Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisFlare-Up FactorsDiet and SupplementsLifestyle ModificationsTreatments and MedicationsManaging SymptomsIBS-C vs. Chronic ConstipationNext in IBS-C GuideDaily IBS-C Treatment: What Helps?
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Flare-Up Factors
Diet and Supplements
Lifestyle Modifications
Treatments and Medications
Managing Symptoms
IBS-C vs. Chronic Constipation
Next in IBS-C Guide
Irritable bowel syndrome (IBS) is a chronic digestive disorder that can cause diarrhea and/or constipation, among other symptoms. Constipation-predominant IBS (IBS-C) is a subtype of IBS that causes constipation and abdominal pain.
Rates of IBS vary widely in different parts of the world, but one large study showed that about 4% of people may live with some form of IBS. IBS-C makes up about a third of all cases of IBS.
While the cause ofirritable bowel syndromeis unknown, it is considered a disorder of brain-gut interaction.This means a disruption of the two-way communication between the brain and the digestive system is causing symptoms. IBS-C may be treated with a combination of diet modification, fiber supplements, lifestyle changes, and, in some cases, medications.
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Common Symptoms of IBS-C
In general, the hallmark symptoms of IBS-C areconstipationand abdominal pain. Constipation is when stools are hard and difficult to pass. Sometimes, this means straining to have a bowel movement. Stools may also be infrequent, such as having fewer than three bowel movements a week.
A set of guidelines called theRome IV criteriais used to diagnoseIBS and its subtypes. It includes:
Abdominal pain that occurs, on average, at least one day a week for at least three months and that started at least six months prior, plus at least two of the following:
Additionally, to be considered IBS-C, at least 25% of stools are hard (stool type 1 or 2 on theBristol Stool Scale), and less than 25% of stools are soft (stool type 6 or 7 on the Bristol Stool Scale).
Other symptoms of constipation may be present, though they are not necessary to diagnose IBS-C. Those symptoms could include:
The Cause Is Unknown
What causes IBS-C is not well understood, though research is being done to learn more. It was previously classified as a functional gastrointestinal disorder (in which symptoms occur without a known underlying cause). As a result of more studies on IBS, It is now called a disorder of gut-brain interaction.
The nervous system has a two-way street between the digestive system and the brain. One can affect the other, and that’s what is thought to be happening in IBS. The brain and the gut are not communicating well enough to work effectively.
There are many causes of IBS, and there are a few risk factors, such as:
Suspicion of other conditions may justify blood tests, stool tests, orendoscopy(imaging via inserting a tiny camera into the body). But this is no longer done as a matter of course if someone meets the Rome Criteria for IBS.
However, some people may feel better about the diagnosis of IBS after testing. People should work with their healthcare providers to decide how to move forward when a diagnosis of IBS is made.
Warning SymptomsSome signs and symptoms are not a part of IBS-C. When these are present, further testing or treatment may be needed:Bleeding from the rectum or blood on the stoolFeverNew symptoms in people over age 50Symptoms that come on suddenly or get worse quicklySymptoms that wake you up at nightUnintended weight lossYou may also need further testing if you have a family or personal history of colon or rectal cancer orinflammatory bowel disease(IBD), which includesCrohn’s diseaseandulcerative colitis.
Warning Symptoms
Some signs and symptoms are not a part of IBS-C. When these are present, further testing or treatment may be needed:Bleeding from the rectum or blood on the stoolFeverNew symptoms in people over age 50Symptoms that come on suddenly or get worse quicklySymptoms that wake you up at nightUnintended weight lossYou may also need further testing if you have a family or personal history of colon or rectal cancer orinflammatory bowel disease(IBD), which includesCrohn’s diseaseandulcerative colitis.
Some signs and symptoms are not a part of IBS-C. When these are present, further testing or treatment may be needed:
You may also need further testing if you have a family or personal history of colon or rectal cancer orinflammatory bowel disease(IBD), which includesCrohn’s diseaseandulcerative colitis.
What causes IBS-C symptoms in one person may not necessarily bother another person with the condition.
Some people find that foods that contain carbohydrates called fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) may cause symptoms. Avoiding foods that contain FODMAPs may be one strategy to help prevent a flare-up.
Working with a dietitian helps understand FODMAPs because knowing which foods contain them is difficult. An abbreviated list of high-FODMAP foods includes:
Other foods that may be connected to flare-ups of IBS include:
Other factors that may be connected to IBS flare-ups are:
Making changes to dietand adding supplements may help prevent some flare-ups of IBS-C. Restrictive diets are not recommended, so working with a dietitian who can help craft a nourishing diet supporting overall health is important.
A low-FODMAP dietis recommended for many people who live with a form of IBS. The diet has several phases. It is helpful to work with a healthcare provider to get it started. Foods will first be eliminated from the diet, and some will be added back over time.
Increasing soluble fibermay help with some symptoms of IBS.Soluble fiberhelps make stool softer and easier to pass. Soluble fiber can be obtained through foods or supplements, especially psyllium fiber.
A few studies have shownpeppermint oilin enteric-coated capsules may help relax the intestinal muscles. The muscles working better to move stool through may relieve constipation.
Increasing physical activity (exercise) may also help with IBS-C. In general, exercise helps improve overall health. It may also help get the bowels moving, making it easier to pass stool.
Exercise could also be associated with a better quality of life. People feel better overall when they exercise on a regular schedule. A healthcare provider can help recommend how to get started with exercise and work it into the overall healthcare plan.
Treatments for IBS-Ccan also include mental health modalities and medication.
Caring for mental health is part of anoverall treatment planfor IBS-C. Gut-directed psychotherapy that includescognitive behavioral therapy (CBT),mindfulness, and/orhypnotherapymay be recommended. Because IBS is a disorder of gut-brain interaction, addressing the mental factors that may contribute to symptoms is a part of treatment.
Some of theprescription medicationsthat might be used to treat IBS-C are:
Should You Take Miralax?MiraLax (polyethylene glycol or PEG)is a type of laxative available over the counter (OTC). For people experiencing constipation, it might seem as though taking thistype of laxativewould solve the issues that IBS-C is causing.However, the evidence says otherwise. Randomized controlled trials showed that MiraLax helped some people with stool consistency but not with pain or other symptoms of IBS-C. Therefore, the American College of Gastroenterology recommends against its use in treating IBS-C.
Should You Take Miralax?
MiraLax (polyethylene glycol or PEG)is a type of laxative available over the counter (OTC). For people experiencing constipation, it might seem as though taking thistype of laxativewould solve the issues that IBS-C is causing.However, the evidence says otherwise. Randomized controlled trials showed that MiraLax helped some people with stool consistency but not with pain or other symptoms of IBS-C. Therefore, the American College of Gastroenterology recommends against its use in treating IBS-C.
MiraLax (polyethylene glycol or PEG)is a type of laxative available over the counter (OTC). For people experiencing constipation, it might seem as though taking thistype of laxativewould solve the issues that IBS-C is causing.
However, the evidence says otherwise. Randomized controlled trials showed that MiraLax helped some people with stool consistency but not with pain or other symptoms of IBS-C. Therefore, the American College of Gastroenterology recommends against its use in treating IBS-C.
Other Tips to Manage Symptoms
It can be helpful to have options to manage or distract from symptoms and feel better. Someideas for self-careinclude:
Chronic constipation, or functional constipation, is different from IBS-C. Chronic constipation has many potential causes, such as a side effect from medication or a problem with the nerves or anatomy of thedigestive system.
The major difference is abdominal pain. Abdominal pain must be present to diagnose IBS-C.Functional constipation might not cause any pain.
The treatments for the two conditions may also be different. For instance, a low-FODMAP diet may not help functional constipation. Laxatives may be helpful for constipation, though they are not recommended in IBS-C treatment guidelines.Plus, they may not work to address all the symptoms of IBS-C.
Knowing which condition is causing the constipation is important because it helps understand how best to treat it. These two conditions might be different ends of the same spectrum of disease. but that is yet unproven, and research is ongoing.
Summary
IBS-C is a complicated condition whose causes are unknown. A disruption in the gut-brain connection may be the source. A set of criteria is used to diagnose IBS-C, and other testing may not be necessary.
Treatments can include making changes to diet, lowering stress, accessing mental health care, and receiving prescription medication when other methods aren’t working. Over-the-counter laxatives are not recommended because they don’t help with abdominal pain.
18 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sperber AD, Bangdiwala SI, Drossman DA, et al.Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation Global Study.Gastroenterology. 2021;160(1):99-114.e3. doi:10.1053/j.gastro.2020.04.014National Institute of Diabetes and Digestive and Kidney Diseases.Irritable bowel syndrome.Rome Foundation.Appendix A: Rome IV diagnostic criteria for FGIDs.Cash BD.Understanding and managing IBS and CIC in the primary care setting.Gastroenterol Hepatol (N Y). 2018;14(5 Suppl 3):3-15.Vélez CD.Recognizing and treating disorders of gut-brain interaction. Harvard Health Publishing.Soares RL.Irritable bowel syndrome: a clinical review.World J Gastroenterol. 2014;20(34):12144-12160. doi:10.3748/wjg.v20.i34.12144Ahuja NK.A case study in the IBS-C management continuum: assessing patient response and tailoring treatment.Gastroenterol Hepatol (N Y). 2024;20(7):383-427.Monash University.FODMAPs and irritable bowel syndrome.Temple Health.These foods may be making your IBS worse.Atlantic Health System.Common triggers for irritable bowel syndrome.International Foundation for Gastrointestinal Disorders, Inc.Tips to make traveling easier.National Center for Complementary and Integrative Health.Peppermint oil.Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for irritable bowel syndrome.Ford AC, Moayyedi P, Chey WD, et al.American College of Gastroenterology monograph on management of irritable bowel syndrome.Am J Gastroenterol. 2018;113(Suppl 2):1-18. doi:10.1038/s41395-018-0084-xHorn A, Stangl S, Parisi S, Bauer N, Roll J, Löffler C, Gágyor I, Haas K, Heuschmann PU, Langhorst J, Keil T.Systematic review with meta-analysis: stress-management interventions for patients with irritable bowel syndrome.Stress Health. 2023;39(4):694-707. doi:10.1002/smi.3226Naliboff BD, Smith SR, Serpa JG, et al.Mindfulness-based stress reduction improves irritable bowel syndrome (IBS) symptoms via specific aspects of mindfulness.Neurogastroenterol Motil. 2020;32(9):e13828. doi:10.1111/nmo.13828Patel S, Doerfler B, Boutros K, Ng S, Manuel M, DeSimone E.Review of treatment options for irritable bowel syndrome with constipation and chronic idiopathic constipation.Int J Gen Med. 2021;14:1457-1468. doi:10.2147/IJGM.S274568.
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sperber AD, Bangdiwala SI, Drossman DA, et al.Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation Global Study.Gastroenterology. 2021;160(1):99-114.e3. doi:10.1053/j.gastro.2020.04.014National Institute of Diabetes and Digestive and Kidney Diseases.Irritable bowel syndrome.Rome Foundation.Appendix A: Rome IV diagnostic criteria for FGIDs.Cash BD.Understanding and managing IBS and CIC in the primary care setting.Gastroenterol Hepatol (N Y). 2018;14(5 Suppl 3):3-15.Vélez CD.Recognizing and treating disorders of gut-brain interaction. Harvard Health Publishing.Soares RL.Irritable bowel syndrome: a clinical review.World J Gastroenterol. 2014;20(34):12144-12160. doi:10.3748/wjg.v20.i34.12144Ahuja NK.A case study in the IBS-C management continuum: assessing patient response and tailoring treatment.Gastroenterol Hepatol (N Y). 2024;20(7):383-427.Monash University.FODMAPs and irritable bowel syndrome.Temple Health.These foods may be making your IBS worse.Atlantic Health System.Common triggers for irritable bowel syndrome.International Foundation for Gastrointestinal Disorders, Inc.Tips to make traveling easier.National Center for Complementary and Integrative Health.Peppermint oil.Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for irritable bowel syndrome.Ford AC, Moayyedi P, Chey WD, et al.American College of Gastroenterology monograph on management of irritable bowel syndrome.Am J Gastroenterol. 2018;113(Suppl 2):1-18. doi:10.1038/s41395-018-0084-xHorn A, Stangl S, Parisi S, Bauer N, Roll J, Löffler C, Gágyor I, Haas K, Heuschmann PU, Langhorst J, Keil T.Systematic review with meta-analysis: stress-management interventions for patients with irritable bowel syndrome.Stress Health. 2023;39(4):694-707. doi:10.1002/smi.3226Naliboff BD, Smith SR, Serpa JG, et al.Mindfulness-based stress reduction improves irritable bowel syndrome (IBS) symptoms via specific aspects of mindfulness.Neurogastroenterol Motil. 2020;32(9):e13828. doi:10.1111/nmo.13828Patel S, Doerfler B, Boutros K, Ng S, Manuel M, DeSimone E.Review of treatment options for irritable bowel syndrome with constipation and chronic idiopathic constipation.Int J Gen Med. 2021;14:1457-1468. doi:10.2147/IJGM.S274568.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sperber AD, Bangdiwala SI, Drossman DA, et al.Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation Global Study.Gastroenterology. 2021;160(1):99-114.e3. doi:10.1053/j.gastro.2020.04.014National Institute of Diabetes and Digestive and Kidney Diseases.Irritable bowel syndrome.Rome Foundation.Appendix A: Rome IV diagnostic criteria for FGIDs.Cash BD.Understanding and managing IBS and CIC in the primary care setting.Gastroenterol Hepatol (N Y). 2018;14(5 Suppl 3):3-15.Vélez CD.Recognizing and treating disorders of gut-brain interaction. Harvard Health Publishing.Soares RL.Irritable bowel syndrome: a clinical review.World J Gastroenterol. 2014;20(34):12144-12160. doi:10.3748/wjg.v20.i34.12144Ahuja NK.A case study in the IBS-C management continuum: assessing patient response and tailoring treatment.Gastroenterol Hepatol (N Y). 2024;20(7):383-427.Monash University.FODMAPs and irritable bowel syndrome.Temple Health.These foods may be making your IBS worse.Atlantic Health System.Common triggers for irritable bowel syndrome.International Foundation for Gastrointestinal Disorders, Inc.Tips to make traveling easier.National Center for Complementary and Integrative Health.Peppermint oil.Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for irritable bowel syndrome.Ford AC, Moayyedi P, Chey WD, et al.American College of Gastroenterology monograph on management of irritable bowel syndrome.Am J Gastroenterol. 2018;113(Suppl 2):1-18. doi:10.1038/s41395-018-0084-xHorn A, Stangl S, Parisi S, Bauer N, Roll J, Löffler C, Gágyor I, Haas K, Heuschmann PU, Langhorst J, Keil T.Systematic review with meta-analysis: stress-management interventions for patients with irritable bowel syndrome.Stress Health. 2023;39(4):694-707. doi:10.1002/smi.3226Naliboff BD, Smith SR, Serpa JG, et al.Mindfulness-based stress reduction improves irritable bowel syndrome (IBS) symptoms via specific aspects of mindfulness.Neurogastroenterol Motil. 2020;32(9):e13828. doi:10.1111/nmo.13828Patel S, Doerfler B, Boutros K, Ng S, Manuel M, DeSimone E.Review of treatment options for irritable bowel syndrome with constipation and chronic idiopathic constipation.Int J Gen Med. 2021;14:1457-1468. doi:10.2147/IJGM.S274568.
Sperber AD, Bangdiwala SI, Drossman DA, et al.Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation Global Study.Gastroenterology. 2021;160(1):99-114.e3. doi:10.1053/j.gastro.2020.04.014
National Institute of Diabetes and Digestive and Kidney Diseases.Irritable bowel syndrome.
Rome Foundation.Appendix A: Rome IV diagnostic criteria for FGIDs.
Cash BD.Understanding and managing IBS and CIC in the primary care setting.Gastroenterol Hepatol (N Y). 2018;14(5 Suppl 3):3-15.
Vélez CD.Recognizing and treating disorders of gut-brain interaction. Harvard Health Publishing.
Soares RL.Irritable bowel syndrome: a clinical review.World J Gastroenterol. 2014;20(34):12144-12160. doi:10.3748/wjg.v20.i34.12144
Ahuja NK.A case study in the IBS-C management continuum: assessing patient response and tailoring treatment.Gastroenterol Hepatol (N Y). 2024;20(7):383-427.
Monash University.FODMAPs and irritable bowel syndrome.
Temple Health.These foods may be making your IBS worse.
Atlantic Health System.Common triggers for irritable bowel syndrome.
International Foundation for Gastrointestinal Disorders, Inc.Tips to make traveling easier.
National Center for Complementary and Integrative Health.Peppermint oil.
Lacy BE, Pimentel M, Brenner DM, et al.ACG clinical guideline: management of irritable bowel syndrome.Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036
National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for irritable bowel syndrome.
Ford AC, Moayyedi P, Chey WD, et al.American College of Gastroenterology monograph on management of irritable bowel syndrome.Am J Gastroenterol. 2018;113(Suppl 2):1-18. doi:10.1038/s41395-018-0084-x
Horn A, Stangl S, Parisi S, Bauer N, Roll J, Löffler C, Gágyor I, Haas K, Heuschmann PU, Langhorst J, Keil T.Systematic review with meta-analysis: stress-management interventions for patients with irritable bowel syndrome.Stress Health. 2023;39(4):694-707. doi:10.1002/smi.3226
Naliboff BD, Smith SR, Serpa JG, et al.Mindfulness-based stress reduction improves irritable bowel syndrome (IBS) symptoms via specific aspects of mindfulness.Neurogastroenterol Motil. 2020;32(9):e13828. doi:10.1111/nmo.13828
Patel S, Doerfler B, Boutros K, Ng S, Manuel M, DeSimone E.Review of treatment options for irritable bowel syndrome with constipation and chronic idiopathic constipation.Int J Gen Med. 2021;14:1457-1468. doi:10.2147/IJGM.S274568.
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