Dealing With Constipation From IBS

Constipation is a very common problem and is estimated to be the cause for approximately 2 million doctor visits each year. Many people with irritable bowel syndrome (IBS) experience diarrhea, but a small group has either constipation (IBS-C) or alternating constipation and diarrhea as their main concern (IBS-A). Fortunately, there are several ways that constipation can be treated effectively or avoided altogether. In most cases, making some changes to diet and activity will get things moving again.

Adding Dietary Fiber

People with constipation (including those with constipation-predominant IBS) are often encouraged to add more fiber to their diet. However, for people with IBS, the type of fiber is very important. There are two types of fiber: soluble and insoluble. Soluble fiber has several benefits that may also reduce symptoms of IBS: it may help prevent spasms, because it keeps the colon somewhat distended and it absorbs water, which helps to keep stools from being too hard and difficult to pass. There should be enough fiber in the diet to ensure that stools are soft and pass painlessly and easily. Initially switching to a diet higher in fiber may increase gas and bloating, but these symptoms should decrease in a few weeks as the body becomes adjusted. Fiber supplements are also an effective way of adding fiber to the diet.

Drink Enough Water

Dehydration is a widespread problem; many people are not even aware that they are dehydrated. Chronic dehydration can lead to constipation. To stay hydrated, drink water each day (8 glasses of 8 ounces each is recommended), and avoid caffeinated drinks, which are dehydrating. Sipping water slowly throughout the day, especially before, during, and after exercise, is best.

Take in Some Exercise

Lack of exercise is another frequent contributor to chronic constipation. Most of us know that exercise is important to our overall health, but it can also be helpful to relieve constipation. The US Surgeon General recommends at least 30 minutes of exercise most days of the week for better overall health. But it doesn't take much to see major health benefits: even brisk walking is better than no aerobic activity.

Spare the Laxatives

Severe constipation may prompt some people to start using laxatives. Laxatives are readily available over the counter, but they should be used with caution, since they can be very harmful to the colon if abused. Over time, laxatives will damage nerves in the colon, causing the colon to be unable to contract and pass stool through on its own. The overuse of enemas is associated with the same undesirable effect on the nerves in the colon. Several foods are considered natural laxatives (such as prune juice, figs, licorice, and rhubarb), and while people with diarrhea-predominant IBS will want to avoid them, they may be helpful for people with constipation-predominant IBS.

Avoiding Complications From Constipation

Chronic constipation may lead to complications such as hemorrhoids or, less commonly, anal fissures.

Hemorrhoids. A hemorrhoid is actually a form of a varicose vein that can occur after straining to have a bowel movement. Symptoms include itching, burning, pain, and bleeding. Bleeding from a hemorrhoid is usually bright red, and more often seen on the toilet paper than in the bowl. Always get rectal bleeding checked out by a doctor, even if you suspect it is due to the hemorrhoid.

Anal fissures. A fissure is a tear or ulcer in the lining of the anal canal which is the last part of the rectum before the anus. Symptoms of a fissure include painful bowel movements, bright red blood in the toilet bowel or on toilet paper, anal lump, or swollen skin tag. Fissures are treated by lessening pressure on the anal canal by making sure stools are soft and ease discomfort or bleeding. This is not very common in IBS, but it is important to keep in mind, because straining on hard stools can contribute to this problem.

Constipation can typically be resolved by using the methods above. Additionally, fiber, water, and exercise are also effective tools in preventing the onset of constipation.

Soluble Sources of Fiber

• Barley
• Brown rice
• Currants
• Dried beans
• Figs
• French bread
• Fresh peas
• Methylcellulose (Citrucel) 
• Oat Bran
• Oatmeal
• Pasta
• Pre-biotic fiber (such as Benefiber)
• Prunes
• Psyllium husks (Metamucil)
• Raisins
• Rice
• Sourdough bread
• Soy

A Word From Verywell

Constipation is frustrating, but doesn't usually lead to complications. In many cases, making some simple changes, such as eating fiber, drinking water, exercising, and taking time to go to the bathroom, can help with alleviating constipation. Laxatives and other over-the-counter remedies may help for a time, but they shouldn't be used on a regular basis without the direction of a physician. If making lifestyle changes doesn't bring results, talk to a doctor to see what else can be done.