Digestive Health Irritable Bowel Syndrome Constipation Predominant IBS (IBS-C) Print By Barbara Bolen, PhD | Medically reviewed by a board-certified physician Updated October 30, 2018 Show Article Table of Contents Symptoms Risk Factors Diagnosis Treatment View All Back To Top Universal Images Group/Getty Images More in Irritable Bowel Syndrome Causes & Diagnosis Living With Nutrition Symptoms Treatment Support & Coping IBS With Constipation IBS With Diarrhea Related Conditions View All Constipation-predominant irritable bowel syndrome (IBS-C) is a condition characterized by chronic constipation with associated abdominal pain. It is a subtype of irritable bowel syndrome (IBS), and approximately one-third of people who have IBS manifest the IBS-C type. IBS-C is one if the functional gastrointestinal disorders (FGD), which are gastrointestinal (GI) disorders that produce signs and symptoms without an identifiable cause despite standard diagnostic testing. These disorders can cause significant distress. Lifestyle modifications and medication may reduce the symptoms. Symptoms The predominant symptoms of IBS-C are frequent constipation accompanied by pain when having a bowel movement. Criteria It is normal to have one or two bowels movements per day, but it is also normal to have less than one per day. Generally speaking, characteristics that denote constipation include: Having fewer than three bowel movements in a weekLumpy or hard stoolsThe need to strain during a bowel movement The Rome IV criteria define FGD based on specific signs and symptoms. According to the Rome IV criteria, IBS-C is specifically defined as a condition in which: Constipation associated with pain occurs at least three days per month.Symptoms have persisted over the past three months.At least 25 percent of stools can be described as hard and less than 25 percent of stools described as soft. Associated Symptoms In addition to the criteria for IBS-C, there are some other symptoms you may experience if you have constipation-predominant IBS. Common symptoms of IBS-C include: Abdominal painGas and bloatingA feeling of incomplete evacuationMucus on the stoolA sensation of blockage in the anus and/or rectumNeed to use fingers to remove stool (digital evacuation) With IBS-C, loose stools are rarely experienced, unless using a laxative. Compared to the other IBS subtypes, people who have IBS-C are more likely to experience anxiety, depression, and a lowered quality of life. IBS-C vs. Chronic Idiopathic Constipation (CIC) IBS-C and chronic idiopathic constipation (also known as functional constipation) share many of the same symptoms. According to the Rome IV criteria, the biggest difference is that IBS-C causes abdominal pain and discomfort alongside constipation, while idiopathic constipation is typically painless. There has been a question among gastroenterologists that these are manifestations of the same disorder along a single disease spectrum, rather than two completely separate disorders. However, the two conditions tend to respond to different treatment, which suggests that they may be accurately considered two different conditions. At this point, the answer is not completely clear. Risk Factors There is no known cause of IBS-C. The symptoms occur because the digestive system does not function as it should, but there is no identifiable cause for this. Dyssynergic defecation, which is dysfunction of the pelvic floor muscles, may play a role. Older individuals and those who have a lower socioeconomic status are at higher risk for IBS-C. This could be due to dietary factors, changes in the function of the GI system with aging, or to a lack of physical activity. Diagnosis IBS-C is a diagnosis of exclusion, meaning that it is only diagnosed after other disorders that could cause your signs and symptoms have been ruled out. If you are being evaluated for IBS-C, your doctor is likely to do a physical examination, run some blood work, and conduct a stool sample analysis. Other tests, including imaging tests and interventional tests such as colonoscopy, may be recommended depending on your symptoms and your medical history. If your symptoms match the diagnostic criteria for IBS-C, and there is no evidence of any red-flag symptoms or other illness, IBS-C will be diagnosed. Treatment Treatment for IBS-C includes dietary and lifestyle modifications, over-the-counter laxatives, and prescription medications. Diet and lifestyle: Your doctor may recommend that you slowly increase the amount of fiber in your diet to promote more regular bowel movements.Laxatives: Over-the-counter laxatives such as Miralax or lactulose may help your constipation. Use only as directed and based on the advice of your doctor, as laxative overuse can cause serious side effects.Amitiza (lubiprostone): A prescription medication that is FDA approved for treatment of IBS-C, lubiprostone increases fluid secretion in the intestines.Medications used for IBS: Antidepressants may have an effect on the nerves of the GI system, and antispasmodics can relax the muscles within it. These medications are not formally indicated for the treatment of IBS, but they are frequently prescribed to reduce the symptoms of IBS.Behavioral interventions: Cognitive behavioral therapy may be recommended for treatment of IBS. If dyssynergic defecation is a contributing factor to your IBS-C symptoms, your doctor may recommend that you try biofeedback. Was this page helpful? Thanks for your feedback! One of the most challenging aspects of having IBS is trying to figure out what's safe to eat. Our recipe guide makes it easier. Sign up and get yours now! Email Address Sign Up There was an error. Please try again. Thank you, , for signing up. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Drossman DA. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016 Feb 19. pii: S0016-5085(16)00223-7. doi: 10.1053/j.gastro.2016.02.032. [Epub ahead of print] Schmulson MJ, Drossman DA, What Is New in Rome IV. J Neurogastroenterol Motil. 2017 Apr 30;23(2):151-163. doi: 10.5056/jnm16214. Continue Reading