I have had IBS C with painful spasms which affect motility for 14 years. In the beginning I could get myself out of a bad patch, but now I've developed very bad incomplete evacuation and have been straining to open my bowels. I strain in order to relieve the pain of stool stuck in my rectum/sigmoid colon. I've given up trying to visualise exactly what it is going on but have had CT scans MRI scans and apparently all is fairly normal. The problem is I'm so anxious about the pain and cramps every morning by the time I try and 'go' I'm rigid with anxiety and so strain and perpetuate the problem.
I've tried deep breathing, Nerva (quite helpful but need to repeat it but they make you sign up for a year for £99!) I eat a blameless diet, do EFT and relaxation but I still find it almost impossible not to strain. I resort to Movicol and herbal laxatives once or twice a week. Has anyone any useful tips from experience about how they overcame straining? It's so hard to think of other things with terrible abdominal pain which disappears instantly if I manage to have a bowel movement.
My heart goes out to everyone on this website for the struggle we have and the impasse we find ourselves in and I take so much encouragement from reading about what has helped others and how they cope with this very difficult condition whether C or D or both.
Rozzy
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Rozzy46
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Hi, I am sorry to hear about your situation. I presume that you drink plenty of liquids, with water probably being the best way to hydrate. Are there any exercises that you could do at home or maybe Yoga, Pilates that you could try that my help so that are more relaxed before going to the toilet.
It is completely understandable that the more anxious that we become the more that IBS has impact on our lives.
Thank you very much for your kind response - drinking more water was a good reminder thank you. Also I did a little bit of yoga tonight which didn't help my guts but made me feel more relaxed. It's very good to feel others understand because I fear that most of my friends and family are bored to death with hearing me talk about my gut problems so I tend not to. Thank you
we have a product here in ontario canada, called restoralax, and other generic brands, I take metamucil as well must drink lots of water, but restoralax ensures ease of bowel movements, no cramping, could check if similar product whete you live
Thank you arvine - I'll look into it. I get so much stomach cramp before I take anything that it would be great to find a laxative that didn't create even more painful spasms!
Yes Ivevexperienced those painful cramps , I also have IBS , diverticulosis and spastic colon, so know what you are dealing with, affects everyday life , good luck finding a brand where you live
Thank you Lizziep - I tried lactulose years ago and unfortunately my abdomen swelled up like I was 7 months pregnant! I'm glad it helped you - it's strange how we're all so completely different - I guess it's our unique microbiomes....
So sorry you are feeling this way. I was exactly like this years ago but not as bad these days. I have learned to incorporate different types of foods into my diet. I was always afraid to eat anything and this lead to even more anxiety than I already suffer and even more straining and incomplete evacuation. For years now I've drank plenty of water every day, eat five or six small portions of fruit, seeds and Flaxseed. I cannot tolerate citrus , but many other kinds of fruit are fine, eg: pineapple, strawberries, raspberries, blueberries, apples, pears, and recently Kiwi Fruit which is a marvelous natural laxative. Only small portions of these fruits mind. I have just half a kiwi. A lot of people cannot tolerate fruit I know, I thought I couldn't at one time, now I can't be without it. It's amazing the difference these changes have made to me, no straining and more regularity most of the time. The main thing is to stick to as natural a diet as you can and cut out processed foods. Make your own meals and think about what goes into them. I find sugars don't do me any good at all so cakes and biscuits don't interest me, natural sugars, as in fruit however are beneficial. Do some deep breathing whenever you can, before you go to sleep, it makes you sleep better. When you get up, it will help you relax.
If you're not used to eating fruit, introduce it slowly and before too long you will feel you want to go to the toilet naturally without straining.
I never take any medications for IBS, prescription or otherwise. It's much better to eat natural foods.
Thank you very much for your kind and helpful response. I do eat lots of fruit including a kiwi every day as I see it's been recommended but I think the deep breathing is a good idea. It used to help me quickly - less so these days but I know I'm very anxious just now. May I ask - do you get any pain or cramps? I suffer from these daily which gives me the urge to strain just to relieve the cramp as it goes off once I've had a BM. I'm pleased you've found a way to manage your symptoms - that goes a long way to easing anxiety I would imagine.
Yes, I do get cramps but not all the time, depends what I've eaten and is usually accompanied by ghastly wind, but these symptoms seemed to have subsided since I've made more changes. For 16 years I've been experiencing bowel issues and experimenting for as long. Like you, if I don't have a proper BM in a morning then I'm reluctant to leave the house especially to go walking. If I don't have a BM the anxiety starts and makes it worse. What tends to happen is after a flare up or even just a blip, the regularity goes and I find myself needing the toilet during the day, afternoon rather than the morning which puts everything out and I can't make plans. People don't understand why plans have to be cancelled or changed and I can't very well say it's because I haven't been to the loo first thing in the morning. Have to wait several days then for things to get back on track. What's frustrating is the fact that I am fit and healthy apart from these issues. I try to accept it now for what it is and expect to have flare ups and when I do, I don't panic and start worrying that it must be something bad. I know it will pass and I just have to go with it. It has restricted my life over the years and there's nothing I can do about that if I want to manage it sensibly and have any kind of normal life myself. The deep breathing has really helped me, and walking is great because I breath deeply naturally. I always feel great when I'm out walking, it's just getting out and the initial preparation for it, where I'm worrying about getting through the day without needing to go. Once I'm past this, I don't think about it.
Porridge is a life saver for me and I eat it every day with various seeds on top. I don't eat any other cereals.
I hope you find a way for yourself and start feeling better soon.
Oh so sorry to hear of your problems, I have similar it the moment and, having had bouts in the past I know what an awful thing it is. Hardest thing is to resist the straining which is the last thing one should do. Also, don't take regular herbal laxatives like Fybogel. In my case, it's diagnosed as Tenesmus. In the past, it's been caused by rectal prolapses which were found and treated by colorectal consultant, CT scans and colonoscopy don't show them. If you do have prolapses they may go away on their own but not if you're straining. Easier said than done. I take two glycerine suppositories, no herbal fibres, plenty of water. If get very constipated then milk of magnesia works for me. I'm waiting to see a colorectal consultant for current bout. I try to ignore constant urge to go if no joy after one "go" . Difficult understandably for others to know what awful thing this is. I have an excellent book on the bowel which covers all of various bowel issues. I so sympathize and do urge you to see a colorectal specialist
Thank you gussmithy - I appreciate your understanding of the constant urge to go which is horrible and makes me scared to leave the house for fear of an accident. I now wear disposable pants for peace of mind and I make myself go out but some days I feel too uncomfortable to go far. If I have a decent bowel movement I'm absolutely fine but that doesn't happen very often at the moment. I've seen a colorectal specialist and even had the ghastly and embarrassing 'defecating MRI' in which it was clear I couldn't evacuate the gel but they couldn't find a reason for it other than my failure to coordinate my muscles. I try to practice the 'bulge, brace, widen the waist and bear down' but as yet I haven't retrained my muscles to do what they ought to do naturally!
How absolutely awful for you. I guess my reply wasn't very helpful, I just know that this feeling of needing to go all the time is dreadful. Maybe you need a second opinion from a colorectal person, I really do not know. One thing I do know, is that straining makes everything worse. But it's so difficult isn't it to avoid keep trying? You surely need professional advice/investigation but don't know how you pursue that. Meanwhile, I'm trying to resist going and trying the loo again..... Maybe a beer or three to try to take my mind off it... Be interested to hear if you get a resolution.
I am long term IBSC over time I have learnt that we should try to drink 2 litres of water a day. It helps. Porridge is a gentle fibre. The doc gave me lactulose which worked for a while, but began to upset me. I am now on fiberglass it takes trial and error to work out the correct dose as we are all different. For me half a sache a day is working for now. Fibogel is NOT a drug. It is a high fibre drink. Good luck finding a solution. I cannot tolerate gluten and lactose but now realise that stress also plays a big part in my problems.
Thank you Sandra600 - I take movicol occasionally but I feel very bloated with it though it does work and I'm grateful to have it as an option if things get very uncomfortable.
Here are my tips for IBS-C, which may make you 'go' more easily:
What is your fibre intake like? To improve constipation in the short term you can try ground flaxseed on your breakfast, starting at 1 teaspoon and increasing at 1 teaspoon every 2-3 days - you'll need to consume extra water with it.
These foods are also high fibre:
8-9 Prunes
2 tablespoon chia seeds (soaked for 10-15 mins in milk or non dairy milk with cereal or water)
Shredded wheat (or if GF: Nutribrex)
60g Quinoa
Wholewheat bread
75g Whole grain pastas (if GF: Buckwheat)
2 Hard pears
5 Dried apricots
90g Raspberries
1 orange (contain a natural laxative)
2 kiwi.
I find that I need to have 1 orange or 2 kiwi a day and then another high fibre fruit later in the day to help with BMs. Introduce new foods and any fibre increases slowly, starting with one new thing at a time, waiting for 2-3 days for a response and keep a food diary. You may not need to consume as much fibre as I do.
For breakfast I make a porridge of 4 tablespoon of oat bran and 4 tablespoon all bran (wheat bran), 2.5 small cups of water and microwave for 10 mins. I then mix in 2 tablespoon of chia seeds and 1 tablespoon ground flaxseed and leave to stand for 15-20 mins since the chia seeds need to form a gel. On top of that I place 8 prunes and eat. The best thing to do is to start with normal oats in similar quantities and, if needed, replace one of the tablespoons of oats with oat bran for a couple of days, carrying on doing this every couple of days until you get to 4 tablespoon of oat bran and 4 tablespoon of oats. Then start replacing with wheat bran in the same manner. You can then add the other ingredients one at a time. You might find you do not need the complete 'recipe' to have a BM. All these individual components are down to tolerance e.g. you may not tolerate wheat (see later about Alflorex), so it is best to keep a food diary (I do this on a spreadsheet) recording symptoms for up to 2-3 days after each change.
I also take 30 drops of ginger extract before bedtime to aid motility. You may need to work up the dose to say 7 drop increments each night.
Exercise can help with BMs. The government recommends 150 mins of moderate exercise (e.g. walking as if you are late for an appointment) or 75 of intense exercise (e.g. jogging) per week. I also have a bit of a walk around straight after breakfast to get things moving.
You need to ensure that you are drinking enough fluids (2 litres of fluid per day).
There is some good advice about constipation here:
There are also medications that help IBS-C (constipation dominant IBS). I suffer from IBS-C and have been prescribed Linaclotide for it. I also take Alflorex probiotic which has made me more tolerant to taking in the extra fibre I need for a BM.
Failing dietary measures, you can try Optifibre, which needs to be worked up to a dose according to instructions. You may not need the full dose - watch out for gas and increment to a level that is acceptable for you.
Some people are more prone to constipation due to their intestinal anatomy. Through colonoscopies I have been told that I have a long loopy (redundant) colon. This means that food takes longer to pass through and in the mean time the intestines have more time to suck out water from the stool, drying them out and causing constipation. I have found that I need to consume much more fibre than other people to have regular BMs.
I have also found useful having most of my food at meal times, leaving 4-5 hours of not eating between meals, eating my fruit snack before a meal. This means that your digestive system has time to process each meal. It also allows something called the MMC (migrating motor complex) to run which sweeps food waste from your small intestine into your large intestine. This only happens when you have an empty stomach. When people snack regularly, it prevents the MMC from working properly. I also find the larger meals help to push things along better than drip feeding through snacking.
Dear xjrs - thank you very much - you have some very interesting and helpful ideas. I feel my MMC no longer works like it used to. My IBSC began suddenly after a gastric upset 14 years ago and from having effortless bowel movements after breakfast, there didn't seem to be any normal peristaltic push. I agree about larger meals but I do graze between meals as I have low blood sugar and am advised to keep eating small things - apple, dates, fruit - between meals. May I ask if your regime has resulted in easy comfortable bowel movements?
I think my condition had become particularly bad due to my microbiome being depleted by a regime that I was put on by nutritional therapists, which I regret. I was at the point where I was constantly getting overflow diarrhoea due to impacted stool and I couldn't leave the house. I mostly now have a BM every day. However, I find that if I don't exercise these can be a little more on the hard side, but I am really grateful that I can evacuate at all. I didn't want to become dependent on laxatives. If I exercise regularly on top of the dietary regime, things are a lot easier.
In terms of needing to graze between meals, I used to suffer from hypoglycaemia (low blood sugar) and needed to eat frequently. I now manage this with a low GI (glycaemic index) diet i.e. avoiding sugary or processed foods and having lots of wholegrains. Additionally, I make sure that I have a mixture of carbs, protein and healthy fats with each meal, which reduces the glycaemic index of the carbs. I can now go for hours without needing to eat, which used to be unheard of for me.
After suffering with IBS C for 3 years I finally got to see a gastro and i asked to go linacoltide. I now have one tablet in the morning and a arloflex with calcium I now have a bowel movement everyday after years of constipation if on the rare occasion i feel a bit backed up a take one sachet of Laxido.
Thank you Krisbetty - I think I tried Afflorex and it gave me terrible bloating and wind but maybe I should try it again. So pleased for you that linacoltide and afflorex work for you - it's very encouraging to hear other people's experiences. I agree laxido/movicol are great to have in case of need. Do you have any side effects from linacoltide?
No side effects at all if anything it seems to calm my colon . I also had a anorectal manometry which diagnosed my pelvic floor muscles are very weak and waiting for a specialist physio appt.
Hi there I know exactly how you feel. Each time I feel a need to go I start feeling nervous, as soon as I sit on the seat my nose starts dripping like a tap. A panic anxiety allergy sets in and can't relax so strain and the muscles seize up. It's caused permanent damage, piles and hernias. I realise now it is a reaction of fear from a past trauma from childhood. When I was a toddler I went on holiday with my aunt and my mother was going to come later. The aunt was very strict and scary. When she took me to the toilet block she stood in front of me, but I couldn't go, so she started shouting so loud for ages insisting I go to the toilet immediately. I still couldn't go, I remember being so scared until my Mum arrived. All my life I have not been able to go while away from home or when any one may hear me. Daft isn't it! But small kids can't understand, and some adults don't understand the damage they can cause. The point being, don't blame yourself or struggle with taking this or eating that too much. Worrying always exacerbates. I don't know if you have or had any stresses. It may be something to think about. I am now 80 and happily live alone but I still have the panics if I get constipated. But feel so happy when I have had a substantial BM. Only humans have these problems it seems. I gave up with NHS Doctors a long time ago. they don't really understand how I feel.
Dear loveyourbunny - thank you for your reply and it's incredible but your story is so similar to my own traumatic childhood experiences about going to the loo and not being able to and then needing the loo at inconvenient moments and making my mother very angry with me. The result was I stopped going because I didn't want to upset my mother. This got better when I married and for 35 years my bowels worked like clockwork until I had a gastric upset and then they stopped working. Slowly the anxiety piled on about the fact I seemed unable to return to my normal functioning and so it's gone on for 14 years. Like you I suffer from anxiety about having a bowel movement and 'bashful bowel syndrome' when away from home. I can't go and stay with people because someone might know what I'm doing or hear me! It's so limiting and frustrating. I'm 77 so we're a similar age and I'm very glad to live alone and have an ensuite and a guest bathroom so I have privacy and no one else can bang on the door and ask me to hurry up. That's bound to bring on constipation and a non relaxing anal sphincter. How do you manage these days or does living alone solve the problem for you?
have you tried fibogel I honestly hated it but promised my Gp I would stick with it for a month it not cured me by any means but it’s certainly made going to the loo a lot more comfortable I was like you straining most days and it left me incredibly uncomfortable
Thank you Poppyseed - I have tried fybogel but unfortunately it made me terribly bloated and gave me a stomach ache and didn't relieve my constipation in fact it made it worse. But I know it works for many and am very glad it works for you and that you find going to the loo a lot more comfortable.
Hi whilst I don't have staining I regularly get constipated which affects my back causing back and leg pain that's sometimes so bad I can't go out. For this I take dioctyl regularly which I buy myself, have movingly, which whilst it's good makes the pressure on my back and legs worse until I eventually go, I eat a healthy breakfast, have orange juice in the mornings and every day I eat a pear, or two. Conference pears to be specific - not soft juicy ones but crunchy ones. Chewing is supposed to stimulate your gut so it could gave something to do with that too.Even with all of that and at least 5 pieces of fruit I still struggle on a daily basis.
Lactose is often prescribed to some as it is sweet and encourages fluid to stay in the large bowel. As excrement passes through the gut it's is watery in the small bowel but that fluid is reabsorbed in the large bowel. If you don't drink enough fluids the excrement becomes dry and whilst it's in the large bowel will continue to dry causing constipation hence the need for extra fluids and why something warm and sweet helps.
I suffer these terrible spasms on a daily basis. I never seem able to pass everything that needs to come out, so to speak, and this means vicious pains on and off throughout the day, every day. It's an absolutely nightmarish existence having to suffer with this terrible affliction on a daily basis. The only things I find helpful with the pain are a tens machine and Pregabalin every other day. I can't take it every day as it's quite constipating but it does help considerably with the pain.
Have you had any abdominal surgery? As I have similar issue I can't even strain my Gastroenterologist says he think all the scar tissue after 3 laps is causing the pain.
I haven’t had abdominal surgery but I’ve had surgery around my vagina, perineum and anus which has severed nerves. Maybe we’re both similarly afflicted. I’m so sorry that you’re a fellow sufferer - I think I have tenesmus and anxiety - a toxic combo! What have you tried to help you? Does gentle exercise or massage help at all? So hard not to feel tense especially as I fear an accident because it feels like I could crap myself at any moment except I can’t!! Do you take Movicol or buscopan? I get the most terrible bloating no matter what I eat. It’s a very wearying and embarrassing problem so you have my deepest sympathy.
For one thing, don't do what I did and use a glycerine suppository. It did work but nearly two days later the effect is still going on! I couldn't eat, then this morning felt slightly better, but as soon as I ate something this evening, well there we go again. My dogs are very sympathetic, and try to come into the bathroom with me! I say no, you really don't want to come in here. Anyway things may change for those of us who are struggling. Does everyone have a family who take you seriously on this subject. Mind certainly don't
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How Can I fully evacuate my Bowels?
incomplete bowel emptying
Stomach strain
