Is long-term use of Polyethylene Glycol safe for IBS-C?

Question

Hi doctor,

I am a male patient aged 35 years.

Over a year now, I've been suffering from constipation together with abdominal pain, which reduces once I defecate. My bowel movements occur thrice weekly, and the stools are very hard, appearing like tiny stones. Moreover, I experience excess gases and feeling of incomplete emptying.

I have done simple blood workups and found normal results:

Hemoglobin: 13.8 g/dL.

Thyroid hormones: Normal.

Sugar levels: Normal.

My doctor has diagnosed me with Irritable Bowel Syndrome with Constipation (IBS-C) and given me Polyethylene Glycol powder to be taken daily.

Could you advise on whether this drug can cause any harm to my bowels if used for prolonged periods? Also, could stress be a major trigger for my symptoms? I notice my symptoms worsen whenever I am under office pressure.

Is there a specific diet, such as a low FODMAP diet, that I should follow, and how long should I try it?

I am seeking detailed guidance on how to manage my condition.

Please help.

Answer 1

Hello,

I hope you are well at icliniq.com.

I am very concerned about your fears.

Your complaints, like difficulty passing hard stool, bowels move just three times per week, feeling bloated and gaseous, along with getting relieved from discomfort once you pass motion, match perfectly with irritable bowel syndrome with predominant constipation (IBS-C). Your normal blood test results also favor that this is not a structural disease but a functional one.

The medicine you have been given, Polyethylene Glycol (PEG), is an osmotic laxative. Its mechanism involves the pulling in of water into the stool, making it soft.

PEG is commonly used and is safe even for long-term management of IBS-C and constipation. It neither damages your intestines nor causes dependency.

Yes, stress certainly can make IBS worse. There is a gut-brain axis, and stress may affect transit time, increasing gut sensitivity and leading to bloating and pain. Techniques to reduce stress, exercise, and sleep are useful in improving bowel habits.

Another factor that can help is food. There are some people who do well on a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet. It is done for about four to six weeks, after which a stepwise introduction of foods helps find out individual triggers.

Other ways to improve the functioning of the bowels involve adding soluble fiber like psyllium to the diet, proper hydration, exercise, and maintaining a bowel schedule.

All these, in combination with PEG, will help most individuals suffering from IBS-C have improved bowel movements and symptom control.

I hope this answers your question.

Thank you.