In addition to making it hard to go, irritable bowel syndrome with constipation (IBS-C) can cause other uncomfortable symptoms but there are steps you can take to manage them.
Do your guts just seem to get cranky, even though you’ve been treating your insides well? Can you tell that you’ve got to go, but your colon seems to have other ideas? You might have IBS-C. This is a subtype of IBS, with constipation as the main symptom.
In addition to the discomfort of being backed up, IBS-C can also cause gas, bloating, and abdominal pain. These symptoms can greatly affect your quality of life. When your gut doesn’t feel well, neither do you
Here’s what you need to know about these symptoms, how to manage them, and when to see a doctor.
As many as 18% of people globally have some form of IBS. IBS has four subcategories, based on their predominant stool pattern:
- mostly diarrhea (IBS-D)
- mostly constipation (IBS-C)
- alternating diarrhea and constipation (IBS-mixed or IBS-M)
- symptoms that can’t be defined by the above patterns (undefined or IBS-U)
Most people with IBS, up to 96%, experience bloating. But people with IBS-C tend to feel more abdominal pain and bloating than those with IBS-D.
According to a 2016 survey, bloating was the most common symptom of IBS-C, reported by 80% of participants. This was followed by:
- excessive gas (71.3%)
- abdominal discomfort (64.3%)
- abdominal pain (29.1%)
People with IBS-C also said abdominal bloating was the most bothersome symptom, and it greatly impacted their quality of life. Bloating is a feeling of gassiness and pressure. Some people with bloating also experience distension, which involves swelling and expansion of the belly.
The causes of these IBS-C symptoms may differ from person to person. But here are a few potential culprits.
Small intestine bacterial overgrowth
Small intestine bacterial overgrowth (SIBO) occurs when there’s an increase in bacteria growth in the small intestine. It can cause symptoms such as abdominal pain, bloating, nausea, and diarrhea. It can also drive gas production when carbohydrates are fermented in the colon. Up to 78% of people with IBS also have SIBO.
Gut microbiome
The gut microbiome refers to the bacteria, viruses, and fungi found in your digestive tract. Changes in the gut microbiome might be causing your bloating or abdominal discomfort.
More research is needed to determine what bacteria, or lack thereof, might contribute to these symptoms. However, researchers note that people with IBS who experience bloating tend to have lower levels of certain types of bacteria.
Motility issues
Motility issues may also be leading to feeling bloated or like you’re having a food baby.
Muscles in your digestive tract contract to move foods and waste through the tract. But sometimes, this motility is slowed or impaired. People with IBS-C who also have slower motility exhibit more abdominal distention than those who have a more average rate of motility.
Pelvic floor dysfunction
Pelvic floor dysfunction involves miscoordination and miscommunication between muscles and nerves in the pelvis. This dysfunction can cause issues with emptying your bowel, and a full bowel can lead to bloating, distention, and abdominal discomfort.
Abdominophrenic dyssynergia
Abdominophrenic dyssynergia (APD) involves the simultaneous contraction of the diaphragm and the relaxation of the abdominal wall.
In people without APD, an increase in the contents of the digestive tract causes a relaxation of both the diaphragm and the abdominal wall to help accommodate the added volume. In APD, the diaphragm contracts and descends, causing distention.
Research has found that APD contributes to distension in a number of gut-related conditions, including IBS.
Visceral hypersensitivity
Visceral hypersensitivity (VH) is pain in your visceral organs when they’re performing their usual functions, such as digesting food. VH may contribute to bloating via the complex relationship between the gut and brain.
It’s been reported that anywhere from 33–90% of people with IBS have VH, though it’s more common in IBS-D. People with VH may experience more severe IBS symptoms than people without VH.
Your go-to methods for preventing bloating, gas, and abdominal pain with IBS-C will be unique to your specific situation and what might be causing your symptoms. But a few methods may help.
Taking a probiotic may help if your symptoms are related to changes in the gut microbiome, for example.
If you have APD, a natural preventive option such as practicing diaphragmatic breathing after eating may help. To do this, place one hand on your belly and one on your chest. Inhale slowly and focus on expanding your belly with each breath, rather than your chest.
Laxatives may help with motility issues. You should speak with your doctor about the type of laxative that would best fit your needs and how to properly take it. Some laxatives are only for occasional or short-term use.
Certain laxatives may lead to electrolyte imbalances in certain people. And some can temporarily increase bloating, leading to worsening symptoms.
Dietary changes can also help. You may choose to eliminate artificial sweeteners and sugar alcohols, which can cause bloating.
A non-celiac gluten sensitivity can also cause abdominal discomfort, so you might want to ask your doctor if you should try a gluten-elimination diet to see if your symptoms improve. Research suggests a low-FODMAP diet, one that’s low in fermentable oligo-, di-, and monosaccharides, can help.
You should see a doctor if your bloating, abdominal pain, or gas symptoms have become chronic issues that are impacting your quality of life or if you’ve tried a host of preventive options and they aren’t working for you.
Your doctor may perform an exam, such as a colonoscopy, or order lab tests or imaging tests. Based on findings, they may prescribe you a medication.
Some people may need an antibiotic to help with gut microbiome issues. Other people might need an antispasmodic to help counteract spasms in the gut that may lead to bloating, distention, and discomfort.
Your doctor may also prescribe a medication specifically for IBS:
- Secretagogues help increase intestinal secretions, which can keep waste moving and ease symptoms. They may also help ease pain, discomfort, and bloating. They include:
- lubiprostone (Amitiza)
- linaclotide (Linzess)
- plecanatide (Trulance)
- Retainagogues block the GI tract’s absorption of sodium from foods and drinks to increase water retention in the intestines. They may also help ease symptoms such as pain and bloating. Tenapanor (Ibsrela) is the first medication in this class.
IBS-C is a common cause of abdominal pain and bloating. But other conditions can cause these symptoms, too. These include:
Some of these conditions may coexist with IBS. If you’re experiencing abdominal discomfort, it’s important to speak with your doctor to determine the cause.
