If you have irritable bowel syndrome C, it means that your main IBS symptom is constipation, or difficulty pooing.
Other names for this condition are:
- IBS-C
- C-IBS
- constipation-predominant irritable bowel syndrome
Along with constipation, you might have bloating, stomach pain and other symptoms. Strategies like changing your diet and taking certain medicines, such as laxatives, can help.
In this article, we’ll provide an overview of IBS-C, looking at its symptoms, possible causes and treatment options. We’ll also explore the differences between IBS-C and chronic constipation.
Symptoms
Having IBS-C can mean that it's hard or painful to poo. You might not need to poo very often, and sometimes, you may feel that your bowel isn’t fully empty.
When you’ve had fewer than three poos in a week, it’s likely to be constipation.
You may also experience other common IBS symptoms. These include:
- stomach pains or cramping
- bloating
- diarrhoea
- increased farting
- mucus in your poo
- tiredness
- nausea
- back pain
- changes to your peeing, such as needing to go more often
Although constipation is a key part of IBS-C, you may also have diarrhoea, just far less often than constipation. We’ll look at this further in the diagnosis section below.
IBS-C symptoms can get better and worse over time. You may have spells when your symptoms are mild and others when they flare up.
Symptoms of IBS can also vary a lot from person to person.
Find out more about IBS back pain.
Causes and triggers
Researchers don’t know exactly what causes IBS, but they know it’s a disorder of the gut-brain axis. In other words, the communication between the gut and brain is disrupted.
This means that digestive functions that aren’t typically noticed or felt show up as gut symptoms that bother you.
Possible factors that could play a role in developing IBS include:
- a bacterial infection in your gut
- stressful or traumatic experiences
- mental health conditions, such as depression and anxiety
- sensitivity to certain foods
- a family history of IBS
If you have IBS, certain things may trigger your symptoms or make them worse.
Common IBS triggers include:
- stress
- anxiety
- dairy products
- fatty foods
- spicy foods
- caffeine
- alcohol
But it’s worth noting that IBS triggers vary from person to person: what’s fine for you may cause symptoms for someone else.
Also, your body may respond to a certain trigger one day but not another.
Learn more about IBS flare-ups.
Diagnosis
There aren’t any specific tests for IBS. Instead, doctors make a diagnosis by asking you about your symptoms. They’ll want to know how long you’ve had them, how often they happen and when.
To diagnose a specific type of IBS, doctors assess your poo using the Bristol Stool Form Scale.
The scale runs from 1–7. Type 1 poo comes in separate, hard lumps that are difficult to pass, while type 7 poo is entirely liquid.
If at least a quarter of your poos are types 1 or 2 and fewer than a quarter are types 6 or 7, doctors will classify your IBS as IBS-C.
Meanwhile, some IBS symptoms overlap with those of other gut conditions, such as coeliac disease and inflammatory bowel disease (IBD). So, your doctor may request a blood or poop test to rule out these issues.
In some cases, they may need to look inside your gut using a long, flexible tube with a tiny camera. This procedure is called an endoscopy or colonoscopy, depending on the part of your gut they’re examining.
Treatment
To treat IBS-C and other forms of IBS, doctors make suggestions that are specific to your symptoms and triggers.
They can recommend several things, from medications to lifestyle adjustments.
Medications
Laxatives are a common treatment for IBS-C. These are medicines for constipation that help you poo more easily.
One laxative that doctors may suggest is ispaghula husk (Fybogel or Ispagel). This increases the weight of your poo, which encourages your bowel to move it along.
Doctors may also recommend medication to relieve pain if you have it.
In some cases, they may prescribe antidepressant medication, such as low-dose amitriptyline, if other options aren’t helping.
Finally, if you’re taking medications that might worsen your constipation, the doctor may have you stop taking them.
These medications can include diuretics (which make you wee more) and iron or calcium supplements.
Lifestyle adjustments
The NHS recommends exercise and relaxation to help relieve IBS symptoms.
This physical activity doesn’t have to be intense. Going for a walk, doing housework and gardening could all help.
In general, daily exercise can help you poo more regularly. It helps wake up your gut and keep things moving.
If you’re looking to relax, try yoga or setting aside time to read a book or listen to a favourite podcast.
Your doctor may also suggest therapy to improve your symptoms. Some people with IBS benefit from psychological therapy, such as cognitive behavioural therapy (CBT) or hypnotherapy.
Probiotics
Probiotics are live bacteria that can offer health benefits. Your doctor may suggest trying a probiotic supplement, as there’s some evidence that these can help ease some IBS symptoms.
Specifically, researchers have found that probiotics can help with:
There’s also evidence that taking probiotics can improve the quality of life for people with IBS and improve the overall symptoms.
But no single probiotic product works for everyone with IBS – or for every symptom. If you’re interested in this approach, you may need to try a few options.
Medical guidelines in the United Kingdom recommend trying a probiotic supplement for at least 4–12 weeks (at the manufacturer-recommended dosage) to see if it eases your symptoms.
Learn more about live, friendly bacteria.
IBS-C diet
Adjusting your diet is a key part of managing IBS-C and relieving constipation.
It’s important to make sure you’re eating enough fibre. This non-digestible carbohydrate helps by bulking out your poo and making it softer and easier to pass.
Different fibres have different characteristics – some are soluble and dissolve in water, some are viscous and form a gel, and some are fermentable and feed the gut microbiome.
Also, different microbes have different fibre 'preferences.' So, it’s important to provide them with a range of fibres by eating many different plant foods.
Good sources of fibre include:
- whole grains
- legumes
- nuts
- seeds
- fruits
- vegetables
If you’re increasing the amount of fibre in your diet, be sure to do it gradually. This will give your gut time to adjust and reduce the chances of experiencing mild, transient gut symptoms, like bloating and wind.
Also, make sure you’re drinking plenty of fluids. Your gut needs enough fluids to work well – dehydration can lead to a sluggish gut.
Being well-hydrated not only softens your poo, it helps fibre do its job.
There’s also good evidence that linseeds, kiwis, prunes and prune juice can help with constipation, as they’re all natural laxatives.
When you have IBS, your doctor or dietitian may suggest a low-FODMAP diet. This means cutting back on certain carbs that your body finds tricky to digest.
Foods that you may need to limit or avoid include:
- certain fruits, such as apples, blackberries and plums
- certain vegetables, such as beans, cabbage and onions
- dairy products
- foods containing wheat or rye
- foods containing artificial sweeteners with names ending in ‘-ol’, like sorbitol
However, this diet can make constipation worse for some people. So, it may be better for people with other forms of IBS.
Overall, managing IBS-C requires a personal approach based on your current triggers and symptoms.
Learn more about high-fibre foods for constipation.
IBS-C vs chronic constipation
You may be wondering how IBS-C is different from chronic constipation.
With both conditions, people may poo less often, strain when trying to poo, have very hard or lumpy poo, and feel like their bowel isn’t fully empty.
The main difference is abdominal pain. It’s a key symptom of IBS-C but not of chronic constipation.
If you have a form of IBS, you’ll likely have stomach pain at least once a week on average. This pain will be connected to pooing. It’ll be linked with a change in how often you poo or how your poo looks.
If these symptoms don’t seem right, you may have chronic constipation rather than IBS-C.
Another difference involves diarrhoea. If you have IBS-C, you may experience diarrhoea sometimes. This isn’t a feature of chronic constipation.
Other types of IBS
IBS-C is just one form of IBS. As we mention above, doctors diagnose different forms according to the consistency of your poo on the Bristol Scale.
Let’s look at the four IBS subtypes:
When to contact a doctor
If you think you might have IBS, let your doctor know. They’ll check whether your symptoms could stem from a different condition and give you advice about how to manage what’s going on.
If you develop any of these symptoms, it’s important to see a doctor straight away:
- rapid weight loss for no obvious reason
- bloody poo
- a hard lump near your belly
- pale skin, shortness of breath and heart palpitations
Outlook
For most people with IBS-C, it's a lasting condition. Around half of people still have symptoms 10 years after they first appeared.
Treatments and management strategies can reduce the impact of IBS-C on your day-to-day life. Plenty of techniques and medications can relieve constipation and any other symptoms that come up.
It’s also worth noting that IBS-C doesn’t increase your risk of developing colorectal cancer or IBD.
Summary
Having IBS-C means that difficulty pooing is a key symptom of IBS for you. Other symptoms may include stomach pain, bloating and back pain.
Doctors treat IBS-C with different forms of medication, including laxatives. Dietary changes can also help, though you may need to experiment to find out what works best for your body.
Getting the right advice and making key adjustments to your daily routine can help manage your IBS-C and reduce its effects on your life.
To learn more about IBS and other gut health topics, visit Symprove’s Gut Hub.
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