What Is IBS C? Symptoms, Causes And Treatments.
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What Is IBS-C?
Irritable Bowel Syndrome is the name for a group of gastrointestinal disorders that are characterized by a wide range of abdominal symptoms, including bloating, gas, stomach pain and irregular bowel movements. For many people with IBS, one of their principal issues is with constipation, and in those cases, what they have is commonly classified as IBS-C. The “C” stands for – you guessed it – “Constipation.”
It’s important to note, however, that not everybody who experiences constipation as part of their condition necessarily has IBS-C. Some patients with constipation can also have episodes of diarrhea, in which case they may be diagnosed with what’s called Mixed IBS, or IBS-M. And there are some forms of IBS that are difficult to classify at all because the patient’s stool consistency doesn’t fully meet the criteria for any of these diagnoses. In these cases, the condition is referred to as IBS-U, with the “U” standing for “Unclassified.”
Symptoms Of IBS-C
Common symptoms of IBS include:
- Abdominal pain or cramping (which often goes away once you have a bowel movement)
- Excess gas and bloating
- Constipation (though you may sometimes also have loose, watery stool, too)
- Changes in stool consistency or frequency
- Mucus in the stool
- Loss of appetite
- Fatigue
THE DIFFERENCE BETWEEN IBS-C AND CHRONIC CONSTIPATION
One condition that’s easy to confuse with IBS-C is chronic constipation, because in many ways, one can resemble the other. Ordinary constipation is generally characterized as having two or fewer bowel movements in a week, and if that goes on for 3 months or longer, it’s usually considered chronic.
That’s a problem in its own right, but it’s not necessarily a sign of IBS-C. The main difference is that IBS-C is usually accompanied by other symptoms such as abdominal pain, nausea, and occasional bouts of diarrhea, while chronic constipation is not.
Chronic constipation is frequently caused by a lack of fiber in the diet, the failure to drink a sufficient amount of liquid, certain medications, and physical conditions such as diabetes, thyroid issues, spinal injuries, abnormal calcium levels and more. These are very different than the causes of IBS-C, which are often hard to identify and may therefore be more difficult to address.
DISTINGUISHING IBS-C FROM OTHER CONDITIONS
Another area of confusion is between IBS and IBD. If you’ve read this far, you already know that IBS stands for Irritable Bowel Syndrome, and that’s exactly what it is – a group of symptoms related to your bowels and digestion. IBD, however, is something completely different – and often much more serious. It stands for Inflammatory Bowel Disease, and it’s the name for a family of autoimmune disorders associated with inflammation in your digestive tract.
In addition to causing severe digestive distress, IBD can also manifest outside of the GI tract, resulting in anemia, arthritis, eye inflammation, skin rashes and other health issues.
It’s also worth noting that neither IBS nor IBD are Celiac Disease. Like IBD, Celiac Disease is related to inflammation in the digestive tract, but it is specifically triggered by the consumption of gluten. Once gluten is removed from the diet, sufferers of Celiac Disease usually see their symptoms diminish or disappear altogether.
Because all of these conditions are fundamentally different from one another, treatment for them can be very different from case to case and person to person. It’s essential that you see a doctor to get a proper diagnosis so you can develop a plan that’s right for you.
Causes Of IBS-C
The jury is still out on what causes irritable bowel syndrome, but doctors do have some thoughts about what may be at the root of the issue for many people. A number of physicians suggest that IBS-C could be caused by food traveling too slowly through your intestine, the intestine absorbing too much fluid from you’re your stool, issues related to the bacteria in your gut, hormonal issues, or poor communication between your brain and your bowels.
Your IBS-C symptoms may worsen or lessen for a whole range of reasons, and what triggers an episode for you may be very different than what triggers and episode for someone else. Here are some of the most common triggers IBS-C patients experience – tracking and identifying your own triggers can be an important step towards managing your condition:
Foods In Your Diet
Foods such as breads and cereals, processed foods, high-protein foods, and dairy products (especially cheese) have been found to contribute to the constipation associated with IBS-C for many patients. You may also find it helpful to avoid caffeine, alcohol and carbonated beverages.
How You Eat
If you have a tendency to eat too quickly or distractedly (like when you’re working or driving), you may be consuming food in a way that contributes to your symptoms. Instead, try eating more slowly and without distractions.
Stress And Anxiety
Stress, anxiety, and depression have all been associated by many patients with worsened symptoms of IBS. Managing stress and maintaining a good mental state can help reduce the physical effects of your condition, but it can also better prepare you to deal with those effects when they do occur.
Hormonal Changes
Many women with IBS often experience an increase in symptoms around their menstrual cycle. Some women have reported that when they use birth control pills that lessen the effects of their periods, their IBS symptoms may be lessened, as well.
Not Enough Exercise
When you get your body moving through exercise, you’re getting your whole body moving – including the muscles that are associated with digestion. In other words, exercise is a great way to help fight constipation. On top of that, exercise is also an outstanding way to manage stress and reduce anxiety, two of the most common triggers of IBS symptoms.
Who Gets IBS-C?
Irritable bowel syndrome is a surprisingly common condition – as many as 1in 5 American adults have it – and there are a number of factors that are associated with an increased risk of having it:
- Age – IBS usually appears before you turn 50, and it often occurs in people before they turn 35.
- Sex – More than half of all patients are female.
- Family History – Though it’s uncertain if IBS is definitively hereditary, if you have family members who’ve had IBS, you may be at a greater risk for developing the condition.
- Mental Health – People with certain mental health issues such as anxiety or depression may be more likely to have IBS, along with those who’ve experienced sexual, physical or emotional abuse.
Diagnosis
IBS-C isn’t usually diagnosed through a particular lab test or imaging. Instead, it’s usually diagnosed based on the symptoms you have. Your doctor will begin by taking a full medical history and performing a physical examination, then compare what you’re presenting against clinical criteria to help identify and classify your condition.
There may be some additional testing required, particularly if your symptoms may be associated with other conditions, as well. These tests usually begin with bloodwork, but can also include breath tests to identify lactose intolerance or bacterial overgrowth in the small intestine. If your symptoms warrant further inspection, your doctor could also prescribe procedures such as colonoscopies, CT scans or upper endoscopies.
Treatment Options
If you’ve been diagnosed with irritable bowel syndrome, there are a number of treatment options available that can make a real difference in the frequency and intensity of the symptoms you experience – eliminating them entirely for some and significantly reducing them for others. Some of the most common include:
Dietary Tracking
It’s no surprise that the foods you eat and how you eat them can have an enormous impact on the symptoms you experience – or don’t experience – as part of your IBS-C. What can be a surprise, however, are the specifics behind which foods can trigger episodes and which might help reduce them.
One of the best ways to identify the foods your body responds to is to track your symptoms and your diet, marking down what you’ve eaten and when you’ve eaten it along with what symptoms you’ve experienced and when you’ve experienced them. NAFC has even prepared a free, downloadable tracker that makes it easy to do – just click here to get yours.
The data you collect can be remarkably valuable for your treatment journey. You may be able to tell straight away which foods are causing issues for you, and you may be surprised to find that others aren’t causing you any distress at all. But even if you’re not able to identify any particular patterns from your diary, there’s a chance our doctor may see things that you don’t, so be sure to share your diary as part of the diagnostic process.
Fiber, Fiber, Fiber!
Most of us probably think of fiber as something to take when your digestion is backed up, so it would sound like an obvious choice for those with IBS-C, right? Turns out, the answer is a little more complicated than that.
There are two types of dietary fiber that you can consume: Soluble and insoluble. Soluble fiber can be broken down by the microbes in your intestines, while insoluble fiber doesn’t get broken down and simply passes through undigested.
If you have IBS-C, soluble fiber is what you want to eat. That’s because it’s an essential source of energy for the microbiome in your gut, contributing to the growth of helpful digestive bacteria in your GI tract. It also helps increase the movement of your gut muscles, directly helping with regularity and improving the symptoms of constipation.
The good news is that it’s not difficult to get plenty of soluble fiber directly from the foods you eat. Oats and barley are good sources, as are peas, oranges, carrots, beans and other legumes. If that weren’t enough, you can also get it in supplement form.
In contrast, insoluble fiber is not recommended for those with IBS-C. Since it doesn’t get digested, it can actually bulk up your stool, which may only make your constipation worse. Try to avoid foods that contain insoluble fiber, including wheat bran, whole wheat flour, nuts, cruciferous vegetables like broccoli and cauliflower and potatoes.
Low-FODMAP Diet For IBS-C
One specialized diet that you’re likely to hear about for the treatment of IBS is the Low-FODMAP Diet. FODMAP is an acronym for “Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols.” That may be a tongue-twister, but all those fancy words really just refer to various types of sugar that can produce digestive distress. The idea is that by avoiding these foods, you can reduce those nutrients that contribute to your symptoms.
There is clinical research that suggests that a diet low in FODMAP foods can make a real difference for those with IBS. A number of studies have found meaningful reductions in symptoms, including abdominal pain, bloating, gas, and flare-ups.
That being said, a low FODMAP diet is not intended to be a life-long change in eating. Instead, it’s typically started as a strict 3 to 6 week restriction of all FODMAP foods to see how your symptoms are impacted. After this initial period, various FODMAPs will be gradually re-introduced to your diet to help you identify which – if any – you are particularly sensitive to. Because of the way this diet is implemented and monitored, it’s particularly important that you do it under the care of a doctor or dietician.
What About Gluten-Free and Keto Diets?
There are a number of popular diets that you may have tried or thought about trying for your IBS-C, including gluten free and keto diets. However, there’s not much research to suggest that either of these will help with your symptoms. Of course, that doesn’t mean that they’ll make things worse, either – only that the science is far from settled.
If either of these diets is something you’re interested in trying, discuss it with your doctor first, and make sure to keep good track of what you’re eating and how it affects you.
Other Dietary Changes
When gas and cramping are getting to you, it’s easy enough to avoid foods like beans and broccoli that can add to the problem. But beyond this, there are many other foods that you may not realize are also potential problem sources:
- Caffeine and alcohol – Many people have no issue whatsoever with these, but they can be real triggers for others; pay close attention to how they affect you and cut back or eliminate them if you find that you’re sensitive to them
- Eat intentionally – Mindlessly eating, rushing through meals, or eating without paying attention can all trigger symptoms
- Eat smaller meals throughout the day – Some research suggests that eating smaller meals more frequently may keep your digestive system running more steadily, helping reduce constipation
- Don’t eat too late – Avoiding late eating can be helpful for many
- Don’t overeat – Learn to recognize when you’re full and stop before you’re stuffed
- Stay hydrated – For most people, this means drinking between 8 and 12 cups a day; if you don’t want to actually keep track, remember to drink whenever you begin to feel thirsty
Counseling
Cognitive Behavioral Therapy, also known as CBT, is a type of talk therapy that is focused on helping you change negative thoughts for the better. It’s a very results-oriented approach to mental health, with a goal of helping you identify specific strategies to generate the outcomes you’re looking for. When it comes to digestive disorders, the thought is that by developing approaches to manage anxiety, you can minimize many of the triggers that aggravate your condition.
Biofeedback
This technique involves training your body to have more control over your bowels and has been proven an effective tool in managing IBS symptoms. Learn more about biofeedback here.
Mindfulness
Practicing mindfulness meditation has been shown to result in a reduction of IBS symptoms. Mindfulness meditation involves focusing on the present moment and has been thought to reduce stress and calm the mind. Read our information on how to cope with a bowel condition here.
Over-The-Counter Medications
Some of the most common OTC products that doctors recommend are fiber supplements, laxatives and stool softeners to treat constipation. Some patients find that peppermint oil can also be helpful in digestion by relaxing the muscles in your digestive tract, but make sure to take peppermint oil under the direction of a doctor, because it can interfere with the absorption of certain nutrients.
Probiotics may also be worth considering. These supplements contain live microorganisms that provide your gut with bacteria that promote beneficial digestion. There is some research to suggest that probiotics improve the frequency and consistency of bowel movements, and there may also be benefits if you have occasional bouts of diarrhea.
Prescription medications
If OTC products aren’t sufficiently helpful for you, your doctor may suggest a prescription medication to help address your symptoms. There are a variety of types of drugs to consider, including those from a class called secretagogues. These medications increase the amount of fluid and movement in your gut, which may help with pain and bloating. Prosecretory agents work by softening stool in the intestine, making bowel movements more frequent and less difficult. And antispasmodics reduce pain by relaxing your digestive muscles.
One of the most recently introduced medications for IBS-C has also become the most prescribed of all: Linzess. Also known as Linaclotide, Linzess is a type of medication called a guanylate cyclase-C agonist. That’s a mouthful, but what the drug does is treat IBS-C (along with other conditions that have similar symptoms) by stimulating a part of your intestine to increase the release of fluid that softens stool and stimulates bowel movements.
Other commonly prescribed medications include Plecanatide (Trulance), which helps food move through your digestive tract; Tenapanor (Ibsrela), which reduces the amount of sodium absorbed from the food you eat and promotes improved digestion; Lubiprostone (Amitiza), a laxative which softens the stool and promotes bowel movements; and antispasmodics, which improve symptoms by helping to stop painful spasms.
For those whose Irritable Bowel Syndrome has an emotional component, antidepressant medications may help with symptoms of stress and anxiety, both of which are common triggers of IBS. There’s even a class of drugs called Selective Serotonin Reuptake Inhibitors – also known as SSRIs – that can improve brain-bowel interactions while also addressing anxiety and depression.
Talking With A Doctor About IBS-C
For most people, having a discussion about bowel issues isn’t something you’re particularly looking forward to. One way to make things a little easier is to remind yourself this isn’t a casual conversation with friends or family; you’re speaking to a doctor – this is something they deal with routinely, and it’s the sort of conversation they’re supposed to have.
Even then, it can still be uncomfortable to be open about your condition, especially when talking face-to-face. The hardest part is often breaking the ice – once you get the conversation going, things tend to get much easier. So how do you start? A good strategy is to ease into things. Rather than beginning with explicit details, a simple statement like, “I’d like to talk about IBS,” or “I have a feeling I might have an issue with IBS,” is often all it takes to initiate a meaningful interaction.
Another challenge is to make sure that you go over everything you’d like to know. All the information your doctor is sharing can be difficult to take in, and in the course of your consultation, it’s easy to forget to ask important questions. The following list is a short-but-thorough guide to make sure you don’t overlook anything – and you can download it in a ready-to-print format by clicking on the “Talking With Your Doctor” link in the Free Resources section below.
- What is causing my symptoms?
- Will it get worse if left untreated?
- What tests do I need to take?
- Is it related to another illness or medical condition?
- Is this a temporary condition or something that may last a while? If so, how long does it usually last?
- What treatments are available?
- What do you recommend?
- Are there any side effects?
- What types of results can I expect with treatment?
- Are there alternate treatments that I should consider?
- Are there things I can do on my own to improve my condition?
- Should I change my diet or drinking habits?
- Are there any foods you recommend to take or avoid?
- Can a fiber supplement help?
- Are there exercises that can help?
- What should I look for in a protective garment?
- Are there any particular products you recommend?
- Are there any brands I should look for?
- Are medications available for my condition/symptoms?
- What is their track record – have they been found to be particularly successful?
- How do I take it?
- What should I expect – how will it affect me?
- How long does it typically take to see results?
- What sort of side effects should I be aware of?
Free Resources On IBS-C For You
Click any of the links to download free, printer-friendly sheets to help you track your condition and have a rewarding consultation with your physician:
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