I have IBS-C. Why do I have stomach pain before passing stool?

Question

Hello doctor,

I am 34 years old, and I have had IBS-C for six months. I have noticed that the symptoms vary with the level of stress.

For instance, during times when I am having a hectic week at work, the case of constipation is more common, and my abdomen feels tight and uncomfortable.

However, when I go on vacation, there is some improvement in the bowel movements. Can stress have such an impact on bowel motility?

Moreover, I suffer from lower abdominal pain before passing stools, which is relieved after defecation.

Is this symptom related to IBS-C? Should it be evaluated?

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

Your symptoms are very characteristic of irritable bowel syndrome with constipation predominance (IBS-C). In IBS, the structure of the intestine is typically unchanged, but the functionality of the intestine is affected. This explains the variable nature of the symptoms, depending on the state of mind, food intake, sleep, and habits of a patient.

In fact, stress can significantly influence the motility of the bowels. It is well known that the digestive tract is intricately linked to the brain, which is referred to by physicians as the gut-brain axis. When a person feels stressed or anxious, his or her nervous system gives signals that cause the slowing of bowel motility and increased gut sensitivity.

Most individuals tend to feel better while on vacation or at times when they experience little pressure from their work. Another common sign of irritable bowel syndrome with constipation is the presence of dull pain in the lower abdomen before defecation, which gets better after it.

This is due to the accumulation of stools in the large intestine, which causes the pain to subside when the bowels empty out.

The management will involve the incorporation of some lifestyle changes, such as gradual increases in dietary fiber intake (e.g., through Psyllium), drinking water, exercising, and stress-reduction mechanisms such as yoga, breathing practices, and meditation.

If you still experience constipation despite all this, then stool softeners such as Polyethylene glycol will be recommended.

It is important for evaluation to be done if there are signs such as unexplained weight loss, blood in the stool, anemia, or pain.

Since none of the above signs is present, your condition suggests that you are suffering from IBS-C, a disorder that responds positively to treatment.

I hope this will be useful.

Feel free to contact me for further questions.

Thank you.