I have been struggling with constipation for many years now (nearly half of my life), and I recently realised that because I have severe IBS, treating constipation is not that straightforward. When I look up how to treat constipation on the internet, all the obvious advice and tips come up like eat more fibre-rich foods and stay hydrated etc. But when I eat foods that are high in fibre, like bananas and flaxseeds, all it does is make me feel more bloated and it doesn't help with my constipation at all. And when I looked this up I found that apparently many people with IBS don't tolerate fibre very well. I have also tried medication like Fybogel, and fibre supplements like psyllium husk, and with those I just get the same result; severe bloating and no constipation relief. So I just wanted to ask and see if any of you on here who have IBS-C have found a solution for your constipation.
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Crescendo251
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You're right, many people with IBS don't tolerate fibre very well, but it's different for us all. We still need fibre but 'soluble' fibre is best. Anything that contains too much wheat like pasta, wholemeal bread, will cause bloating. For me personally, I've spent many years experimenting and I still have to be very careful. I know that I will be constipated if I give up fibre altogether, so I try to get as much as I can to keep things moving. For me, I can eat more fruits than vegetables, Apples are good but peeled, berries, peaches, pineapples, bananas in moderation. I bake my own bread so I add some Golden Milled Flaxseed to it rather than try to eat it as it is. Psyllium Husk the same but not as often. I eat nothing but Porridge Oats every morning, they are soluble fibre, and I add Seeds, Chia, Pumpkin, Sesame, if tolerated, Walnuts. Bread is just plain white which I bake with no additives. Of course, these are just preferences of my own that I've found I can tolerate, it's a game of trial and error as I'm sure you will know.
Anxiety and Stress play a huge part too, not just food. Take Care
Another thing to try is going gluten free. That has really improved things for me. I put a desertspoon of crushed flax seed on my cereal in the morning. Windeze also helps with bloating. Everyone has different tolerances. I can't eat sausage meat, apples or grapes! Do keep a food diary and see what makes it worse.
I also have had chronic constipation for years. I have to use two suppositories to have any chance of opening my bowels. I recently gave up daily fibre supplements (Fybogel) after reading a good book about the bowel - this has improved things a lot. Too much fibre means there's no bulk to push on. For relief on my occasional periods of several days constipation I use Milk of Magnesia.
I use Now magnesium caps 400 mg, I take three at bedtime this dosage was recommended on Dr. Allison Siebecker‘s website. She recommends 1000 mg plus for constipation, I also take one pro Prucalopride tablet half an hour before breakfast. I also have fibre in the day, but if you can’t tolerate fibre just try the they have helped me get off over the counter laxatives i.e. Dulcolax et cetera. The other make you could try is Cosmocol they are an osmotic laxative in a sachet that you take at bedtime. The dosage varies on how many you need.
Here's my general advice about IBS-C - though the key is to try to improve tolerance to fibre before making increases in fibre as I have suggested below. For me, this was done with Alforex probiotic and Linaclotide (on prescription). Though I would try Alflorex on its own first, on a 3 month trial, since you may not need the Linaclotide. The probiotic helps to break down complex carbs, reduces gas producing bacteria and helps to kick into touch dominating bad bugs that might be contributing to IBS symptoms:
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. Additionally, there are a number of mechanisms that help propel food through the intestines. One of these mechanisms is something called the MMC (migrating motor complex) which sets off 'cleaning waves' that sweep 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 and could hinder this 'cleaning' activity. I also find the larger meals help to push things along better than drip feeding through snacking.
have you seen a gastro doctor? They can do motility tests on you and prescribe medication that can help sleep up the system and check for other problems it is well worth seeing a gastro if you have not started that journey already as self treatment only goes so far and can mask a medical problem so it’s best to talk to a professional xx
You need a motility specialist doctor they should so gastric emptying tests and a shape study to test the motility in bowel there are loads more tests they can do but if you have delayed gastric emptying there are some medication that can speed up the process and there are also medication for slow transit constipation to save you using laxatives there are medications you can take long term Prucalopride is one of them xx
i dont think what other people take or do works for anyone else were all different and react to things different its all a matter of experimenting and finding for yourself what helps you
Like You i have tried everything but i have now given up gluten refined sugar and alcohol and now take linacoltide and hour before breakfast and 2 amitriptyline before bed, it has definitely increased my BM to at everything other day. I have a very slow mobility too. I do try and drink lots more fluids very day.
Hi crescendo I have a few thing I turn too like prunes. dates.liquorice.dried fruit.and as a cheat bounty chocolate as I find the coconut. also helps until the blockage eases I also have diverticulitis so I just sort of play it day to day hope any of these help.x
I wish I knew the answer . I do know how hard IBS d and c are. I had chronic gas, pain bloating d for about 6 years. The d changed into c for the next 5 years. I tried every diet or way of improving things including the suggestions I read in replies here. None helped me to get back to normal. Only an occasional course of antibiotics helped , but after a few months all the problems would return. I had my gallbladder removed recently due to a blocked bile duct and since then my bowel problems are better. It is too soon to say if this is temporary or not but it is great to be free of c. I have been told my bowel is long , loopy and floppy which could add to the cause of my symptoms. Doctors tell me they are unsure of the cause of IBS and many bowel symptoms. I think much is trial and error. Good luck.
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