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ibs with constipation

IBS with constipation is one of three main types of irritable bowel syndrome, alongside IBS with diarrhea and IBS with alternating constipation and diarrhea. IBS with constipation (or IBS-C) for short tends to be less common than diarrhea-predominant IBS, but there are still many sufferers who find that constipation is their main symptom.

Many healthy people suffer from constipation as well, of course, but the real problem for the IBS with constipation sufferer is that their sensitive intestines may be far less tolerant to constipation, leading to pain and a great deal of discomfort from even minor constipation.

Patients may also find that if they treat their constipation too aggressively they end up with diarrhea instead, swapping one problem for another. Traditional treatments such as fiber supplements can also cause pain and bloating if used incorrectly. Hemorrhoids may be a problem if you are often straining to go to the toilet. Below are a few ideas for the treatment of IBS with constipation.

Fiber supplements

The traditional remedy for constipation is to stuff the patient full of fiber and water and tell them to take more exercise. Although this often works for non-IBS sufferers, because it adds bulk to the stool and makes waste travel through the intestines at a quicker pace, it can cause more problems than it is worth for the IBS constipation sufferer.

If you start out with too much fiber, for example, it can often cause bloating and gas, and may even cause more constipation if you are not taking it with enough water. Also, doctor-recommended forms of fiber such as bran can be very irritating to an IBS stomach, and are full of gluten and wheat which are often causes of food intolerance.

Having said all that, fiber supplements can still be very useful in treating IBS constipation if they are used with care.

Pam says:

'I still have problems but not so often as I used to. I drink Metamucil (psyllium fiber) every day and try to relax, pray or meditate, even do a little yoga. The more I make myself relax and take time to de-stress the better I can manage my problem. I also drink at least three bottles of water a day.'

Some people find that psyllium irritates their stomach, and prefer the methylcellulose product Citrucel or the acacia fiber product Heather's tummy fiber.

Food and diet

Some sufferers find that there are one or two foods that help them go to the bathroom, or even a particular kind of mineral water or drink. It may be worth keeping a food diary to see if you can spot foods which are helping you or making the constipation worse.

Gluten is often cited as a cause of IBS with constipation, and it may be worth trying a gluten-free diet. Note that this is not the same as a wheat-free diet - if you cut out wheat then you could still be eating gluten in the form of rye, oats and barley. It's important to check labels carefully as even foods such as soups can be have gluten added as a thickener.

A nutritionist can help draw up an elimination diet where you cut out foods one by one and gradually reintroduce them to see when your symptoms recur.

Magnesium tablets

Magnesium supplements in pill form can sometimes help deal with constipation (diarrhea sufferers should try calcium instead).


Laxatives are never recommended for long-term use as they can cause real damage to the body. However, for temporary relief they often work well, although some may cause cramping pains. Milk of magnesia is sometimes recommended as a gentle laxative.


Latest News About Zelnorm: Zelnorm has now been withdrawn in most countries, including the US, Australia, Canada and Switzerland.

Zelnorm (called Zelmac in some countries) is a new drug for the treatment of IBS constipation which was approved by the Food and Drug Administration in the United States on July 2004. It increases the movement of stools through the bowels, and is only available on prescription.

It is designed to relieve abdominal pain, bloating and constipation in women - unfortunately it has not been tested on men, although the official Zelnorm website seems to indicate that men may be prescribed the drug as well.

It is intended to be taken for short periods of a few weeks/months at a time rather than for an indefinite period.

A number of contributors to this site have used Zelnorm with good results. Amanda says:

'About two or three weeks ago I started taking a new medicine called Zelnorm. What is amazing is that it actually works! I do not have to go to the chiropractor anymore, my back feels great. I feel way better. I actually go to the bathroom more than once every two weeks. I was not even going to try it because I have taken many medications before and they either did nothing or made me feel worse.'

Gretchen has also had success with Zelnorm:

'Well, I wrote my tale a little while ago and I was desperate. I talked to my doctor for the like 50th time and she said since I had been suffering for about two years that there was enough evidence to show that something was seriously wrong. So I went to a gastroenterologist at the hospital a few weeks later and told him about everything that had been going on.

He put me on Zelnorm which is clearly a drug to treat IBS and works only in women. So far I've been taking it for about a month and it's definitely saved me. I've been going to the bathroom almost twice a day But I've realized that I have to exercise every day in order for the drug to work its way into my system. Hey, I'm all up for exercising if I'm going to go to the bathroom, so you should talk to your doctor too and make sure you're clear so they listen to you.'

Further reading

There are many more personal experiences of IBS with constipation in the Read The Tales section. If you would like to share your own experiences then please contact me.