IBS with constipation (IBS-C) is a recognised subtype of irritable bowel syndrome, categorised by predominant stool pattern to guide treatment selection. Accurate subtyping is the starting point for directing an appropriate therapeutic approach.
Patients with IBS are subgrouped according to their predominant stool pattern — IBS with constipation (IBS-C) being one of the defined categories — to direct therapy toward the specific presentation.
Management of IBS-C centres on a laxative-based approach, with dosing adjusted according to the patient's individual symptom response. The primary clinical goal is an increase in the frequency of bowel movements.
Patients are subgrouped according to their predominant stool pattern into IBS with diarrhoea (IBS-D), IBS with constipation (IBS-C), IBS with mixed bowel habits (IBS-M) or IBS unclassified (IBS-U), to direct therapy.
Polyethylene glycol may be an effective treatment for constipation in IBS. Abdominal pain is a common side effect (recommendation: weak; quality of evidence: very low).
Current NICE guidance for the management of IBS suggests that patients with IBS-C can be treated with laxatives, advising dose titration according to symptoms.
DOI: 10.1136/gutjnl-2021-324598 View source ↗