdominal pain that can be rather severe in some cases. Constipation presents itself as a hardening of stool, making stool difficult to pass.

The Cause

No clear cause has been identified. The following five causes have been proposed.

Theory 1

A change in the sensitivity of the gut is responsible for IBS.

Theory 2

The rate at which digested food moves through the bowels is responsible for IBS symptoms. Those with diminished transit times tend to become constipated.

This is because, as stool stays longer in the colon, the more water is absorbed out of it. Stool that stays longer in the colon generally becomes dry and hard.

The proposed reason for this slow transit time is that the signals sent from the bowel to the brain are either limited or insufficiently strong to promote normal bowel motions.

Theory 3

It is caused by the consumption of high amounts of junk food and fried foods.

Theory 4

Dietary factors such as the lack of sufficient fiber can also precipitate constipation in patients who already have IBS.

Theory 5

Certain psychological and stress factors have been implicated in the development of IBS constipation.

In particular, patients who tend to be emotionally high strung and anxious can have numerous changes in body chemicals that can alter their bowel habits.

It is somewhat common for people under a lot of stress who have not had not previously been diagnosed with IBS to suddenly develop symptoms suggestive of IBS constipation.

Diagnosis

The diagnosis of IBS constipation is often made through clinical history alone.

Additional tests are rarely required and patients can begin treatment immediately.

Treatment

There are a number of treatment approaches.

Prior to commencing any form of treatment, you should visit your doctor and confirm the diagnosis. Once confirmed, you can start treatment.

Fiber

In the early stages of diagnosis, it is essential for patients to empty their bowels in order to resolve their symptoms. Switching to a high fiber diet is sufficient in most cases.

Hi fiber foods include:

Whole grain cereal and bread
Fresh fruits and vegetables
Nuts and seeds
Most types of beans

Another way to get more fiber is by taking a fiber supplement. There are numerous over the counter fiber products, or you may prefer eating bran flakes or All Bran to get that extra fiber.

The amount of fiber should be increased gradually. Too much fiber all at once may result in diarrhea, gas, and cramping.

A magnesium supplement

IBS sufferers have found that taking 300 to 400 mg. of magnesium each day can clean out the colon and relieve constipation.

In fact, magnesium is used to clear out stool prior to any form of bowel surgery.

There is some evidence to suggest that constipation in IBS is related to low magnesium levels, though this needs further research.
A magnesium supplement has proven to be an effective treatment for managing constipation linked with IBS.
Many doctors choose magnesium as the primary treatment.

Exercise

Another form of therapy for IBS constipation is regular exercise.

Exercise has been shown to stimulate normal bowel movement.
It may help to prevent constipation even in patients suffering from IBS.

Exercise can include something as simple as regular walks, or something more aerobic and higher in intensity, such as running, cycling and swimming.

Combining exercise with a high fiber diet and a daily magnesium supplement is a great combination for managing constipation with IBS.

Medication

Patients who have abdominal pain from constipation may require medication such as antispasmodic agents.

These agents prevent the contraction of the walls of the bowel and can reduce the colicky abdominal pain that patients experience.