From the Guidelines
Irritable Bowel Syndrome with Constipation (IBS-C) is caused by a complex interaction of multiple factors, including altered gut motility, visceral hypersensitivity, and dysregulation of the brain-gut axis, as supported by recent studies such as 1 and 1. The primary mechanisms underlying IBS-C involve:
- Abnormal gut motility
- Visceral hypersensitivity
- Altered brain-gut communication
- Intestinal inflammation
- Imbalances in gut microbiota Genetic factors may predispose some individuals to IBS-C, while psychological factors such as stress, anxiety, and depression can trigger or worsen symptoms, as noted in studies like 1 and 1. Dietary factors also play a significant role, particularly foods high in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) which can exacerbate symptoms in sensitive individuals, as discussed in 1. Hormonal changes, especially in women, can influence IBS-C symptoms, explaining why the condition is more common in females. Previous gastrointestinal infections may trigger post-infectious IBS in some cases, as described in 1. The condition involves dysregulation of serotonin signaling in the gut, which affects bowel movements and pain perception. Understanding these multiple contributing factors helps explain why treatment often requires a personalized, multi-faceted approach addressing both physical and psychological aspects of the condition, as emphasized in 1 and 1. Key considerations for managing IBS-C include:
- Dietary modifications, such as the low FODMAP diet
- Psychological therapies to address stress, anxiety, and depression
- Medications to regulate bowel movements and alleviate pain
- Lifestyle changes to promote overall gut health and well-being.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Causes of Irritable Bowel Syndrome with Constipation (IBS-C)
The causes of IBS-C are multifactorial and complex, involving various factors that contribute to the development of the condition. Some of the key factors include:
- Abnormal gastrointestinal motility 2, 3, 4
- Low-grade inflammation 3, 5, 4
- Increased epithelial permeability 2, 3, 4
- Visceral hypersensitivity 2, 3, 4
- Diet and psychosocial aspects 5, 4
- Interaction between diet and gut microbiota 5, 4
- Genetic associations 4, 6
- Alterations in gastrointestinal microbiota 3, 5, 4, 6
- Disturbances in mucosal and immune function 3, 4, 6
Risk Factors for IBS-C
Several risk factors have been identified that increase the likelihood of developing IBS-C, including:
- Acute enteric infection 4
- Psychological comorbidity 3, 4
- Young adult women 4
- Family history of inflammatory bowel disease or coeliac disease 4
Pathophysiology of IBS-C
The pathophysiology of IBS-C involves a dysregulation of brain-gut interactions, with alterations in central and peripheral (gut) mechanisms 2, 3, 4, 6. The bidirectional communication between the brain and the gut plays a crucial role in the development of symptoms, with factors such as stress, diet, and gut microbiota contributing to the condition 2, 3, 5, 4, 6.