If you have irritable bowel syndrome, you know pain. Add some constipation to the mix, and you have all the makings of something totally uncomfortable.
The other symptoms of IBS -- changing bowel habits, bloating, cramping, constipation and diarrhea -- come and go. Many happen at the same time. IBS is a persistent, chronic, often confusing disorder.
Still, you can manage it all, including the constipation.
First, whether it’s a family doctor, an internist or a specialist, find someone who:
- Knows your medical history
- Understands what you’re going through
- Can team with you to ease your discomfort
The causes of IBS are unclear. It may come from how the gut, brain, and nervous system interact. Genetics may play a part. What you eat could matter, too. It could be a combination of those and other things.
To figure out if you have IBS or IBS-C (IBS with constipation), your doctor probably will do a complete medical history and a physical exam. That usually includes:
- A talk about your symptoms
- Questions about your family’s health history
- An inquiry of any stress-related problems that you have
- A complete list of any drugs you’re taking
- An exam where the doctor listens to your belly and checks for signs of tenderness or pain
You usually won't need tests, but your doctor may call for some or ask for stool samples. He'd do this to check for other problems not related to IBS.
IBS-C is tricky to discover because its symptoms overlap with chronic constipation. Still, folks with what doctors call “functional” constipation may not have the pain, the periods of regularity, or diarrhea you'd have with IBS-C.
After you’re diagnosed with IBS, in any of its forms -- IBS-C, IBS-D (with diarrhea), IBS-M (mixed, both diarrhea and constipation), or IBS-U (unsubtyped) -- the next step is treatment.
Your doctor can help you manage your symptoms in three main ways:
Diet and Nutrition
Foods don’t cause IBS, but some can trigger symptoms. It’s a good idea to keep a diary -- especially if you’ve just been diagnosed -- to keep track of what you eat and what symptoms follow. It may help you get a feel for what foods to stay away from.
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Other things that may help some people with IBS:
- Eat more modest portions or smaller meals more often.
- Fiber could help your constipation, though it probably won’t help with other IBS-related pain. Some experts question its use on folks with IBS, so add it in slowly. Also, know that too much at once can cause belly pain.
- Avoid dairy, high-fat foods, and beans.
- Cut down on alcohol and caffeine.
Your doctor may suggest something called a FODMAP diet. Basically, you cut down on carbohydrates that are hard for your body to digest.
The foods you'd scale back on or avoid can include:
- Apples
- Pears
- Milk
- Rye and wheat breads
- Asparagus
- Artichokes
- Onions
- Garlic
Medications
Because the symptoms of IBS-C can vary from person to person and can swing wildly from day to day -- even hour to hour -- no one medicine works for everyone all the time. Your doctor may choose from these or other medicines to ease your symptoms:
- Cimetropium or hyoscine for colon muscle spasms
- Laxatives for constipation
- Loperamide (the active ingredient in things like Imodium) for diarrhea
- Some antidepressants for constipation or diarrhea
- Linaclotide (Linzess) or lubiprostone (Amitiza) for abdominal pain with IBS-C
Another potential help for IBS symptoms that's not a medicine or a food is probiotics. These are tiny organisms, most often bacteria, found in things like yogurt and dietary supplements. Studies about them are ongoing.
Talk with your doctor before taking any medications or supplements.
Stress Management
It’s not clear what the relationship is between the pressures of life and IBS symptoms. Still, learning to manage your stress can help your symptoms. Whether it’s through exercise, yoga, meditation or just being around loved ones, experts say you can calm your body if you can take a load off your mind.
You might try:
- Relaxation exercises, such as rhythmic breathing
- Positive thinking and visualizing
- Hypnosis
- Behavioral therapy
- An IBS support group, either in person or online
Talk to your doctor to find out what may work best for you.