Introduction

Irritable bowel syndrome with constipation (IBS-C) is one of the most common digestive problems seen in the clinic today. As a doctor, I have seen countless patients who describe their bowel movements as “slow,” “bloated,” or “never comfortable.” Unlike typical constipation, IBS-C involves both changes in bowel habits and increased bowel sensitivity. The good news? You can manage it effectively with the right understanding and lifestyle approach.

Before we dive into treatment, let’s unpack what happens inside your gut when IBS-C strikes.

What is Irritable Bowel Syndrome With Constipation

Irritable Bowel Syndrome with Constipation (IBS-C) is a functional bowel disorder where the bowel looks normal on tests but doesn’t function normally. People with IBS-C often have infrequent, hard stools, abdominal pain, bloating, and a persistent feeling of incomplete evacuation. This is caused by a combination of problems with gut brain communication, slow bowel movements, and desensitization of the nerves in the intestines. Unlike structural diseases, IBS-C is diagnosed by symptoms rather than by scans or lab results. Effective management includes dietary fiber, stress management, and sometimes medication under the supervision of a doctor.

Understanding Irritable Bowel Syndrome with Constipation

The Gut Brain Connection

Your gut and brain constantly “text message” each other through nerves and hormones. In IBS-C, this communication is muddled imagine a slow internet connection that delays each command. The intestinal muscles contract very slowly, the stool becomes hard, and pain signals are heightened even with mild straining.

Unique insight from a doctor: Many IBS-C patients report that their symptoms worsen during exams, night shifts, or family stress. This clearly demonstrates how psychological stress is translated into physical bowel changes through the vagus and enteric nervous systems.

How is IBS-C different from common constipation?

Common constipation is usually the result of low fiber, dehydration, or inactivity and responds well to simple lifestyle changes. IBS-C, on the other hand, involves abdominal pain or discomfort that improves after a bowel movement a defining feature defined by the Rome IV criteria (2016).

Characteristic constipation IBS-C

• The pain is usually absent, relieved after a bowel movement.
• Bloating Mild Common and bothersome
• Stool form hard, dry variable, often lumpy
• Cause Nutritional/lifestyle Functional (gut brain axis)

Signs and symptoms you should look out for

• Abnormal bowel movements (less than 3 per week)
• Hard or lumpy stools (bristle type 1-2)
• Bloating or fullness
• Relief from lower abdominal pain after passing a bowel movement
• Feeling of incomplete evacuation
• Excessive gas and fatigue

According to a 2023 PubMed review, IBS-C affects approximately 5–7% of the global population, with women being almost twice as likely to experience it.

Why does IBS-C occur? Finding the Causes

Slow Colonic Transit

• Some people have a naturally slow colon, which absorbs more water from their stool resulting in dryness and discomfort.

Visceral Hypersensitivity

• Even simple gas or straining can cause pain because the nerves in the gut are overly sensitive, sending exaggerated signals to the brain.

Microbiome Imbalance

Low diversity in gut bacteria, particularly low levels of bifidobacteria, has been linked to IBS-C (Mayo Clinic, 2024). Restoring balance through probiotics and fiber can help.

Diet and FODMAP Sensitivity

Certain fermentable carbohydrates (FODMAPs), found in beans, apples, and dairy, can worsen bloating and pain.

Read in Detail: Natural remedies for constipation

Stress and hormonal factors

Cortisol spikes and women’s hormonal changes may affect bowel rhythm and perception of pain, explaining why many women report flare ups during their menstrual cycle.

How do doctors diagnose irritable bowel syndrome with constipation?

Diagnosis is largely based on the Rome IV criteria and exclusion of other diseases:

• Abdominal pain at least one day a week for the past 3 months

Associated with two or more of the following:

• Related to bowel movements
• Change in bowel frequency
• Change in stool appearance

Additional tests may include:

• Complete blood count (CBC) to rule out anemia
• Thyroid function test since hypothyroidism can mimic IBS-C.
• Celiac serology to rule out gluten sensitivity
• Colonoscopy (if red flag symptoms are present: bleeding, weight loss, family history of cancer)

Moving on to 7 Proven Ways to Feel Better Naturally.

By this point, we’ve understood the mechanisms and triggers of IBS-C. Now let’s explore seven evidence based natural strategies that can truly make you feel lighter, more regular, and more in control of your bowel movements.

7 Proven Ways to Feel Better Naturally

These seven strategies combine evidence based medicine with practical, everyday advice that I share with my patients who suffer from Irritable Bowel Syndrome with Constipation (IBS-C).

1. Eat the right kind of fiber.

Not all fiber is created equal. While insoluble fiber (like bran) can sometimes worsen bloating, soluble fiber like psyllium husk, oats, and chia seeds absorbs water and softens stool without causing discomfort.

Doctor’s advice:
Start small 1 teaspoon of psyllium husk twice a day with warm water. Gradually increase the dose over two weeks to avoid gas.

Read in Detail About: [High fiber diet]

Supporting evidence:
A randomized controlled trial published in the American Journal of Gastroenterology (2021) found that soluble fiber improved stool consistency and pain in 57% of patients with IBS-C.

2. Follow a gentle low FODMAP diet.

FODMAPs are fermentable sugars found in some fruits, dairy, and wheat products. They cause gas and bloating when poorly absorbed.

Examples of high FODMAP foods to limit:

• Apples, pears, and mango
• Onions, garlic, and beans
• Milk, yogurt, and soft cheeses
• Wheat based breads and pasta

Better alternatives:

• Bananas, oranges, and strawberries
• Rice, quinoa, and gluten-free oats
• Lactose free milk or almond milk

A study in Gastroenterology (2020) found that a 4 week low FODMAP plan reduced bloating by 60% and significantly improved stool frequency in patients with IBS-C.

Read in Detail About: [Irritable bowel syndrome foods to avoid]

3. Keep your gut hydrated

A lack of water thickens stool, making it harder to pass. Aim to drink 2-3 liters of water daily, and include water rich foods like cucumbers and watermelon. Herbal teas like peppermint or chamomile soothe the gut and reduce bloating.

Unique Insight:
Patients who only drink water with meals often miss out on the benefits of consistent hydration throughout the day. Encourage water between meals.

4. Manage stress before it manages you.

Your gut doesn’t just digest food, it also “digests” emotions. Chronic stress increases gut sensitivity and slows down bowel movements.

Try these stress reducing routines:

• Breathe deeply for 5 minutes twice a day.
• Morning stretching or yoga
• Journaling before bed
• Listening to soothing music

Doctor’s insight:
Patients who combine bowel care with stress management often improve faster than those who rely on diet alone.

WHO (2023) supports integrated care, noting that psychological treatment can reduce the severity of IBS-C symptoms by up to 50%.

5. Establish a consistent bowel routine

Train your bowels like clockwork.

• Go to the bathroom at the same time every day, ideally after breakfast.
• Don’t ignore the urge to pass stool holding it in signals your colon to absorb more water, which worsens constipation.
• Sit comfortably, and if necessary, place a small footstool under your feet to mimic a squatting posture (improves the angle of impact).

6. Strengthen your gut microbiome

A balanced microbiome can improve motility and reduce bloating. Include:

• Probiotic rich foods: yogurt, kefir, sauerkraut
• Prebiotic foods: bananas, garlic, onions (if tolerated)
• Probiotic supplements: containing Bifidobacterium infantis or Lactobacillus plantarum

Clinical evidence:
A 2022 PubMed meta analysis found that probiotics improved bowel regularity and reduced bloating in patients with IBS-C.

7. Move your body, move your bowels.

• Physical activity increases bowel movements and reduces stress hormones.
• Take a brisk 30-minute walk every day.
• Try light yoga or stretching after meals.
• Avoid sitting for long periods of time.

According to the Mayo Clinic (2024), moderate physical activity 5 days a week can reduce constipation episodes by 40%.

The doctor’s insight was rarely discussed.

1. Sleep and bowel health are deeply connected.

• Poor sleep increases cortisol, slows down bowel rhythms, and worsens IBS-C symptoms.
• Encourage patients to maintain 7-8 hours of consistent sleep.

2. Hormonal cycles affect IBS-C.

• Estrogen fluctuations, especially before menstruation, can cause temporary constipation it’s not psychological, but hormonal.

3. The “more is better” trap

• Some patients over consume fiber, probiotics, and supplements, thinking more is better. This often backfires with more bloating.
• Moderation and gradual changes are key.

When to see a doctor.

Seek medical help if you experience:

• Blood in your stool
• Unexplained weight loss
• Severe pain that keeps you awake at night.
• A family history of colon cancer

These symptoms may suggest other conditions that need further evaluation.

Living Better with IBS-C – A Patient’s Story

Case Study:

Sarah, a 35 year old teacher, had struggled with bloating and infrequent bowel movements for several years. She blamed it on stress and often skipped meals. After following a structured IBS-C plan adding soluble fiber, taking daily walks, and reducing FODMAPs  her bowel habits returned to normal within three weeks. Her story reflects what I tell my patients: Small, consistent changes can lead to big relief.

Conclusion

Managing irritable bowel syndrome with constipation isn’t about a quick fix it’s about listening to your gut and understanding its signals.

With proper diet, hydration, stress management, and a patient centered approach, most people can enjoy long term relief naturally.

Call to Action

If you’re struggling with irritable bowel syndrome with constipation, don’t suffer in silence.
Share your experience in the comments below, or reach out to me through my website lifecarecure.com.
for guidance tailored to your symptoms.

Together, we can help your gut find its natural rhythm again. 

References 

• Mayo Clinic. (2024). Irritable Bowel Syndrome (IBS-C): Symptoms and Treatment. https://www.mayoclinic.org

• World Health Organization. (2023). Integrative Approaches to Functional Gut Disorders. https://www.who.int

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🧑‍⚕️ About the Author

Dr. Asif, MBBS, MHPE

Dr. Asif is a licensed medical doctor and qualified medical educationist with a Master’s in Health Professions Education (MHPE) and 18 years of clinical experience. He specializes in gut health and mental wellness. Through his blogs, Dr. Asif shares evidence-based insights to empower readers with practical, trustworthy health information for a better, healthier life.

⚠️ Medical Disclaimer

This blog is intended for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard or delay medical advice based on content you read here.