8 Tips to Manage IBS with Constipation
If you struggle to use the restroom on a routine basis, you likely experience a lot of discomfort and pain from these irregularities. About half the people with Irritable Bowel Syndrome (IBS) experience constipation. Constipation can exacerbate other issues such as abdominal pain, bloating, and gas.
Tips to Manage Constipation:
Portion, timing, and hydrating. Before starting a low FODMAP diet it is best to first look at your current eating patterns. Having smaller portions and spacing out meal times will allow food to pass through your digestive tract with more ease. Increasing your fiber can help bulk stools and move them along, but it is important that you also stay well hydrated. If you are not seeing improvements with your bowel movements with these changes, then it could be time to start a low FODMAP diet. But this is a complicated diet, and is best done with a dietitian.
Review Medications and Supplements. Several medications and supplements can have a side effect of constipation such as pain medications, iron, or calcium supplements. Your doctor or dietitian can help review your medications to see if they are contributing and come up with a treatment plan.
Increase Fiber Intake. Most western diets do not consume adequate fiber. We need at least 25-30 grams per day. But gradually increase fiber to avoid further bloating or gas. Not all fiber is created equal either. A lot of fiber sources are removed on the Low FODMAP diet. Some high fiber sources that are typically tolerated are: blueberries, raspberries, strawberries, kiwi, quinoa, brown rice, canned chickpeas, canned lentils, broccoli crowns, carrots, and make sure to eat the peel on potatoes. If needed, talk to your dietitian if a fiber supplement would be ideal for you.
Try Probiotics. By adding in probiotics, you are increasing the number of healthy gut microorganisms in your intestines. This can help with bulking of stools, and with consistency of stools. There is a wide variety of options of probiotics, so work with your dietitian on supplements that have been show to benefit IBS.
Consider Magnesium Supplement. Magnesium can have a laxative effect, and several magnesium rich foods are eliminated on a low FODMAP diet or not tolerated with IBS. So, supplementing with magnesium can be helpful.
Toilet Posture. It is true that there is proper ergonomics for improved defecation. The traditional toilet with your fleet flat on the ground, puts a curve in our colon making it more difficult to pass a stool. However, if you raise your knees above your hips and bend forward, this can "unkink" your rectum to allow for an easier bowel movement. I recommend getting a stool such as the discreate squattypotty, ore even stack books to place your feet on.
Regular Exercise. Exercise has several benefits, and one of them does help to ease your constipation. By moving your body you are allowing gravity to do its work and encourages your intestines to contract to move stools through. This can be as simple as a daily walk.
Schedule an Appointment with a Pelvic Floor Specialist. A pelvic floor specialist is a physical therapist that treats incontinence, difficulties with urination and bowel movements, constipation, and chronic pelvic pain. About a quarter of people with constipation may suffer from dyssynergic defecation, which is where your pelvic muscles don't coordinate with the surrounding muscles and nerves to pass a normal bowel movement (1). They will assist on the best course of treatment for this condition.
The low FODMAP diet can bring relief for IBS with constipation. However, you may need additional treatment beyond FODMAPs for long term control of your constipation. Work with a dietitian to identify the best care plan for your individual needs.
University of Iowa Hospital and Clinics. Dyssynergic Defecation. Retrieved from: https://uihc.org/health-topics/dyssynergic-defecation#:~:text=Dyssynergic%20defecation%20is%20a%20condition,the%20rectum%2C%20uterus%20and%20bladder. July 9, 2020.