Welcome to the (Almost) Definitive IBS-C treatment list. My goal is to collect all the different treatments, supplements, medicines, therapies, etc for constipation predominant IBS out there and bring them together in one place. Irritable Bowel Syndrome with constipation can be incredibly difficult to treat and finding the cause can be near on impossible; hopefully this list will give you ideas about what to try next and reassurance that there may be something out there that helps you.

Over-the-counter laxative medications

Stimulants

Bisacodyl (Ducolax) – stimulant laxative with effects ranging from mild to severe for IBS-C suffers

Senna (Senakot) – naturally derived stimulant laxative with varying efficacy

– naturally derived stimulant laxative with varying efficacy Sodium Picosulfate (Ducolax Pico) – contact stimulant laxative used to clear the large bowel ahead of colonoscopy

Softeners

Docusate calcium (Surfak) – increases the amount of water absorbed by stools in the gut, making them easier to pass

Docusate sodium (Colace) – increases the amount of water absorbed by stools in the gut, making them easier to pass, contains sodium

Osmotics

Milk of Magnesia/Magnesium Hydroxide – draws water into the intestines which causes bowel movements

Polyethylene glycol 3350 (Macrogol, Miralax, Glycolax) – powder that works to increase water in the intestines

Lactulose (Cephulac, Enulose, Constulose) – synthetic sugar that draws water into the bowel, slow acting

Bulk formers

Wheat dextrin (Benefiber) – a soluble fiber that helps absorb water, making stools softer and larger (triggering intestinal muscles to contract), contains gluten

– a soluble fiber that helps absorb water, making stools softer and larger (triggering intestinal muscles to contract), contains gluten Methylcellulose (Citrucel) – created by chemically treating natural plant cellulose, softens and increases the size of stools

– created by chemically treating natural plant cellulose, softens and increases the size of stools Polycarbophil calcium (FiberCon) – a synthetic ingredient that is not absorbed in to the body and is said to not ferment in the colon (preventing excess gas)

– a synthetic ingredient that is not absorbed in to the body and is said to not ferment in the colon (preventing excess gas) Psyllium husk/ Ispaghula husk (Fybogel, Metamucil) – plant husk derived soluble fiber that increases water in the gut, it is also a prebiotic

Suppositories

Gylcerin – attract water in to the bowel and stimulate the urge for a bowel movement

– attract water in to the bowel and stimulate the urge for a bowel movement Bisacodyl – suppository with a stimulant laxative that causes colonic contraction as well as increasing fluids/salts in the bowel

Enema

Bisacodyl (Fleet) – a stimulant laxative, inserted into the rectum will trigger muscle movement and the body to pass stools, usually works in less than 15 minutes

a stimulant laxative, inserted into the rectum will trigger muscle movement and the body to pass stools, usually works in less than 15 minutes Mineral oil (Fleet) – works as a lubricant laxative, inserted into the rectum to stimulate a bowel movement, usually works in less than 15 minutes

– works as a lubricant laxative, inserted into the rectum to stimulate a bowel movement, usually works in less than 15 minutes Saline Water (Fleet) – saline water, inserted into the rectum to stimulate a bowel movement usually in less than 5 minutes

– saline water, inserted into the rectum to stimulate a bowel movement usually in less than 5 minutes Peristeen – a trans-anal irrigation system that helps to stimulate bowel movements by introducing water into the bowel via the rectum, similar to an enema

Prescription IBS-C Medications

Lubiprostone (Amitiza) – aims to treat idiopathic constipation and IBS-C FDA approved for women only

– aims to treat idiopathic constipation and IBS-C FDA approved for women only Linaclotide (Linzess, Constella) – increases fluid in intestines and speeds up food moving through the gut, for those with IBS-C, approved by the FDA for women and men

– Plecanatide (Trulance) – increases fluid secretion and muscle movement in the gut, treatment for idiopathic constipation, approved for women and men

– increases fluid secretion and muscle movement in the gut, treatment for idiopathic constipation, approved for women and men Prucalopride (Resolor, Resotran) – a 5-HT4 receptor agonist that increase colonic motility, predominately for women, the most recent drug to be approved by the FDA for IBS-C

Prescription Medications With Potential Benefits for IBS-C

Selective Serotonine Reuptake Inhibitors SSRIs (Escitalopram) – IBS sufferers may have decreased levels of the serotonin transporter (SERT) which may cause or exacerbate IBS symptoms

– IBS sufferers may have decreased levels of the serotonin transporter (SERT) which may cause or exacerbate IBS symptoms Tricyclic antidepressants TCA (Doxepin, Desipramine) – antidepressants may have the ability to alter pain perception therefore reducing the severity of pain related symptoms from IBS-C

– antidepressants may have the ability to alter pain perception therefore reducing the severity of pain related symptoms from IBS-C Low-Dose Naltrexone (LDN) – may act as an anti-inflammatory agent for the central nervous system acting as a treatment for chronic pain

– may act as an anti-inflammatory agent for the central nervous system acting as a treatment for chronic pain Rifaximin (Xifaxan) – an FDA approved antibiotic for the treatment of IBS, with generally more success in improving symptoms for IBS-D sufferers, there are potential benefits for SIBO and SIBO symptoms

Over the counter medicines that may address IBS-C symptoms

Simethicone (GasX) – an anti-foaming agent that reduces pain/discomfort and bloating caused by excess gas

– an anti-foaming agent that reduces pain/discomfort and bloating caused by excess gas Dicyclomine (Bentyl) – an anti-spasmodic drug which is designed to relax muscles in the gut wall and reduce cramping

– an anti-spasmodic drug which is designed to relax muscles in the gut wall and reduce cramping Hyoscine butylbromide (Buscopan) – an anti-spasmodic medication used to treat stomach cramps by reducing movement in the gut, because of this one of the side effects may be constipation

– an anti-spasmodic medication used to treat stomach cramps by reducing movement in the gut, because of this one of the side effects may be constipation Mebeverine hydrochloride (Colofac) – an anti-spasmodic drug that relaxes certain muscles in the intestinal wall, it is used to treat symptoms of IBS including constipation

– an anti-spasmodic drug that relaxes certain muscles in the intestinal wall, it is used to treat symptoms of IBS including constipation Pinaverium bromide (Dicetel) – an anti-spasmodic that may help to relax the smooth msucle of the bowel

Lactase (Lactaid) – an enzyme supplement to help with the digestion of milk and other dairy, poor digestion of lactose may be causing IBS-C symptoms

Vitamins and Supplements (Single ingredient)

Magnesium Citrate (CALM, Solgar, Now) – an osmotic laxative that draws water into the bowl, magnesium also reduces muscle spams in the bowel. Magnesium citrate my be more easily absorbed in to the body than magnesium oxide

– an osmotic laxative that draws water into the bowl, magnesium also reduces muscle spams in the bowel. Magnesium citrate my be more easily absorbed in to the body than magnesium oxide Magnesium Oxide (H2Go) – like other types of magnesium it works by drawing water into your colon

– like other types of magnesium it works by drawing water into your colon Magnesium Salate – like magnesium citrate, it is an osmotic laxative that can also reduce muscle spams

– like magnesium citrate, it is an osmotic laxative that can also reduce muscle spams Magnesium Sulfate (Epsom salts) – can be used in the bath to soothe and relax muscles, Epsom salts may also be drunk as an osmotic laxative

– can be used in the bath to soothe and relax muscles, Epsom salts may also be drunk as an osmotic laxative Cascara Sagrada – bark of a shrub with stimulant laxative properties that irritates colon muscles making them contract

– bark of a shrub with stimulant laxative properties that irritates colon muscles making them contract Aloe Vera – can be taken in juice or tablet form, it is stimulant laxative

– can be taken in juice or tablet form, it is stimulant laxative Mineral oil – is a lubricant laxative that helps to soften stools and coat the intestinal tract

– is a lubricant laxative that helps to soften stools and coat the intestinal tract Spirulina – a freshwater blue-green algae with high levels of protein and amino acids, as well as other vitamins

– a freshwater blue-green algae with high levels of protein and amino acids, as well as other vitamins Chlorella – a freshwater green algae with high levels of protein that is said to improve bowl function by stimulating the growth of friendly bacteria

– a freshwater green algae with high levels of protein that is said to improve bowl function by stimulating the growth of friendly bacteria Tumeric/Curcumin – has anti-inflammatory properties with the possibility to soothe the digestive tract

– has anti-inflammatory properties with the possibility to soothe the digestive tract Flaxseed/Linseed – is a seed that contains a high level of (insoluble) fiber, it creates a gel in the bowels which softens stools making them easier to pass

– is a seed that contains a high level of (insoluble) fiber, it creates a gel in the bowels which softens stools making them easier to pass Vitamin C – high doses of vitamin C are reported by IBS-C suffers to relieve constipation

high doses of vitamin C are reported by IBS-C suffers to relieve constipation Vitamin B5 – also known as pantothentic acid taken on an empty stomach can stimulate peristalsis (wave like muscle contractions) in the bowel

– also known as pantothentic acid taken on an empty stomach can stimulate peristalsis (wave like muscle contractions) in the bowel Vitamin B9 – unclear information about why or how this works but may improve digestion speed/soften stools

– unclear information about why or how this works but may improve digestion speed/soften stools Ginger – has anti-nausea and anti-spasmodic properties which can help treat the symptoms and causes of IBS C, it can also aid digestion by stimulating the release of saliva, bile and gastric juices

– has anti-nausea and anti-spasmodic properties which can help treat the symptoms and causes of IBS C, it can also aid digestion by stimulating the release of saliva, bile and gastric juices Cayenne Pepper – home remedy for constipation that encourages peristalsis, it also increases saliva and secretions in the stomach promoting good digestion

– home remedy for constipation that encourages peristalsis, it also increases saliva and secretions in the stomach promoting good digestion Peppermint Oil – capsules of peppermint oil may help with IBS C symptoms like muscle spams and bloating

– capsules of peppermint oil may help with IBS C symptoms like muscle spams and bloating Collagen/Gelatin – said to improve hydrochloric acid production making foods easier to digest

– said to improve hydrochloric acid production making foods easier to digest Silicol Gel – forms a protective coating over the stomach and intestines to improve digestive comfort, more generally used for IBS-D

– forms a protective coating over the stomach and intestines to improve digestive comfort, more generally used for IBS-D Betaine HCL – betaine hydrochloride can be used to increase stomach acid levels which may be causing IBS symptoms and constipation

Vitamin and Supplement Formulas (multiple ingredients)

Probiotics – can help in many ways including; improving gut transit time, stool frequency, and stool consistency

Atrantil – combination of active botanicals (peppermint, quebracho extract and conker extract) designed to tackle bloating and abdominal

– combination of active botanicals (peppermint, quebracho extract and conker extract) designed to tackle bloating and abdominal Renew Life – offers a range of products advertised to target ‘occasional constipation’ with natural ingredients and including stimulant laxatives

B-Supreme – made by Designs for Health consists of a B-vitamin blend that may help the digestive process

MotilPro – by Pure Encapsulations is designed to promote GI motility by supporting nerves that release and are stimulated by serotonin, contains a lot of ginger

by Pure Encapsulations is designed to promote GI motility by supporting nerves that release and are stimulated by serotonin, contains a lot of ginger Dr. Schulze’s – a range of products in their ‘Eliminate’ range tackle constipation and the large intestine

– a range of products in their ‘Eliminate’ range tackle constipation and the large intestine Candibactin AR and BR – herbal extracts and essential oils which may have to naturally relieve some of the symptoms of IBS-C including constipation

– herbal extracts and essential oils which may have to naturally relieve some of the symptoms of IBS-C including constipation Swedish Bitters – combination of 22 herbs some of which target digestive issues, including rhubarb root and senna leaves

Iberogast (STW5) – proprietary blend of herbs that claims to have anti-inflammatory benefits, includes liquorice root, peppermint, chamomile and other herbs

– proprietary blend of herbs that claims to have anti-inflammatory benefits, includes liquorice root, peppermint, chamomile and other herbs Triphala Powder – an Ayurvedic herbal formula including the amla, haritaki, and bibhitaki fruits, it is said to have laxative qualities. the ability to strengthen intestinal muscle as well as anti-inflammatory properties

– an Ayurvedic herbal formula including the amla, haritaki, and bibhitaki fruits, it is said to have laxative qualities. the ability to strengthen intestinal muscle as well as anti-inflammatory properties Protein Shakes – …. mentioned on IBS-C forums, but there is a lack of information or evidence to back up the idea

Teas for IBS-C

Mint Tea – relaxes intestinal tract muscles and can help to reduce symptoms of IBS

– relaxes intestinal tract muscles and can help to reduce symptoms of IBS Pu’er Tea – has been shown to have a laxative quality, helping to alleviate constipation

Senna Tea – contains sennosides from the senna plant that have a laxative effect

– contains sennosides from the senna plant that have a laxative effect Cascara Sagrada Tea – derived from the bark of a shrub, a stimulant laxative that causes the intestinal muscle contractions

Ginger Tea – may have a mild laxative effect, decrease transit time, and regulate stomach acid

Dandelion Tea – a gentle laxative and detoxifier, may also improve healthy bacterial function in the digestive tract

Chamomile Tea – helps with a range of digestive issues that may relieve the symptoms of IBS

– helps with a range of digestive issues that may relieve the symptoms of IBS Licorice Root Tea – used in traditional medicine, although there is not a lot of evidence regarding IBS-C, licorice may help soothe the digestive tract, have anti-inflammatory qualities as well as potentially have a laxative effect

– used in traditional medicine, although there is not a lot of evidence regarding IBS-C, licorice may help soothe the digestive tract, have anti-inflammatory qualities as well as potentially have a laxative effect Rhubarb Tea – used for digestive issues, rhubarb may help with constipation as it includes anthraquinones (like aloe and senna)

– used for digestive issues, rhubarb may help with constipation as it includes anthraquinones (like aloe and senna) Aloe Vera Tea – aloe vera is a stimulant laxative, drunk in a tea it may cause a bowel movement

– aloe vera is a stimulant laxative, drunk in a tea it may cause a bowel movement Chinese Diet Tea – the main ingredient is often senna (a stimulant laxative), may contain other beneficial or non beneficial ingredients

– the main ingredient is often senna (a stimulant laxative), may contain other beneficial or non beneficial ingredients Teas promoted to relieve constipation – there are lots of teas on the market targeting digestive issues related to IBS and more specifically constipation, they have a range of different ingredients and combinations

Therapies for IBS-C

Due to the physiological symptoms associated with IBS (such as anxiety and depression), the use of different types of therapies are a logical inclusion in a IBS treatment plan. Some therapies may help to address the causes, others may help suffers deal with the symptoms.

Pelvic Floor Physical Therapy – particularly useful for outlet constipation (though may help to address other types), physical therapy can help to relieve tight pelvic floor muscles that may be making it hard to pass stools

– particularly useful for outlet constipation (though may help to address other types), physical therapy can help to relieve tight pelvic floor muscles that may be making it hard to pass stools Myofasical Release – an alternative method that claims to work with the myofascial tissues to release tension and decrease sensitivity, may be used alone or in conjunction with pelvic floor therapy

– an alternative method that claims to work with the myofascial tissues to release tension and decrease sensitivity, may be used alone or in conjunction with pelvic floor therapy Biofeedback – has been shown to help with gastrointestinal symptoms by using techniques that help the patient to learn to control and relax certain muscles that may be exacerbating IBS-C symptoms

– has been shown to help with gastrointestinal symptoms by using techniques that help the patient to learn to control and relax certain muscles that may be exacerbating IBS-C symptoms Cognitive Behavioural Therapy (CBT) – a type of psychotherapy that works with the patient to understand there thoughts, beliefs, and attitudes, it may be useful in helping IBS-C suffers to process their situation

– a type of psychotherapy that works with the patient to understand there thoughts, beliefs, and attitudes, it may be useful in helping IBS-C suffers to process their situation Hypnotherapy – gut directed hypnotherapy still lacks significant research, but there evidence to show, at least in the short term, it may be able to improve abdominal pain and other gastrointestinal symptoms

– gut directed hypnotherapy still lacks significant research, but there evidence to show, at least in the short term, it may be able to improve abdominal pain and other gastrointestinal symptoms Acupuncture – a traditional Eastern therapy that uses thin needles to work with energy lines in the body, it is an alternative therapy that may provide some relief of IBS-C symptoms

Mind and Body

Physical Activity – movement is an effective way to encourage bowel movements, improve blood flow to the digestive tract and tone intestinal muscles. Exercise is frequently recommended by physicians as a way to combat constipation, whatever movement you chose is likely to be beneficial

– movement is an effective way to encourage bowel movements, improve blood flow to the digestive tract and tone intestinal muscles. Exercise is frequently recommended by physicians as a way to combat constipation, whatever movement you chose is likely to be beneficial Walking – walking is a gentle way to way increase your heart rate and get your blood flowing, it is easy to add into your daily routine

– walking is a gentle way to way increase your heart rate and get your blood flowing, it is easy to add into your daily routine Running – aerobic exercise increases blood flow to the organs, including the intestinal tract. Many people report needing to use the bathroom when they run (Runner’s Trots/diarrhea)

– aerobic exercise increases blood flow to the organs, including the intestinal tract. Many people report needing to use the bathroom when they run (Runner’s Trots/diarrhea) Yoga – yoga has many health and well being benefits, additionally routines and poses can target the stomach and pelvic floor area in a way that may provide relieve for IBS-C symptoms

– yoga has many health and well being benefits, additionally routines and poses can target the stomach and pelvic floor area in a way that may provide relieve for IBS-C symptoms Stretches – stretches and yoga poses can be done as part of a routine or throughout the day targeting stomach and pelvic floor muscles

– stretches and yoga poses can be done as part of a routine or throughout the day targeting stomach and pelvic floor muscles Meditation – meditation and mindfulness practices have been shown to reduce IBS symptoms in suffers, due to the link between the brain and the gut. There are many ways of embracing mindfulness

– meditation and mindfulness practices have been shown to reduce IBS symptoms in suffers, due to the link between the brain and the gut. There are many ways of embracing mindfulness Deep Breathing – practicing deep breathing can help to relax and release stomach muscles that may be tight

– practicing deep breathing can help to relax and release stomach muscles that may be tight Massage – whilst it may not be effective for the chronic constipation associated with IBS-C it is easy to learn and self administer making it worthy of trying

– whilst it may not be effective for the chronic constipation associated with IBS-C it is easy to learn and self administer making it worthy of trying Hot or Cold Packs – the use of heat or cooling on the stomach may help to reduce or relieve IBS-C symptoms such as cramping and relax the muscles, baths are another way of achieving the same effect

– the use of heat or cooling on the stomach may help to reduce or relieve IBS-C symptoms such as cramping and relax the muscles, baths are another way of achieving the same effect Foot Stool – research has shown that posture and positioning on the toilet can help to reduce straining and allow easier bowel movements

Foods

Foods with potential laxative effects (e.g. prunes, apricots, coconut, ginger)

(e.g. prunes, apricots, coconut, ginger) Natural probiotics (e.g. sauerkraut, kefir, kombucha, yoghurt)

(e.g. sauerkraut, kefir, kombucha, yoghurt) Insoluble fiber (e.g. whole grains, vegetables, wheat bran, whole flaxseed etc.)

(e.g. whole grains, vegetables, wheat bran, whole flaxseed etc.) Soluble fiber (e.g. oat bran, barley, lentils etc.)

(e.g. oat bran, barley, lentils etc.) Fruits with potential benefits (kiwi, papaya)

(kiwi, papaya) Olive oil and lemon with hot water – often recommended by nutritionists to aid in digestion but does not have scientific research backing it up

– often recommended by nutritionists to aid in digestion but does not have scientific research backing it up Apple Cider Vinegar – listed on the internet as a miracle cure for a whole range of issues, can be beneficial for digestive symptoms

Diets for IBS-C

Low FODMAP – reducing intake of short chain carbohydrates that the small intestine finds difficult to absorb

Dairy Free – milk protein intolerance can cause constipation, a dairy free diet can help to prevent IBS-C related symptoms

Gluten Free – gluten intolerance may exacerbate IBS-C symptoms. It is important to check for celiac with is a serious autoimmune disease

Low Carbohydrate – simple carbs break down into sugars which feed bacteria and can worsen IBS-C symptoms

– simple carbs break down into sugars which feed bacteria and can worsen IBS-C symptoms Exclusion Diet – works by temporarily removing all potential trigger foods from the diets, waiting till the digestive system has cleared, and them reintroducing potentially problematic foods one by one. This can be a difficult diet for IBS-C sufferers as the symptoms and effects of food are not alway as immediately as they are for those with IBS-D

– works by temporarily removing all potential trigger foods from the diets, waiting till the digestive system has cleared, and them reintroducing potentially problematic foods one by one. This can be a difficult diet for IBS-C sufferers as the symptoms and effects of food are not alway as immediately as they are for those with IBS-D Allium Free – many IBS suffers note the onions, garlic and other alliums (chives, spring onions, and leeks) can cause or worsen IBS symptoms

– many IBS suffers note the onions, garlic and other alliums (chives, spring onions, and leeks) can cause or worsen IBS symptoms Removing Processed Foods – IBS-C sufferers note that removing processed foods from their diets can help alleviate symptoms

– IBS-C sufferers note that removing processed foods from their diets can help alleviate symptoms Increased Water Intake – every IBS-C sufferer has been told the prevents of water, increased water intake means there more water can stay in the bowels (theoretically) making stools easier to pass

– every IBS-C sufferer has been told the prevents of water, increased water intake means there more water can stay in the bowels (theoretically) making stools easier to pass Small Portions vs Large Portions – there are arguments on both sides,some suggesting that small meals prevent over loading the digestive systoms, other saying that large meals trigger the digestive system encouraging it push food through the system.

New and Emerging IBS-C Treatments

Fecal microbiota transplantation

Neurotrophin-3

Interferential Therapy

Sacral Nerve Stimulation

Cannabis/Marijuana

Tests for potential diagnosing

Colonoscopy – allows for visual inspection of the rectum and the large bowel, allowing for possible causes to be ruled out

Blood work – used to rule out other potential conditions that present similar symptoms

Barium enema – checks for changes or abnormalities in the large intestine (colon) using an x-ray

– checks for changes or abnormalities in the large intestine (colon) using an x-ray Sitz Marker Test – using tiny markers the test tracks the time it takes for food to move through the intestines. It allows doctors to understand more about your gut motility and food transit time

– using tiny markers the test tracks the time it takes for food to move through the intestines. It allows doctors to understand more about your gut motility and food transit time SIBO testing – a hydrogen breath test that may help with the diagnosing of small intestinal bacterial overgrowth and carbohydrate malabsorption

– a hydrogen breath test that may help with the diagnosing of small intestinal bacterial overgrowth and carbohydrate malabsorption Intolerance testing – can help identify potential food intolerance, indicating what items, if avoided, may reduce IBS symptoms

Genetic testing

Stool testing – tests for calprotectin which is associated with IBD, additional stool tests can check gut flora levels, bacteria and parasites

Anorectal manometry – measures the pressure of the anal sphincter muscles, sensation in the rectum and the natural reflexes

What has your doctor, friend, therapist, or hairdresser suggested? What’s worked for you, or for someone you know? Please comment below with more treatments to add to the list, let’s build the IBS-C list together!