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Understanding and Managing Irritable Bowel Syndrome with Constipation (IBS-C)

If you’re experiencing persistent abdominal pain, bloating, and gas, accompanied by constipation, you may be dealing with Irritable Bowel Syndrome with Constipation (IBS-C). This common gastrointestinal disorder affects millions of people worldwide, with women, individuals under 50, and those with anxiety, depression, and other mental health conditions being more prone to it.

Recognizing the Signs and Symptoms

IBS-C can manifest in various ways, including:

• Abdominal pain
• Bloating and gas
• Constipation
• Unintentional weight loss
• Unexplained iron deficiency anemia
• Nocturnal symptoms
• Family history of colon cancer, inflammatory bowel disease, or celiac disease

If you’re experiencing any of these symptoms, it’s essential to consult a doctor to rule out other potential causes and develop an effective treatment plan.

What to Expect During a Doctor’s Visit

During your appointment, your doctor will:

• Take a detailed medical history to understand the severity and duration of your symptoms
• Ask about your lifestyle and over-the-counter (OTC) treatments you’ve tried
• Perform a physical exam to check for abdominal tenderness or palpable stool
• Order diagnostic tests, such as blood counts, thyroid level tests, and abdominal X-rays, to rule out other conditions

Lifestyle Changes to Manage IBS-C Symptoms

Making the following lifestyle adjustments can help alleviate IBS-C symptoms:

• Minimize stress through meditation and relaxation techniques
• Engage in moderate to vigorous physical activity (3-5 days a week)
• Get adequate sleep
• Drink enough water
• Eat a high-fiber diet (25-35 grams daily, depending on sex and weight)
• Avoid high gas-producing foods by trying the low FODMAP diet

Over-the-Counter Treatment Options

If lifestyle changes aren’t enough, OTC fiber supplements like psyllium husk or methylcellulose can help. Polyethylene glycol (Miralax) can also be used to treat constipation. However, be aware of potential side effects like bloating, gas, and dehydration.

Prescription Treatment Options

If OTC treatments aren’t effective, your doctor may prescribe medications like:

• Linaclotide (Linzess)
• Plecanatide (Trulance)
• Lubiprostone (Amitiza)
• Tenapanor (Ibsrela)
• Prucalopride (Motegrity)

These medications can help alleviate constipation, abdominal pain, and bloating. However, they may have side effects, such as worsening bloating, gas, abdominal pain, dizziness, and diarrhea.

Additional Treatment Options for Bloating and Abdominal Pain

In addition to prescription medications, antibiotics like rifaximin (Xifaxan) may help treat small bowel bacterial overgrowth. Dicyclomine (Bentyl) or hyoscyamine (Levsin) can treat gut spasms, while menthol (Ibgard) can help relax the gut.

Risks and Side Effects of IBS-C Treatments

It’s essential to be aware of potential side effects and risks associated with IBS-C treatments, including:

• Worsening bloating, gas, abdominal pain, dizziness, and diarrhea
• Allergic reactions
• Increased risk of upper respiratory infections (URIs)
• Suicidal ideation and worsening depression with Prucalopride (Motegrity)

What to Do If OTC or Prescription Medications Aren’t Enough

If you’re not responding to OTC or prescription medications, your doctor may refer you to a motility specialist or recommend additional testing, such as a sitz marker test or anorectal testing. Behavioral modification or hypnosis may also be beneficial.

By understanding IBS-C and its treatment options, you can take control of your symptoms and improve your quality of life. Consult with your doctor to develop a personalized treatment plan that works best for you.