I have constipation. Can diet changes worsen constipation?

Question

Hello doctor,

I am 31 years old, and I have suffered from constipation for about a year. I pass my stool once in three to four days and have feelings of being bloated and heavy in my stomach. At times, I strain a lot when passing stool, and the stool comes in small quantities and is hard.

My GP said it might be IBS-C since blood tests and an ultrasound were normal. But I am still unsure how IBS causes this problem if the intestines look normal. Can IBS-C really cause severe constipation like this?

Also, I notice symptoms get worse when I travel or eat outside food. Is that common with IBS patients, or should I be checking for some other digestive condition?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Passing of stool every few days, hard and pellet-like stool, bloating, and straining are symptoms associated with Irritable Bowel Syndrome with Predominant Constipation (IBS-C).

IBS is characterized by an appearance of the intestine that is generally normal on radiological and laboratory tests; however, there is an abnormality of the function of the bowel.

Slow motility of the colon and increased sensitivity to distention are the factors responsible for constipation, weightiness of the abdomen, and bloating. So yes, IBS-C can sometimes cause quite severe constipation even when investigations are normal.

The problem is related to changes in gut motility and the communication between the brain and the digestive tract (often called the gut–brain axis).

Stress, traveling, irregular meals, dehydration, and altered schedules are among factors that can trigger these symptoms, and this is why IBS patients often get triggered while traveling or eating new types of food.

The management process should begin with some changes in the lifestyle. Slow intake of soluble fibers (such as Psyllium), sufficient fluid intake, physical activity, and regular visiting of the bathroom after eating can help to induce defecation.

Avoiding the intake of processed foods and finding your triggers are other ways to alleviate the condition. In case the above-mentioned methods do not work, then Polyethylene glycol can be prescribed to soften the stool.

Other prescribed drugs may be considered if symptoms persist. It is necessary to consult your doctor if there are signs that warrant a further workup, such as unexplained weight loss, presence of blood in the stool, anemia, continuous severe pain, or family history of colon cancer.

In the absence of these, IBS-C is a very frequent reason for the symptoms, and many patients manage to control their disease effectively through proper diet and medications.

I hope this will be useful for you.

Thank you.