Is irritable bowel syndrome causing my constipation at 35?

Question

Hello doctor,

I am a 35-year-old woman who has been dealing with constipation for months. I only have bowel movements two to three times a week, and when I do, they are hard and painful. I eat fiber and drink water, but nothing helps. Laxatives work short-term, but I do not want to rely on them. I would like to know what tests or treatment options can give me lasting relief. Please tell me,

Is this something related to hormones, stress, or medication?
Could there be a deeper issue, like irritable bowel syndrome (IBS )or thyroid problems?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Chronic constipation, like you are describing, hard, painful stools only two to three times per week, can really affect your comfort and quality of life. Though fiber and water help some people, they do not always solve the problem.

The probable causes in your case can be;

Chronic constipation can be due to a mix of factors, like

Sluggish bowel motility.
Poor diet.
Hormonal shifts due to stress.
Medications (like iron, antidepressants, and calcium supplements).
Diseases like hypothyroidism or irritable bowel syndrome, constipation type (IBS-C).

You must know that it is also more common in women and can worsen with anxiety, poor physical activity, or disrupted routines.

I suggest the following investigations,

Thyroid profile to rule out hypothyroidism.
Complete blood count (CBC): To check for anemia or underlying inflammation.
Serum calcium: A high calcium level can slow gut motility.
Stool occult blood test: If any concern for hidden bleeding.
Abdominal ultrasound: In case bloating or pain is prominent.
Colonoscopy: If there is weight loss, anemia, and the patient is over 40.

I can suggest the following treatment planfor you.

Gradual increase in soluble fiber (like oats, psyllium husk/isabgol, and chia seeds) in the diet. But avoid abrupt increases, which can worsen bloating.
Stick to fiber-rich foods like fruits with skin, leafy greens, and whole grains.
Avoid processed foods, red meats, cheese, and refined flour.
Adequate hydration: Aim for two point five to three liters of water per day.
Scheduled toilet time: After meals, when the natural gastrocolic reflex is active, it is good.
Regular physical activity: Brisk walking or yoga improves gut motility
Probiotics: Daily for a few weeks (curd or pharmacy-based).
For short-term relief, osmotic laxatives like lactulose or Polyethylene glycol (PEG) based syrups are gentler and safer for longer use under supervision.
Avoid harsh stimulant laxatives long-term (bisacodyl, senna) as they may lead to dependency.

If symptoms persist despite these, or if blood in stools, unexplained weight loss, or a family history of gastrointestinal issues is present, a gastroenterologist referral is advised for further workup.

I hope this information helps you.

Feel free to ask further queries.

Thank you.