Symptoms, Causes, Diagnosis, Treatment, and More

Irritable bowel syndrome with constipation (IBS-C) is a type of IBS, a condition that causes different digestive symptoms.

The main symptom of IBS-C is constipation, with infrequent, hardened bowel movements that are difficult to pass. You also have other telltale IBS symptoms like stomach pain and bloating.

IBS-C makes up about a third of all IBS cases. While it can cause chronic (long-term) discomfort, getting a diagnosis and implementing a recommended treatment plan can help make IBS-C manageable.

IBS-C symptoms include frequent constipation along with other digestive symptoms of IBS.

With this condition, bowel movements are infrequent and difficult to pass—with more than a quarter of your stools being hard or dry, and less than a quarter being watery or loose.

While IBS-C symptoms can vary slightly by person and range in severity, additional common signs include:

• Stomach pain or cramps
• Gas and bloating
• Straining while trying to have a bowel movement
• Feeling like you haven’t fully emptied your bowels after a bowel movement

Experts aren’t exactly sure what causes IBS-C, but they suspect factors such as gut dysbiosis and diet may contribute.

Gut dysbiosis: This is an imbalance in the gut’s bacterial environment. It may cause food to move more slowly through your digestive tract. This allows your large intestine to absorb more water from your stool, which may harden it and make it more difficult to pass.

Diet: What you eat is another likely factor. Research suggests that a low-fiber diet and other food sensitivities tend to trigger constipation in IBS-C.

Risk Factors

Some factors may make developing this digestive disorder more likely. For example, research suggests that IBS-C is more common among people assigned female at birth. Age may also be a factor. While it’s possible to experience IBS-C at any age, it’s more prevalent in younger adults.

Your healthcare provider may be able to diagnose IBS-C based on a physical exam and a review of your symptoms. In some cases, other testing may be helpful.

History and Physical Exam

A healthcare provider will typically start by reviewing your medical history and current symptoms. They may also perform an abdominal physical exam.

As you describe your symptoms, your provider may evaluate you based on a set of standards known as the Rome IV criteria. These standards can help with any type of IBS diagnosis.

According to these criteria, you’re likely to have IBS if you’ve experienced stomach pain at least once a week over the past three months, along with at least two of the following:

• Stomach pain related to a bowel movement
• Changes in how often you have bowel movements
• Changes in how your stools look

Other Testing

Your healthcare provider may also order tests to help rule out or diagnose other health conditions. These may include:

• Blood tests: A blood sample can help detect signs of other digestive disorders, such as celiac disease, ulcerative colitis, and Crohn’s disease.
• Stool tests: A stool sample allows a healthcare provider to check for infection or bloody stool.
• Upper gastrointestinal endoscopy: Checking the inside of your digestive tract can help screen for celiac disease or collect a tissue sample for biopsy.
• Colonoscopy: This test can help check for colon cancer or inflammatory bowel disease (IBD). It may be an option if you have abnormal blood test results, your symptoms started after age 50, or you have unexpected weight loss and bloody stools.

You may experience temporary relief of IBS-C symptoms after going to the bathroom, but long-term symptom management likely requires a treatment plan. There’s no cure for IBS-C, so the goal of treatment focuses on relieving symptoms.

Your healthcare provider will likely recommend a personalized approach based on your specific symptoms. They may suggest incorporating dietary and lifestyle changes before moving on to medication recommendations.

Dietary Changes

There is no specific IBS diet overall, but making certain dietary changes may help manage your IBS-C symptoms.

Your healthcare provider may recommend increasing your fiber intake to help relieve constipation. Foods with soluble fiber, such as oats, oranges, carrots, and greens, may be good choices. Fiber supplements may also help.

Healthcare providers may also recommend a low-FODMAP diet. This diet eliminates certain carbohydrates, like wheat, onion, and high-fructose corn syrup. It may be helpful for the short-term management of IBS-C.

Lifestyle Changes

Other lifestyle changes may also help you manage IBS-C. Some strategies include:

• Increase your physical activity levels to keep your bowels moving, which makes it easier to pass stool
• Get plenty of sleep to minimize IBS-related pain
• Manage stress levels to help improve constipation

Medications

Healthcare providers may suggest different types of medications for managing IBS-C symptoms. These include:

• Medications such as Linzess (linaclotide) that help speed up the movement of food through your digestive system
• Prescription or over-the-counter (OTC) laxatives, such as Amitiza (lubiprostone), to make your stool easier to pass
• Tricyclic antidepressants to help ease pain

IBS-C is associated with some other conditions. These include:

• Anxiety and depression: Research has found that a majority of people with IBS may also have mental health conditions. Anxiety and depression can worsen your experience of IBS-C symptoms, too.
• Dyspepsia (indigestion): About a third of people with IBS also have indigestion. When it comes to IBS-C, research suggests you may be more likely to experience more severe symptoms of both conditions, particularly constipation and a feeling of stomach fullness.

IBS-C is a chronic condition. While it may interfere with your work and personal life, IBS-C is not associated with permanent harm to the digestive tract or other serious health conditions like cancer.

With the right combination of self-care and treatment tactics, symptoms of IBC-C can be managed. Being open with your healthcare provider about your symptoms is important for your quality of life. It can help uncover the best treatment options for you.