Irritable Bowel Syndrome - Constipation Type (IBS-C)

Irritable Bowel Syndrome with Constipation (IBS-C) is a disorder of gut–brain interaction. This means the signals between your gut and nervous system become oversensitive. As a result, the bowel does not move as it should, and you may feel discomfort or pain even when there isn’t a dangerous problem.

IBS-C is now recognized as a real condition where pain is the main symptom. Doctors diagnose it using rigorous criteria called Rome IV, which are internationally accepted standards.

IBS-C is different from diseases like Crohn’s or ulcerative colitis. It does not cause damage to the bowel. Instead, it changes how the bowel works.

A colonoscopy is not always required to make the diagnosis. It may be needed if there are concerning features, such as:

Strong family history of colon cancer
Unexplained weight loss
Blood in stool
Symptoms that wake you at night or are otherwise unusual

If these warning signs are absent, your doctor can usually diagnose IBS-C based on symptoms, investigations, and exam findings.

Common Causes and Triggers

Changes in gut bacteria (microbiome imbalance)
Overactive pain signals in the gut nerves
Stress or anxiety, which can worsen gut sensitivity
Certain foods (especially high in FODMAPs—fermentable sugars that draw water and gas into the gut)

Typical Symptoms

Fewer bowel movements than usual
Hard or lumpy stools
Abdominal bloating, cramping, or pain
Feeling of incomplete bowel emptying

Treatment Approach

Managing IBS-C works best with a multifaceted plan. No single option works for everyone, so we build a tailored plan together.

Lifestyle and Diet

Low-FODMAP diet: With the help of a dietitian, reducing certain hard-to-digest sugars (such as lactose, fructose, and some fibers) can ease bloating, gas, and pain. This diet can be complex, so the best results come when it is guided by a trained dietitian rather than trying to follow it on your own.
Probiotics: A multi-strain probiotic can help balance gut bacteria.
- i.e. Jamieson Probiotic 10 billion - 14-strain daily probiotic(Costco) or Weber Naturals Probiotic 30 billion - 8 strain daily probiotic (Walmart)
Fluids: Aim for at least 6–8 cups of water per day.
Exercise: Regular physical activity improves bowel movement.

Medications

If lifestyle changes are not enough, medications may help:

Linaclotide (Constella): Taken once daily, improves bowel movement and reduces abdominal pain.
Tenapanor (Ibsrela): Taken twice daily, helps soften stools and reduce pain.
Prucalopride (Resotran): Taken once daily, stimulates bowel movement and may reduce bloating.

These medicines don’t just help the bowels move—they also reduce nerve sensitivity, which helps pain.

Mind–Body Care

Psychotherapy (such as CBT): Can help reduce the stress and anxiety that often worsen IBS symptoms. This is especially helpful if symptoms are long-lasting or affect quality of life.

What You Can Expect

IBS-C is a chronic condition, but it can be well-controlled with the right combination of diet, lifestyle, and medications.
It is not dangerous and does not increase your risk of cancer.
Symptoms often come and go. You may have better weeks and tougher weeks.

When to Seek Medical Advice

Contact your doctor if you notice:

Blood in your stool
Unexplained weight loss
Symptoms waking you at night
Symptoms not improving despite treatment