Irritable bowel syndrome with constipation is referred to as IBS-C. People with IBS-C experience constipation-related abdominal pain. This is usually accompanied by a change in the frequency or form of their stools.
When there’s persistent constipation without abdominal pain as the main symptom, it’s referred to as chronic idiopathic constipation (CIC). Abdominal pain isn’t a predominant or frequent symptom in CIC, which is the main distinction between the two conditions.
Abdominal discomfort is a symptom that’s frequently present in IBS-C, but it can also occur sometimes in people with CIC.
Both IBS-C and CIC will have persistent constipation symptoms. Both can have abdominal pain. But abdominal pain isn’t a predominant or frequent symptom in CIC.
Symptoms associated with IBS-C and CIC include:
- abdominal pain
- abdominal bloating
- straining during bowel movements
- passing stools that are hard, dry, or lumpy
- feeling that a bowel movement is incomplete
- changes in bowel habits
The primary distinction between the two conditions is abdominal pain related to bowel movements.
While pain isn’t the major symptom and is neither frequent nor severe in people with CIC, it’s the predominant complaint in those with IBS-C. The primary symptom that sets CIC and IBS-C apart is abdominal pain.
IBS is a functional gastrointestinal (GI) illness that has multiple underlying causes. It’s a disorder of the gut-brain interaction.
Visceral hypersensitivity, immunological response, gut microbiota, gut motility, and central nervous system processing of visceral information are the ways in which altered brain-gut interactions are manifested.
While CIC can also be considered a brain-gut disorder, abnormal gut function and motility are the main issues.
Because the underlying causes of IBS-C and CIC are unknown and neither ailment has a specific test, diagnosing these conditions can be difficult. Eliminating other potential causes of these symptoms is part of the diagnostic process. This is called an exclusionary diagnosis.
If all other scenarios have been ruled out, IBS-C or CIC are the likely cause for a person’s symptoms. The particular symptoms a person has and how severe those symptoms are determine whether they have IBS-C or CIC.
To diagnose these conditions, I conduct a physical examination and go through the person’s medical history to determine the cause of their constipation. The workup will often include a blood panel and stool samples. The GI tract may be examined via additional exams such as a colonoscopy, as well as imaging tests such as X-rays or CT scans.
Treatments for IBS-C and CIC may involve lifestyle modifications including diet and exercise. Patients must ensure that they’re getting enough water and increasing their fiber intake through meals or fiber supplements.
Because both types of patients have constipation symptoms, IBS-C and CIC can both benefit from using drugs or treatments that reduce constipation. The main distinction between IBS-C and CIC is visceral hypersensitivity, which appears as stomach pain, bloating, and discomfort in addition to constipation.
If a person has IBS-C, they experience both abdominal pain and constipation. There are several medications that can help with both these symptoms and these are the treatments I consider for these patients.
Both IBS-C and CIC cause chronic constipation and share a number of other overlapping symptoms. IBS-C and CIC are regarded as different syndromes by some criteria, but others contend that they’re both on the same continuum of disorders.
No. Slow transit constipation is a subtype of CIC where the transit time of stool through the colon is slower than normal.
Saurabh Sethi, MD, MPH, is an ABMS board certified internal medicine physician specializing in gastroenterology, hepatology, and advanced interventional endoscopy. He is currently a gastroenterology practitioner in the San Francisco Bay Area.