VIDEO: Distinguishing between different types of constipation

Editor’s note: This is a previously posted video, and the below is an automatically generated transcript to be used for informational purposes. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

There's a lot of overlap in terms of constipation. If you think about the definition of IBS constipation, it's abdominal pain associated with a change in bowel movements and in the setting of constipation, it's infrequent bowel movement or hard bowel movements, but the hallmark is the abdominal pain component of it. Chronic idiopathic constipation is the infrequent or hard stools, but patients with chronic idiopathic constipation can also experience abdominal pain. So you see that there's an overlap there, and oftentimes many of us will write into our notes about patients that it's IBS-C/CIC because of that spectrum. Now in patients with IBS-C, oftentimes you'll find that as you progress through therapies and treat the bowel component, so their stools are more frequent, they're softer, but they continue to have the abdominal pain aspect. That's more IBS constipation because that's the pain part that is generally due to visceral hypersensitivity. When you first meet someone with abdominal pain and constipation, it might be difficult to tease out but as you treat the bowel symptoms, the pain symptoms will persist in patients with IBS-C which is why in the ACG guidelines for treatment of IBS-C, the use of polyethylene glycol or MiraLax is not recommended because it helps the bowel symptoms but not the pain.