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About your adult patients with Irritable Bowel Syndrome
with Constipation (IBS‑C)
DISEASE STATE OVERVIEW
Irritable Bowel Syndrome with Constipation (IBS‑C) is one of the 3 subtypes of IBS,7 a chronic functional GI disorder that arises from an abnormal functioning of the GI tract and not from structural or biochemical abnormalities.8 The other 2 subtypes of IBS are IBS with diarrhea (IBS‑D) and IBS with mixed bowel pattern (IBS‑M), which can vary between constipation and diarrhea.7
IBS‑C is defined as abdominal pain or discomfort that occurs in association with constipation.7 IBS‑C is associated with hard or lumpy stool consistency in at least 25% of bowel movements, and loose or watery stool consistency in less than 25% of bowel movements.7 In IBS‑C, symptoms are chronically present.8
In an Internet-based survey,* adult IBS‑C sufferers indicated that they often experience multiple symptoms, including constipation, abdominal pain, and incomplete evacuation. These symptoms occur frequently and can be severe in sufferers.4
The exact cause of IBS‑C has not been identified. Instead, IBS‑C is considered to be a disorder resulting from the interaction of a number of factors.9 Potential factors include:
Visceral hypersensitivity is an enhanced responsiveness or perception within the intestine that can occur even in response to normal events.10,11 Sufferers may feel more pain than healthy individuals when their intestines are stimulated or stretched. Visceral hypersensitivity may also lead to changes in intestinal motility and secretion.12
Disturbance in water balance and GI tract motility
Colonic motility may be delayed in IBS‑C sufferers, which may be due to decreased contractions that move contents through the colon leading to infrequent defecation.9 Water imbalance may also occur due to the colon absorbing too much water, resulting in stools that are hard, dry, and difficult to pass.13,14
IBS‑C patients may have altered brain‑gut communication leading to changes in motility, sensation, and secretion in the bowel.15
Additional possible causes of IBS‑C include local inflammation of GI tract, intestinal bacterial overgrowth, and psychological factors.9
TALKING TO PATIENTS ABOUT THEIR SYMPTOMS
Talking to sufferers can be a challenge. Many find their condition embarrassing to talk about and may not think to bring up multiple symptoms. Since IBS‑C is a multi‑symptom condition, additional prompting may be required.