Most people with irritable bowel syndrome (IBS) suffer from diarrhea, but a small group has either constipation or alternating constipation and diarrhea as their main complaint. Constipation is a very common problem and is estimated to be the cause for approximately 2 million doctor visits each year. Fortunately there are several ways that constipation can be treated or avoided altogether.
Adding fiber to your diet. People with constipation (including those with constipation-predominanat IBS) are often encouraged to add more fiber to their diet. However, for people with IBS, the type of fiber is very important. There are two types of fiber: soluble and insoluble. Soluble fiber has several benefits that may also reduce symptoms of IBS. Fiber may help prevent spasms because it keeps the colon somewhat distended and it absorbs water, which helps to keep stools from being too hard and difficult to pass. There should be enough fiber in the diet to insure that stools are soft and pass painlessly and easily. Initially switching to a diet higher in fiber may increase gas and bloating, but these symptoms should decrease in a few weeks as the body becomes adjusted. Fiber supplements are also an effective way of adding fiber to the diet.
Drinking enough water. Dehydration is a widespread problem; many people are not even aware that they are dehydrated. Chronic dehydration can lead to constipation. To stay hydrated, drink water each day (8 glasses of 8 ounces each is recommended), and avoid caffeinated drinks which are dehydrating. Sipping water slowly throughout the day -- especially before, during and after exercise -- is best.
Getting more exercise. Lack of exercise is another frequent contributor to chronic constipation. Most of us know that exercise is important to our overall health, but it can also be helpful to relieve constipation. The US Surgeon General recommends at least 30 minutes of exercise (even brisk walking is better than no aerobic activity) most days of the week for better overall health.
Use laxatives with care. Severe constipation may prompt the use of laxatives. Laxatives are readily available over the counter, but they should be used with caution as they can be very harmful to the colon if abused. Over time the laxatives will damage nerves in the colon causing the colon to be unable contract and pass stool through on its own. The overuse of enemas is associated with the same undesirable effect on the nerves in the colon. Several foods are considered natural laxatives, and while people with diarrhea predominant IBS will want to avoid them, they may be helpful for constipation predominant IBS.
Avoiding complications. Chronic constipation may lead to complications such as hemorrhoids or, less commonly, anal fissures.
Hemorrhoids. A hemorrhoid is actually a form of a vericose vein that can occur after straining to have a bowel movement. Symptoms include itching, burning, pain, and bleeding. Bleeding from a hemorrhoid is usually bright red, and more often seen on the toilet paper than in the bowl. Always get rectal bleeding checked out by a doctor, even if you suspect it is due to a hemorrhoid.
Anal fissures. A fissure is a tear or ulcer in the lining of the anal canal which is the last part of the rectum before the anus. Symptoms of a fissure include painful bowel movements, bright red blood in the toilet bowel or on toilet paper, anal lump, or swollen skin tag. Fissures are treated by lessening pressure on the anal canal by making sure stools are soft and ease discomfort or bleeding.
Constipation can typically be resolved by using the methods above. Additionally, fiber, water, and exercise are also effective tools in preventing the onset of constipation.
Soluble Sources of Fiber
Psyllium husks (Metamucil)