Hi, I have been diagnosed with IBS. My main symptom is constipation, which builds up no matter what I eat or drink and is accompanied by severe bloating and flatulence to the point where (especially in the evenings) I cannot be around people. I almost constantly feel as though I need the toilet but often am unable to go or can only pass small hard stools. When I do go to the toilet it is often urgent and I still feel as though I have not emptied my bowels properly.
I have tried different diets (low fodmap, dairy free, gluten free, increasing fibre) but none have made any difference. I have tried various laxatives. Several (including laxido, fybogel, and lactulose) have made my stool softer but I still could not empty my bowels properly and would have to go urgently several times throughout the day (to the point where I could not leave the house). Dulcolax did empty my bowels but I also had the worst cramps ever so cannot take it again. Senna had no effect.
Does anyone have any suggestions for other things I can try or has been experiencing similar symptoms?
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Emeraldtiger1
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I have IBS-C and this is how I manage it, which mainly relates to diet, but you say increasing fibre doesn't help, but I'll post it anyway:
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.
Thank you for your advice! I already eat two kiwis a day and oranges but will try adding flaxseeds and chia seeds into my diet. I have also been recommended linaclotide but am unsure whether I should try it. How have you found it?
The maximum pain effects are felt with Linaclotide after 10 weeks. At that point my pain was reduced by 50%-60%. When I added in the Alflorex the pain was reduced to zero (except when I eat something I am still intolerant to). In terms of the 'C', unfortunately it doesn't help me there, but I know it certainly does for others - everyone is different. This is why I concentrate on dietary measures for the 'C'. I was happy to take it since it acts locally in the gut and is broken down into peptides which are eliminated in waste.
Hello. I have chronic constipation too. Relatively recently I have gradually given up herbal laxatives like Fybogel because apparently they stool too much and one needs bulk to push on. Also body can become kind of addicted. This approach has improved things for me, when things get too bad I take milk of magnesia which clears things. But this approach may not work for you, we are all different. I also have a feeling that I need to go a bit later even after emptying bowels TENESMUS apparently. In my case due to internal rectal prolapses which I occasionally get treated by banding which sometimes works for awhile. I do know how distressing this condition can be. If you haven't already, then if advise seeing a colorectal consultant.
I only take occasionally when several days being blocked. Instructions on label, trial and error - I take about one añd a half cap fulls last thing at night. Hope you're situation improves. Understandably, our symptoms not always given much attention by others, " it's not cancer is it" one GP told me.
I only take occasionally when several days being blocked. Instructions on label, trial and error - I take about one añd a half cap fulls last thing at night. Hope you're situation improves. Understandably, our symptoms not always given much attention by others, " it's not cancer is it" one GP told me.
Thanks, I'll try it. Yeah I've found GPs and gastroenterologists to be very dismissive of my symptoms because all the tests come back normal. They have been very reluctant to do further testing to try and figure out the cause of my problems, instead prescribing laxatives which just make things worse.
Still think it worthwhile seeing a colorectal man/woman. Better than gastroenterologist for your symptoms. Yes sometimes daily laxatives are not what you need.
Hi, in a similar predicament to yourself and got diagnosed at the beginning of this year too. After months of trial and error I'd find that I'd become intolerant to a lot of diary products and wheat products seem to make me more constipated so like yourself have opted for a more Gluten and dairy free diet.
First is to eat little and often, it's hard to want to make 4/5 meals a day so try and meal prep or get things in that are easy to pick up like Bananas, nuts, make smoothies, rice dishes, mashed potato freeze it and so it's easy to reheat just as ideas.
Currently I'm taking Laxido (Movicol) and it's definitely a balancing act, start slow (2 first day as an example) and after a few days of 1 a day I'd suggest give a day break between taking them as I've found that's when they seem to edge toward giving diarrhea instead, but that's just been my experience yours may be different.
Peppermint oils, 6 a day has helped in a little way shift some wind and bloating feeling.
Exercise, when people say this to me I always imagine running around the block (which how can you do when in pain and stuck on the toilet right?)
I mean stretches, straight out of bed, after meals, try and stay somewhat mobile after food instead of sitting and hunching after meals too.
I've also been taking Alflorex probiotics, I tried 3 other probiotics and none others have worked like these have so I'd contemplate giving them a try aswell, as I did from a recommendation from this forum.
Hopefully some of this experience and information is of some help to you as I know I looked for information myself to try and find what would work when thing became difficult, but it's unfortunately all a balancing act to find what works for your body. Good luck and take care
Thank you! I am already pretty active and do stretches or go for a walk after a meal when possible. I am taking peppermint oil at the moment but haven't noticed any difference unfortunately. I will try the Alflorex probiotics, thanks.
Peppermint tea or Colpermin for the gas and bloating. Flax (small amount on cereal), prunes are useful - also kiwi but only in small amounts to see how it works. I have also found the ginger shots you can buy in M and S and other places seem to work to get me moving. Drinking water also after eating.
I find magnesium citrate or magnesium oxide at night is pretty effective. I’ve also heard that psyllium husk is a helpful added fibre, especially if you have IBS C/IMO, so I am about to try that. Fibre is tricky, as insoluble fibre can make IBS worse. Soluble fibre may be better. Have you had hydrogen and methane breath testing? If you have bacterial or methanogen overgrowth, you need antibiotic or herbal microbial treatment. Methanogens produce methane, and this gas is known to slow motility by keeping your gut muscles contracted, so things don’t move. I’ve found that the AIRE 2 device for monitoring your gas breath levels at home has been very helpful, and isn’t that expensive. It measures hydrogen and methane levels, and you can tell what food is causing higher levels day by day.
Thank you! I've tried magnesium citrate but it hasn't helped. Yeah my dietitian has recommended increasing soluble fibre rather than insoluble fibre but so far I've not seen any improvement. I haven't had any breath testing as it's not available on the NHS, but I'm looking at going private for it.
I have a bowl of fruit every day consisting of Apple, Pineapple, Berries of some sort, Banana not too ripe, Blueberries, also use ground Golden Flaxseed in my bread making, eat seeds every morning on top of porridge, eg: Chia, Sunflower Pumpkin, Sesame. Drink lots of water through the day. I've recently been trying Pasta but not wheat pasta as I can't tolerate that. This Pasta is made with Yellow Peas and is just like regular pasta. It's really nice and packed with fibre. I used to have a lot of constipation but not so much these days. Ginger is another thing, if I feel like I'm getting constipated, I take a Ginger Capsule after my dinner.
It's a case of experimenting really. As someone else said on here, exercise such as walking helps get the bowels moving naturally, swimming is also good and cycling, and it's fun to do and keeps us fit. 😉
If you already take magnesium citrate, try two. I normally take one 150 mg. capsule, but if I am having difficulty I will open the capsule and then take one and a half. In very difficult times I have taken two. I also take 3 teaspoons of Metamucil every day. Try to eat a mix of vetables each day, as well. Garbanzos are also helpful, and are OK on the fodmap diet.
Yes l have experienced similar symptoms however managing your IBS is so much more than what you eat which l am sure you are aware of with exercise, sleep etc.
If you need any help with other aspects of managing your IBS please let me know.
Hi, yeah I agree its much more than just diet. I'm sort of at a loss for what to try because no diet changes have helped my symptoms. I get enough sleep and do regular exercise. There's really no reaason why I should be this constipated all the time. Have you got any other advice?
Hi. I try to drink plenty of water and avoid caffeine and alcohol. I also spend at least an hour going for a walk on a daily basis. It gets everything moving and has really helped. I have given up trying to understand why I get constipation or having diarrhoea but l suspect the amount of anxiety and stress l am experiencing at the time has an impact on my bowel movements.
Managing my mental health and getting the right support for the stress and anxiety l experience also helps with keeping all of my IBS symptoms at bay! Unfortunately this isn’t always achievable but l am focusing on getting the support I need.
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