Types of irritable bowel syndrome (IBS)
Irritable bowel syndrome symptoms include stomach cramps, bloating, diarrhoea and constipation.
There are three main types of IBS, described by their main symptoms: diarrhoea, constipation or a mixture of the two:
- IBS with constipation. This comes with stomach pain and discomfort, bloating, abnormally delayed or infrequent bowel movement, or lumpy/hard stool.
- IBS with diarrhoea. This comes with stomach pain and discomfort, an urgent need to move your bowels, abnormally frequent bowel movements, or loose/watery stool.
- IBS with alternating constipation and diarrhoea.
There are about an equal number of people in each category. There is also evidence that most people with IBS will alternate between types over time.
This makes it difficult for researchers to find a single drug treatment that will relieve all the symptoms of IBS.
Identifying the type of IBS is important for doctors to decide on a treatment.
Different medications work for IBS with constipation and for IBS with diarrhoea. Doctors will usually tailor treatment for people who have IBS with alternating symptoms.
The Core charity says the type of IBS that appears to follow gastroenteritis often leads to persistent diarrhoea.
A person's bowel movements with IBS may change over time needing an adjustment in treatment.
Irritable bowel syndrome (IBS), constipation and laxatives
Many people with irritable bowel syndrome (IBS) turn to laxatives to relieve constipation, but laxatives often offer limited help.
Although laxatives do ease constipation, there's no proof that they relieve stomach aches, bloating, and the discomfort that come with IBS. This does not mean laxatives are out of the picture for IBS sufferers with constipation. Some doctors recommend them to increase the number of bowel movements.
If you're considering laxatives for IBS-related constipation, make sure to talk with your doctor first. There are different kinds of laxatives. Some of them are safer than others for long-term treatment of constipation.
Osmotic laxatives for IBS with constipation
Osmotic laxatives pull water back into the colon, which softens stool so it is easier to pass for those with IBS and constipation. They do have different effects on different people. They ease stool passage in most people, but in some they may also cause bloating, diarrhoea, and dehydration. In rare cases, some osmotics may lead to kidney or heart disease.
Stimulant laxatives for IBS with constipation
Stimulant laxatives usually contain a chemical called senna, which triggers muscles in the bowels to contract, moving stool through the bowel. While these laxatives work for occasional constipation, they are not recommended for long-term use.
Stimulant laxatives are sold over-the-counter under many names, including senna, bisacodyl and docusate sodium. Side effects can include diarrhoea, upset stomach, vomiting, irritation and stomach cramping.
To find out more about laxatives, talk with your doctor. There are other options for treatment of IBS with constipation. These include other medications, fibre supplements, dietary changes, stress management, behavioural therapy, and complementary therapies.