Can chronic constipation in women indicate IBS?

Question

Hello doctor,

I am a 34-year-old woman struggling with chronic constipation. Sometimes I pass stool only once or twice a week, which leaves me bloated, tired, and very uncomfortable. I have tried over-the-counter laxatives, but they either do not help or cause painful cramps.

I also drink enough water and eat fiber, but it does not make much difference. Could this be irritable bowel syndrome (IBS) or something more serious? Is it safe to keep using laxatives long-term? Are there newer medicines or natural remedies that work better for women? Also, can hormones or stress make constipation worse? Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Chronic constipation is very common in women and can happen for many reasons, like diet, lifestyle, hormones, or underlying medical conditions. Since you are going only once or twice a week with bloating and discomfort, this could suggest slow bowel movement or irritable bowel syndrome with constipation (IBS-C, a long-term gut problem where your intestines do not move food and waste the way they should).

However, other causes, such as thyroid issues, side effects from medications, or even structural problems in the colon, should be considered if this condition has persisted for years.

Over-the-counter laxatives may help in the short term, but they are not ideal for daily long-term use, especially stimulant types that can cause cramps or dependence. The good news is that newer prescription medicines (like Linaclotide, Plecanatide, or Lubiprostone) are made specifically for chronic constipation and IBS-C. These work by drawing water into the gut or helping the bowel move more naturally, often with fewer side effects.

Hormones and stress can both make constipation worse; many women notice symptoms around their period. Along with medicines, simple changes like regular exercise, setting a consistent bathroom routine, adding probiotics, or even pelvic floor physical therapy can help.

Since you have had this problem for a long time, it is best to talk to a gastroenterologist. They can guide you on the safest treatment, check if tests like a colonoscopy or motility studies are needed, and help you find relief without depending too much on laxatives.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.