Are long-term laxatives safe for my cousin with IBS-C at 35?

Question

Hello doctor,

My cousin is 35 years old and has been struggling with constipation and abdominal discomfort for about a year. She often passes hard stools only once every three to five days and feels bloated most of the time. She also complains of gas and occasional nausea.

Her hemoglobin is 10.9 g/dL, CRP is normal, and the colonoscopy was normal. She recently lost around three kg because she feels uncomfortable eating large meals. Doctors suggested IBS-C, but we are worried that something more serious could be missed. Please tell me;

How is IBS-C confirmed?
Are medications like laxatives safe to use long term?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I want you to understand that irritable bowel syndrome with constipation (IBS-C) is usually diagnosed based on symptoms and by ruling out other serious diseases. There is no single test that confirms it.

Doctors look at the pattern of symptoms over time. Common symptoms include:

Constipation with hard stools every few days.
Abdominal bloating.
Gas.
The feeling that the bowel has not emptied completely after passing stool.

When tests such as colonoscopy, inflammation markers like C-reactive protein, and routine blood tests are normal, and the symptoms have been present for several months, this condition becomes the most likely explanation.

The mild anemia and the small amount of weight loss should still be watched carefully. However, the normal colonoscopy result is reassuring because it makes serious conditions such as colon cancer or inflammatory bowel disease very unlikely. In some people, bloating and discomfort can reduce appetite, and eating less can lead to slight weight loss.

Treatment usually begins with lifestyle and diet changes. These include:

Gradually increasing fiber in the diet, especially with fiber supplements such as Psyllium (bulk-forming laxative), can help regulate bowel movements.
Drinking enough water every day.
Staying physically active.
Trying to go to the toilet at the same time each day can also improve bowel habits.

If these steps are not enough, doctors may recommend medications that help soften the stool and draw water into the intestines. Examples include Polyethylene glycol or Lactulose. These medicines are commonly used and are generally safe when taken under medical supervision. In some situations, doctors may also prescribe medicines that are designed specifically to improve bowel movement and reduce bloating in people with this condition.

Although this condition can be uncomfortable and may last for a long time, it is not dangerous, and it does not damage the intestines. Regular follow-up with the doctor is still important so that symptoms, anemia, and the response to treatment can be monitored. With proper management, many people are able to control their symptoms and feel much better.

I hope this helps.

Thank you.