How to Effectively Manage IBS-C/CIC

Medically reviewed by Elaine K. Luo, MD on March 13, 2017Written by Kimberly Holland on March 13, 2017
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If you’ve been diagnosed with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC), you may find yourself giving your gastrointestinal system a little extra attention from time to time. After all, effective treatments require some attention.

However, if you find you’re thinking about it regularly, it’s possible your treatment plan isn’t working. An effective treatment plan should leave you without symptoms and feeling empowered to live your life. If you don’t feel that way, you may need to adjust your treatment plans or find new ways to handle the symptoms.

How long will I need treatment?

IBS-C is chronic. Once you’re diagnosed, you’ll likely deal with symptoms and need to treat it for the remainder of your life. An effective treatment plan eases symptoms, reduces the likelihood of flares, and helps you regain a sense of control over your day-to-day life.

If treatments for IBS-C are successful, you might only think about the condition from time to time. If treatments aren’t effective, you may find that you think about what you eat, how you feel, and what you can do to feel better entirely too much.

Unlike treatment for IBS-C, treatment for CIC may not be ongoing. CIC is recurring constipation. Periods of constipation may last for several weeks or months. After that time, symptoms stop, and your bowel movements could return to normal. Treatment may only be necessary when you’re experiencing constipation or difficulty having a bowel movement.

What are the treatments for IBS-C and CIC?

Treatments for IBS-C and CIC are similar because the symptoms are similar. The primary focus is on relieving symptoms. However, treatment for IBS-C is a bit more comprehensive.

Because IBS-C is chronic, treatment plans should be designed to ease symptoms and prevent future issues. You may have to adjust treatment, especially during times of stress and change, but the treatment goal should be the same.

The goal of treatment for CIC is to ease constipation and improve your body’s ability to properly move waste through your intestines. The treatments are usually only needed temporarily, but certain lifestyle changes may help prevent future issues with constipation.

How is IBS-C treated?

Treatments for IBS-C fall into three main categories:

Dietary changes

Focus on fiber: Certain fiber-rich foods are known to make symptoms of IBS-C worse. These include foods that can cause gas like cabbage, beans, broccoli, and asparagus.

Some high-fiber foods may help ease constipation, but use them with caution if you have issues with gas and bloating. Introduce them to your diet slowly over the span of a few weeks. Suddenly increasing the amount of fiber you eat could make the situation worse.

Eliminate trigger foods: The best way to identify problem foods may be a food journal. Record what you eat, when you eat it, and any symptoms you experience after eating. Then work with your doctor to identify possible trigger foods.

Trigger foods include gluten, fatty foods, alcohol, and certain fruits and vegetables. These foods may cause symptoms or make symptoms worse. Stop eating them, and then slowly reintroduce them one at a time. You can work with a registered dietitian to do this.

Ponder probiotics: Probiotics are healthy bacteria. They’re present in your gastrointestinal (GI) tract, but sometimes their level isn’t sufficient enough to maintain proper GI health.

Research shows eating foods with large amount of probiotics can improve symptoms of IBS. Probiotics are found in foods like yogurt, sauerkraut, and kombucha. You can also take supplements that contain high doses of the bacteria.

Medications and supplements

Consider fiber supplements: High-fiber foods come packed with a host of healthy benefits, like vitamins and nutrients. However, they can sometimes make IBS-C symptoms like bloating and gas worse.

Fiber supplements such as Metamucil and Citrucel may actually be more beneficial. They give you the extra bulk you need without the other symptoms. Be sure to drink plenty of water each day to reduce possible side effects.

Look for prescription options: Lubiprostone (Amitiza) is a prescription medication that increases the amount of fluid your small intestine secrets. With more fluid, your body may be able to pass stool more easily.

Currently, this medication is approved for use only in women ages 18 and older. This medicine is also typically only prescribed to women with IBS-C who have found little success with other treatment options.

Be cautious with laxatives: Over-the-counter medications may seem enticing as a quick fix, but they can actually cause you more problems if not used correctly. Before you use one, talk with your doctor or pharmacist. This is especially true if you already take medications for IBS-C.

Lifestyle changes

Boost your healthy lifestyle: Small changes in habits can have significant impacts on your overall health.

Drinking plenty of water each day can ease constipation. Eating a balanced diet will help you get adequate nutrients and a constant supply of fiber.

People who are sedentary are more likely to experience constipation, but regular exercise stimulates the GI tract’s normal function.

Protect your mental health: Research suggests a strong relationship between stress or anxiety and IBS. Finding ways to manage stress, reduce anxiety, and cope with changes in your life may help reduce your symptoms and prevent future flares.

How is CIC treated?

Treatment for CIC falls into three main categories:

Lifestyle changes

Focus on fiber: Before you reach for an over-the-counter laxative, consider that what you eat may impact how your bowels work. Fiber adds bulk to your stool, which can make passing a bowel movement easier. Increase the number of fiber-rich foods in your diet, but start slowly. If you eat too many high-fiber foods at once, you may experience bloating and stomach pains.

Get moving: If you sit the majority of your day, a little movement may make a big difference. Regular exercise boosts muscle activity in your intestines, so take 15 to 20 minutes each day to go for a walk around the neighborhood.

Medications

Look into laxatives: Several types of laxatives are available over the counter. Some are better than others for people who experience chronic constipation. Before you pick one up off the shelf, ask your pharmacist for a recommendation.

Using laxatives too frequently may cause unintended side effects, including dehydration, electrolyte imbalance, and possibly increased constipation.

Talk about prescriptions: Prescription medications are available for people with CIC. Each one works a little differently, so talk with your doctor about your primary concerns or most vexing symptoms.

Lubiprostone (Amitizia) is available for women age 18 or older who experience chronic constipation. It draws water into your intestines, which can improve how well bowel movements pass.

A second medication, linaclotide (Linzess), also draws water into your intestines to speed up stool movement.

Surgery

Remove blockages: If the constipation you’re experiencing is the result of a blockage in your GI tract, surgery may be the best option. Anal fissures or strictures may prevent bowel movements from passing through your GI tract normally. That can lead to constipation, which can cause additional symptoms of GI distress.

Remove portions of the colon: As a last resort, your doctor may suggest removing a part of your colon. This is an option, but it’s one doctors rarely use.

Which treatments are most effective?

The most effective treatment is the one that eases or stops your symptoms and helps you feel in control of your condition. Your first line of treatment may not be enough, and you’ll need to adapt with a new strategy.

For many people, a holistic approach can help tremendously. This allows you to make meaningful lifestyle changes that can ease symptoms, and you can use medication or other traditional treatments as prescribed by your doctor.

For example, you may find great success with diet changes, including eating more probiotics, while also taking medications during IBS flares. A treatment approach that helps you feel in control is the one that’s best.

Now that you know about the wide variety of treatment options for both IBS-C and CIC, consider talking with your doctor about the ones you want to try. Schedule an appointment, write a list of questions you have, and start feeling empowered to make changes for your health.

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