Constipation-Predominant Irritable Bowel Syndrome (IBS-C)

Last Updated: March 27, 2025

Constipation-predominant irritable bowel syndrome (IBS-C) is a subtype of irritable bowel syndrome (IBS) that leads to abdominal pain, bloating, and straining. The exact causes are unknown, but research suggests that multiple factors — such as the gut-brain axis, abnormal muscular contractions, gut microbes, and genetics — could play a role in the disease. IBS-C can be managed with dietary modifications, supplements, and prescription medications.

What is IBS-C?

IBS-C is a subtype of irritable bowel syndrome that is characterized by abdominal pain, bloating, and difficulty passing stool; it affects approximately one-third of people with IBS and has a higher prevalence in women. It is associated with anxiety but not with depression, which distinguishes it from IBS-D.

What are the main signs and symptoms of IBS-C?

The main signs and symptoms of constipation-predominant irritable bowel syndrome (IBS-C) include abdominal pain, bloating, and constipation, which is the most common bowel habit. Individuals with IBS-C often experience straining during bowel movements, and symptoms typically ease after a bowel movement.

How is IBS-C diagnosed?

IBS-C (constipation-predominant IBS) is diagnosed by ruling out other diseases through blood and stool tests because there is no specific test for IBS-C. The Rome IV criteria are used to assess the proportion of bowel movements that are classified as constipation, and symptoms need to occur at least once per week for 3 months to confirm the diagnosis.

What are some of the main medical treatments for IBS-C?

Main medical treatments for IBS-C (constipation-predominant IBS) include osmotic laxatives and guanylate cyclase-c agonists to enhance bowel water retention and motility, as well as antidepressants and antispasmodics to alleviate abdominal pain. Additionally, antibiotic treatment for methane-positive small intestinal bacterial overgrowth (SIBO) has shown some promise in improving constipation.

Have any supplements been studied for IBS-C?

Several probiotic strains have been shown to temporarily reduce symptoms of IBS-C (constipation-predominant IBS), and over-the-counter fiber supplements like psyllium husk and peppermint oil can also help normalize the stool and ease abdominal pain. Additionally, a traditional Persian herbal blend and flixweed have demonstrated effectiveness in improving bowel movement frequency and alleviating discomfort.

How could diet affect IBS-C?

A low-FODMAP diet is not recommended for IBS-C (constipation-predominant IBS), but some individuals may experience increased abdominal distension from high-FODMAP foods. Additionally, eating 2 kiwis daily or 45 grams of dried figs twice per day may help improve IBS-C symptoms.

Are there any other treatments for IBS-C?

In a study, electroacupuncture showed effectiveness in relieving constipation and abdominal pain in participants with IBS-C (constipation-predominant IBS), but the effect of concurrent laxative use during the study remains unclear. Additionally, although traditional Chinese medicine may be as effective as pharmaceutical treatments, many studies on this topic are of low quality and have a high risk of bias.

What causes IBS-C?

The exact cause of IBS-C (constipation-predominant IBS) remains unknown, but research indicates that factors such as the gut-brain axis, abnormal muscular contractions, gut microbes, hormones, and genetics may contribute to the condition. Additionally, a higher prevalence of methane-positive small-intestinal bacterial overgrowth (SIBO) has been observed in people with IBS-C, which potentially relates excess methane production to slowed intestinal transit.

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