Why am I having bloating and cramps along with my IBS-C?

Question

Hello doctor,

I am a 38-year-old woman who was recently diagnosed with irritable bowel syndrome with constipation. I have been experiencing severe bloating and stomach cramps, and sometimes there is no bowel movement for four to five days. When a bowel movement finally occurs, the stool is very hard and painful to pass.

What exactly happens inside the gut that causes these symptoms?
Is this condition related to long-term eating habits, or can it also be genetic?

There is also concern about whether irritable bowel syndrome with constipation can develop into something more serious, such as colon cancer, if it remains untreated for a long time.

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand the concern.

The symptoms described are typical of irritable bowel syndrome with constipation (IBS-C). In this condition, the intestine is structurally normal, but its function and sensitivity are altered. The muscles of the colon may move stool more slowly than usual. This allows more water to be absorbed from the stool. As a result, the stool becomes hard, dry, and difficult to pass.

This can lead to infrequent bowel movements, straining, and abdominal discomfort. In addition, the gut becomes more sensitive to gas and stretching, which explains the bloating and cramps.

Irritable bowel syndrome (IBS) is not caused by something eaten over many years, and it is usually not due to a single genetic problem. Instead, it develops from a combination of factors. These may include changes in the gut–brain interaction, differences in intestinal movement, increased gut sensitivity, stress, and sometimes changes in gut bacteria. Certain foods may trigger symptoms in some individuals, but they are usually not the main cause of the condition.

Importantly, irritable bowel syndrome with constipation (IBS-C) does not develop into colon cancer and does not damage the intestines over time. It is considered a functional gastrointestinal disorder. This means that the bowel appears normal on tests but does not function normally. However, if warning signs appear, such as unexplained weight loss, blood in the stool, anemia (low red blood cell levels), or a strong family history of colon cancer, further medical evaluation may be necessary.

Management mainly focuses on improving bowel function and reducing discomfort. Helpful steps include:

Increasing soluble fiber, such as psyllium.
Maintaining adequate hydration, engaging in regular physical activity, and managing stress.
In some cases, medications may be prescribed to soften stool or improve intestinal movement.

Commonly used medicines include Polyethylene glycol (PEG) as an osmotic laxative, Lactulose, or medicines that improve bowel motility, such as Prucalopride or Lubiprostone. With proper management and lifestyle changes, most individuals with irritable bowel syndrome with constipation (IBS-C) can achieve good symptom control and maintain a good quality of life.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.