Constipation dominant IBS

Why constipation is common in IBS


Alison Cullen
Nutritional Practitioner, BA (Hons), DN, DNT (Distinction)
@AVogelUK
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An introduction to IBS and constipation

Constipation refers to less frequent defecation which is often painful and hard to pass. This usually results from abnormally slow or weak contractions in the gut. This leads to extra water being reabsorbed from the waste material in the large intestine leaving stools which are hard and either abnormally small (pellet like) or too large.

There is no obvious answer to how often we should be opening our bowels as it can vary from person to person. However, most naturopaths generally agree that we should be opening our bowels at least once a day.

Why does IBS cause constipation?

People with IBS often experience abnormal and uncoordinated bowel contractions. When these are too fast, the end result is diarrhoea. If too weak or too slow, constipation is the outcome.

Constipation may occur alone or appear with alternating bouts of diarrhoea. It is not exactly clear why the contractions aren’t as rhythmical as they should be.

Gut contractions are a result of a so-called gastrocolic reflex, which is activated by stimulation of nerves in the stomach triggering rhythmic movements (peristalsis) of the colon, allowing food waste to travel through the gastrointestinal tract. In IBS, this gastrocolic reflex is in some way disturbed or less coordinated.

Another theory is that the strains of bacteria in the gut (also known as microbiota) of IBS sufferers differ from those found in people without IBS. Generally microbiota can be categorised as ‘good’ or ‘bad’. If the ‘bad’ strains over-populate the ‘good’ strains, symptoms of IBS result.

What can I try at home for constipation?

There are a few simple steps you can take at home which may help to ease constipation:

  • Increase dietary fibre: Dietary fibre is a type of carbohydrate, which is undigestible, arriving in the large intestine to undergo fermentation. There are two types of dietary fibre, soluble and insoluble. Soluble fibre includes foods such as oatmeal, nuts, beans, lentils, apples and blueberries. Soluble fibre absorbs water as it travels through the digestive system which will allow for softer stools. Insoluble fibre is doesn’t dissolve in water and will add physical roughage to stools, encouraging more movement in the bowels. In some cases certain types of fibre may be problematic and if you think this is the case, you may want to consider adopting a FODMAP diet
  • Drink plenty of water: Dehydration can make constipation worse. Drink sufficient water to keep stools softer and easier to move
  • Exercise: Physical exercise encourages rhythmic contractions of the gut to reappear if they are dwindling resulting in constipation. Read our blog on exercise for constipation to learn more about the benefits
  • Go to the toilet, as and when you need to go: Bypassing a loo break can result in excess water from stools being reabsorbed back into your body, resulting in them becoming firmer and even harder to pass. Go as and when you need to go to keep things moving as much as possible.

How can natural remedies help me?

If faeces remain in the colon too long, as well as excess water being reabsorbed into the body, toxins which are in the process of being excreted may also be reabsorbed. A product called Silicol acts almost in a similar way to soluble fibre, binding and excreting toxins from the body which may be useful in the case of constipation.

If you need help to get things moving, a natural product called Linoforce can be really helpful. Linoforce contains dietary fibre and herbs, which will gently stimulate contractions in the colon.

How can my doctor help?

If home and natural remedies do not help, please speak to your doctor. There is a number of prescribed constipation and IBS medicines that can be used to help symptoms and these are appropriate if the condition is severe.

Lastly, if your constipation has come on suddenly or if you notice blood in your stools, make an urgent appointment to see your doctor.

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Here’s what I recommend

As the A.Vogel Digestion advisor, I recommend Silicol® Gel and Molkosan® Original, to help with your IBS symptoms.

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