Daily IBS-C Treatment: What Helps?

Living with irritable bowel syndrome with constipation (IBS-C) means coping with bloating, pain, irregular bowel movements and other IBS-C symptoms. Finding an IBS-C treatment can leave you feeling better.

While you might be wondering about the best laxative for IBS constipation, there are other important treatment options for IBS-C, including dietary changes, lifestyle changes, and non-laxative medications. In fact, certain laxatives could make symptoms worse. 

IBS-C Treatment With Medication

If you’re constipated, often defined as having fewer than three bowel movements in a week, you might find yourself reaching for laxatives, a type of medication that increases bowel movements. However, laxatives may or may not be part of your treatment plan for IBS-C, since treatment for IBS-C is different from treatment for constipation.

While laxatives can help with bowel movements, they don’t address the other symptoms of IBS-C. In addition, they’re not meant to be taken frequently. Dietary and lifestyle changes may also be needed. You can use laxatives or other medications when your symptoms are particularly severe. Here’s an overview of ISB-C medications, including the best laxative for IBS-C.

Over-the-Counter Options 

The best OTC treatment for IBS-C are bulk-forming laxatives. These medications use fiber products to bulk your stool. The ingredient psyllium is the best laxative for IBS-C, because it can reduce inflammation in the gut. Psyllium is found in laxatives including: 

• Konsyl
• Metamucil
• Perdiem

Other bulk-forming laxatives that can treat IBS-C include: 

• Citrucel
• Benefiber
• FiberCon
• Fiber-Lax
• Miralax

People with IBS-C shouldn’t use osmotic laxatives, like Miralax. These laxatives work by drawing fluid into the intestines. However, they don’t help with symptoms of IBS-C, including pain. In addition, pain can be a common side effect of these medications, meaning they can make your IBS-C symptoms worse, rather than better.

Prescription Options

There are a number of prescription medications that can help manage IBS-C. One of the most effective is plecanatide, sold under the brand name Trulance. This medication, called a guanylate cyclase activator, addresses both constipation and pain. It can address other symptoms of IBS-C such as bloating and cramping.

Other prescription medications that are approved for treating IBS-C include:

• Linzess (linaclotide) is another type of guanylate cyclase activator. 
• Amitiza (lubiprostone) is a chloride channel activator medication that increases fluid in the gut and gut movement. 
• Ibsrela (tenapanor) decreases the amount of sodium your body absorbs, increasing fluid in your gut. It's a type of medication called sodium/hydrogen exchanger 3 (NHE3) inhibitors.

Antidepressants aren’t specifically approved for treating IBS-C, but they can help with symptoms in some patients. That’s because they interact with neurotransmitters in the gut. Selective serotonin reuptake inhibitors (SSRIs) are the type of antidepressant most often used for people with IBS-C.

IBS-C Treatment Through Diet

Changing your diet can help you manage symptoms of IBS-C. Here are two changes that might help reduce symptoms. Adjusting your diet can be difficult, especially if you have IBS-C. Working with adietitian who is experienced with the condition may help. 

Focusing on fiber

Getting enough fiber can help with constipation. But in people with IBS-C, not all fiber is created equal: Soluble fiber can help with symptoms, but insoluble fiber can actually make symptoms worse.

Try increasing foods that contain soluble fiber, including oats, peas, oranges and carrots. At the same time, limit foods that contain lots of insoluble fiber, like nuts, broccoli, potatoes and wheat.

Low-FODMAPs diet

Some research shows that a low-FODMAPs diet can help with IBS-C symptoms, particularly in the short run. The acronym “FODMAP” stands for “fermentable oligosaccharides, disaccharides, monosaccharides and polyols” and refers to a number of carbohydrates that can make symptoms of IBS-C worse.

The food plan involves eliminating high-FODMAP foods, including wheat, onion, and high-fructose corn syrup. Then, these items are slowly reintroduced, so you can identify which foods cause symptoms for you.

Using Laxatives Safely With IBS-C

If you’re constipated, it makes sense to reach for laxatives. They’re very effective in the short run. They might help relieve constipation, but they won’t address other IBS-C symptoms, like pain and bloating. In addition, laxatives aren’t meant to be used frequently, as they can cause more discomfort and pain.

Talk with your healthcare provider about how and when to use laxatives. While they can be an important tool for treating IBS-C, they shouldn’t be overused. 

Integrated IBS-C Treatment

Research has shown that an integrated approach to IBS-C is the best way to manage symptoms. This means using medications along with lifestyle changes to treat IBS-C.

An integrated approach to IBS-C can include:

• Making dietary changes that work for you
• Scheduling your meals and snacks
• Increasing soluble fiber
• Getting lots of fluid intake
• Therapy and mental health supports
• OTC or prescription medications
• Exercise

An integrated approach is complicated. A healthcare provider who has experience treating IBS-C can help you develop a treatment plan that works for you. 

How to Treat IBS-C During a Flare

When your IBS-C symptoms flare up, they can cause a lot of pain and anxiety. Here’s how to treat the symptoms of an IBS-C attack, or flare:

• Use heat: A hot water bottle, heat pack, or warm bath can help ease spasms in the gut and reduce pain.
• Drink tea: Certain teas, including peppermint, black, white and green tea, can soothe symptoms like cramping. Reach for peppermint tea first, since peppermint can help relieve spasms that cause pain. 
• Relax: Stress hormones, including adrenaline and cortisol, can make symptoms worse. Find ways to relax yourself, including deep breathing, gentle stretches, or even distractions. 

Unfortunately, traditional pain relievers like non-steroidal anti-inflammatory drugs (NSAIDs) don’t typically work on IBS pain.

Chronic Management Between IBS-C Flares

Although IBS-C is a chronic disease, it’s possible to cope and live well with IBS-C. These steps can help:

• Prioritize emotional and mental health: IBS-C can take a toll on your mental and emotional health. Therapy and self-care can help you process feelings like shame or frustration. 
• Keep a food diary: IBS-C triggers vary widely. Keep a food diary to help you track what foods seem to make your symptoms worse. This is a great way to take control over your disease. 
• Build your treatment team: Primary care providers, gastroenterologists, therapists, mental health providers, and dietitians can all help you manage IBS-C. Finding providers you trust can take time. Remember, it’s always OK to change providers if you’re not comfortable with your team. 

Learning more about your body’s patterns with IBS-C can help you create a daily schedule and treatment plan that works for you. 

Summary

The best treatment for IBS-C is an integrated approach that incorporates dietary and lifestyle changes alongside medications. While it may be tempting to use laxatives when your constipation gets bad, laxatives shouldn’t be used frequently or they may make symptoms worse.

There are many options for treating IBS-C, so finding a healthcare provider with experience treating the condition and learning how to advocate for yourself are important.