If there's one good thing about irritable bowel syndrome with constipation (IBS-C), it's that you've got a lot of options to treat it. You might have started your search for relief with diet changes and over-the-counter remedies. If those didn't help enough, your doctor may have put you on laxatives, antidepressants, or a medicine made just for IBS-C.
But what if you take the medicine your doctor prescribed and you still have symptoms? Or what if your medicine causes side effects that you can't stand?
IBS-C treatments don't help everyone who takes them. And some may be hard to take.
When you see signs that your treatment hasn't relieved your symptoms, work with your doctor to find a medicine that does help you.
Your Symptoms Haven't Gotten Better
The clearest sign that your treatment isn't helping is that you still have IBS-C symptoms like these:
- You poop less than 3 times a week.
- You strain when you poop.
- Your poop is lumpy or hard.
- You have belly pain or cramps.
- You feel the urge to poop, but you can't go or your bowels don't fully empty.
- You've got gas and bloating.
You might want to track your symptoms. Keep a log of the medicines you take and what you ate or did right before your symptoms started. This will help you learn how your medicine and lifestyle habits affect IBS-C symptoms.
.You can keep a handwritten journal or use an app to track IBS symptoms. Share the journal with your medical team so they can see your progress.
The Side Effects Are Too Much
The whole point of taking medicines for IBS-C is to relieve your symptoms. But there's always a chance the drug you take could cause side effects that you didn't expect.
The most common side effects from IBS-C medicines are:
- Diarrhea
- Belly pain
- Nausea
- Headache
- Gas
- Bloating
Rarely, these medicines can cause more serious side effects like:
- Allergic reactions
- A blockage in the intestines
- Trouble breathing
If you have any of these side effects, your doctor might lower the dose of your medicine. Another way to stop side effects is to switch to a different drug.
Understand Your Treatment Options
The first medicine you try may not relieve your symptoms. In that case, a medicine change could be the key to IBS-C relief.
For mild symptoms, you might have started with a laxative to help you go or an antispasmodic medicine to relax the muscles in your digestive tract. If those medicines didn't work, the next step might be to upgrade to a prescription medicine for IBS-C, such as:
- Linaclotide (Linzess)
- Lubiprostone (Amitiza)
- Plecanatide (Trulance)
- Tenapanor (Ibsrela)
- Tegaserod (Zelnorm)
If you still have symptoms, your doctor might add one or more of these treatments:
- Antidepressants
- Cognitive behavioral therapy (CBT)
- Peppermint oil
- Hypnosis
Your IBS triggers and other health conditions could affect your choice of treatment. For example, if you also have depression, an antidepressant can help with both IBS pain and depression. If you only get constipated when you're stressed, CBT eases stress and IBS symptoms.
Work With Your Doctor
A good relationship with your doctor is important. They'll listen to your symptoms, ask about the medicines you take, and find out what you've been eating to see where you can make changes. You may need to see other specialists too, like a dietitian and psychologist who treat IBS.
Your doctor will consider factors like these before making changes to your treatment:
- How long you've been taking the medicine
- How much it has helped your IBS symptoms
- What side effects you have had and how much they bother you
Here are some questions to ask when your doctor suggests a new drug:
- Why did you recommend this medicine?
- How will it help my IBS-C?
- How quickly will it start to work?
- How do I take it?
- What side effects could it cause?
Constipation can be embarrassing to talk about. But if you are honest about your symptoms, it will help your doctor find a treatment that's more likely to work for you.
Add Lifestyle Changes
Making lifestyle changes like these might help your medicine work better and improve your odds of treatment success:
Eat more fiber. Get at least 20 to 30 grams of soluble fiber each day from foods like oats, beans, and broccoli. Fiber helps food move more easily through your GI tract.
Drink extra fluid. Water also helps digested food move through your digestive system. Try to drink about 8 8-ounce glasses a day.
Exercise. It helps your digestive system work better and relieves symptoms like belly cramps and bloating.
Try a low-FODMAP diet. FODMAPS are a type of carbohydrate that your body doesn’t absorb well. Cutting out certain fruits, vegetables, and milk products that have them might help with symptoms like belly pain, cramps, gas, bloating, and constipation.
Manage stress. When you're relaxed, your GI tract is too, and food digests more easily.
Avoid medicines that cause constipation. Those include NSAID pain relievers, high blood pressure medicines, antacids, and iron or calcium supplements.
Tips for Success With a New Treatment
IBS-C is different for each person. That's why your doctor should personalize treatment to you.
Listen to your body and communicate with your doctor. You might need to try a few medicines or change the dose of a medicine you already take. Be patient. With time, you'll find the treatment that manages your IBS-C symptoms.
Show Sources
Photo Credit: Stone/Getty Images
SOURCES:
American Gastroenterological Association: "Pharmacological Management of Irritable Bowel Syndrome with Constipation (IBS-C)."
Canadian Digestive Health Foundation: "How to Treat and Manage IBS-C," "Understanding the Low FODMAP Diet."
Cleveland Clinic: "Irritable Bowel Syndrome," "Linaclotide Capsules," "Lubiprostone Capsules."
Dignity Health: "How to Discuss a Medication Change With Your Doctor."
Gastroenterology: "How to Approach a Patient with Difficult-to-Treat IBS."
Harvard Medical School: "How to Talk to Your Doctor About Medication."
International Journal of General Medicine: "Review of Treatment Options for Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation."
Minerva Gastroenterologica e Dietologica: "Irritable Bowel Syndrome: Diagnosis and Management."
Rome Foundation: "Rome IV Criteria."
