Q. I struggle with constipation and IBS. Kindly help.

Answered by
Dr. Thakre Mahendra Shivram
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 18, 2020 and last reviewed on: Jan 16, 2021

I have struggled with constipation my enter life. It is normal for me, but nonetheless uncomfortable and fatigue-inducing. I often can go up to two weeks without having a bowel movement or feeling that my bowel movements are incomplete. As a result, I tend to feel bloated, especially in the lower part of my stomach. Also, as a kid I was diagnosed with IBS, but never received a medication for it. Sometimes, I have some undigested pieces of food in the stool.

I have tried stool softeners, home-remedies, probiotics, osmotic laxatives, everything I can think of, but neither treatment maintained their effect. I always end up back where I started. I drink about a liter and a half of water daily and for eat a majorly vegetarian diet rich in fruits and vegetables (I occasionally eat poultry and fish) Could a misalignment of my tailbone be part of the cause? Could my anxiety disorder be a factor as well? Is there anything you can recommend that I can do right now given the circumstances. Taking multi-vitamin 18 years old Female 5 foot 1 inch 92 pounds



Welcome to icliniq.

I hope you are doing well. I understand your concern. Based on your symptoms you have a condition called Irritable bowel syndrome (IBS). IBS can be of two types, one is Constipation predominant other is diarrhea predominant. Looks like you have constipation-predominant IBS.

Anxiety can aggravate this symptom Irritable bowel syndrome is defined as recurrent abdominal pain or discomfort at least three days per month in the last three months with two or more of the following: improvement with defecation, onset associated with a change in frequency of stool, or onset associated with a change in form (appearance) of stool.

Alarm feature in IBS which need endoscopic evaluation are.Weight loss, Rectal bleeding, Unexplained iron deficiency anemia, and Nocturnal symptom. IBS is a chronic benign disease. So don't worry.

A low FODMAP diet and a strict traditional IBS diet improve IBS symptoms. (avoid gas-producing foods; a diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) Patients with IBS should exclude foods that increase flatulence (eg, beans, onions, celery, carrots, raisins, bananas, apricots, prunes, Brussels sprouts, wheat germ, pretzels, and bagels), alcohol, and caffeine. Physical activity has benefits in IBS symptoms.

Antidepressants Amitriptyline/ nortriptyline, and imipramine can be started at a dose of 10 to 25 mg at bedtime. Osmotic laxatives (eg, lactulose, milk of magnesia) is useful. lubiprostone in women with IBS with persistent constipation have good result but its long-term safety remains to be established. Antibiotics and Probiotics are not routinely recommended in patients with IBS.

The use of anxiolytic agents in patients with IBS should be limited to short-term. Although irritable bowel syndrome can cause pain and stress, the majority of patients are able to control their symptoms and live a normal life without developing serious health problems. I hope this is useful for you. Regards.

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