What is Functional Constipation and How is it Different from IBS?

Most people suffer from bouts of constipation from time to time. However, when those bouts become more frequent and begin to impact daily life, it is time to get the problem checked by a well-trained doctor that practices functional medicine, like Dr. Tiffani Fries, DC of Genesis Chiropractic to ensure there are no underlying medical reasons for this situation. While most people are uncomfortable discussing their bowel habits with others, this is an important subject to discuss with your doctor. 

Functional constipation is a common gastrointestinal disorder characterized by difficulty in passing stools or infrequent bowel movements, typically fewer than three times per week, along with other symptoms such as straining during bowel movements, hard stools, a feeling of incomplete evacuation, and abdominal discomfort or bloating.

The term “functional” implies that there is no identifiable structural or biochemical cause for the constipation. Instead, it is often related to factors such as inadequate dietary fiber intake, insufficient fluid intake, lack of physical activity, or certain medications. Functional constipation can also be influenced by psychological factors such as stress or anxiety.

Treatment for functional constipation usually involves lifestyle modifications such as increasing fiber and fluid intake, exercising regularly, establishing a regular bowel routine, and sometimes using over-the-counter laxatives or stool softeners. In more severe cases, prescription medications or biofeedback therapy may be recommended.

Understanding the 3 Types of Functional Constipation

It is important to understand that there are 3 different functional constipation types.

These types include:

  • 1. Normal Transit Constipation
  • 2. Slow Transit Constipation
  • 3. Defecation Disorders

1. Normal Transit Constipation

This is the most diagnosed functional constipation type: the muscles responsible for propelling waste through the intestinal tract squeeze and relax in the normal and expected manner.

2. Slow Transit Constipation

Like its name, this type of functional constipation type is diagnosed when colonic waste is slow to transit the colon.

3. Defecation Disorders

This third type of functional constipation is seen when a very specific muscle of the colon is dysfunctional in some manner.

Young woman suffering from abdominal pain while sitting on sofa at home

Most Common Functional Constipation Symptoms

Individuals should monitor their bowel habits and alert their doctor if they have any ongoing problems with constipation or other symptoms that may indicate functional constipation or another issue.

Common symptoms of functional constipation include:

  • Dry or Extra Hard Stool
  • No Real Urge to Have Bowel Movements
  • Fewer than 3 Bowel Movements a Week
  • Spending a Lot of Time Sitting on Toilet with No Results
  • Bloating Abdominal
  • Weight Loss for Unknown Reasons
  • Headaches – More Common in Children
  • Blood Mixed with Stool
  • Lowered Blood Count

Unlike IBS and other bowel conditions, most individuals do not suffer from intense abdominal cramping or pain with functional constipation.

How Long Will Functional Constipation Last Without Treatment?

Without intervention, functional constipation may continue to cause discomfort and inconvenience, and it can potentially lead to complications such as hemorrhoids, fecal impaction, or anal fissures. Therefore, it’s generally advisable to seek treatment if constipation symptoms persist for more than a few days or if they are causing significant discomfort or disruption to daily life.

How Is Functional Constipation Diagnosed?

It is important to speak with your doctor regarding your abnormal bowel habits. Your doctor will need to know exactly what symptoms you have been having, and parents should pursue this matter for their children.

You will need to convey your personal and family history of bowel-related disorders or diagnoses. There is usually not a genetic connection for functional constipation issues, but this information can help the physician rule out or in certain types of symptomologies to make an accurate diagnosis. This includes environmental factors as well as genetic triggers.

The one significant indicator of functional constipation is having fewer than 3 bowel movements in a given week. Everyone will have different bowel habits, but this is a key factor that should always be relayed to the physician.

Expect to undergo a physical exam to determine what is causing constipation. This exam may include:

  • Blood Tests
  • Rectal Exam
  • Defecography
  • Endoscopy
  • Anorectal Manometry
  • Balloon Expulsion Testing & Other Tests

A doctor will rule out any possible organic causes of your constipation such as IBS. One of the most important differences between IBS and functional constipation symptoms is that IBS usually causes intense abdominal discomfort or pain while functional constipation lacks this symptom.

Distinguishing Functional Constipation with IBS-C

Distinguishing between functional constipation and irritable bowel syndrome with constipation (IBS-C) can sometimes be challenging because they share some similar symptoms, such as infrequent bowel movements and abdominal discomfort. However, there are some key differences that can help differentiate between the two conditions:

  • Symptoms beyond constipation: While both functional constipation and IBS-C involve constipation as a primary symptom, IBS-C typically involves additional symptoms such as abdominal pain or discomfort that is relieved by defecation, changes in stool consistency (such as alternating between constipation and diarrhea), and a feeling of incomplete evacuation.
  • Associated features: IBS is a functional gastrointestinal disorder characterized by a combination of symptoms, including abdominal pain or discomfort, bloating, and changes in bowel habits. In contrast, functional constipation is primarily defined by infrequent bowel movements and difficulty passing stools, without the broader spectrum of symptoms seen in IBS.

Possible Causes of Functional Constipation

Although functional constipation does not have a physical or other true cause, there are some risk factors in both children and adults that can lead to constipation, and some causes are commonly accepted by medical doctors.

These risk factors include:

  • An Imbalance in Gut Bacteria
  • Poor Dietary Habits
  • Dehydration & Lowered Fluid Intake
  • Chronic Underlying Stress & Anxiety
  • SIBO – Small Bowel Overgrowth of Bacteria
  • Too High or Too Low Fiber Intake
  • Nervousness or Anxious Behaviors
  • Descending Perineum Syndrome – Indicated When Perineum Balloons Outward
  • Development of Anismus – Patient Doesn’t Relax Muscles of the Pelvic Floor
  • Unwilling to Evacuate Bowel or Defecate
  • After Use of Some Types of Laxatives

Special Note Regarding Children with Functional Constipation

Researchers estimate that up to a quarter of kids develop some type of constipation that may become chronic. This is usually the result of an early bowel training event that caused the child pain during defecation.

As a result, the child will try to avoid undergoing this pain again by not putting forth the effort needed to evacuate the bowel of stool.

Managing Functional Constipation

Managing functional constipation typically involves a combination tactics. Here are some strategies that may help manage functional constipation:

Consider the following treatments and management measures:

  • Dietary Changes
  • Probiotics
  • Stress Relieve Measures
  • Enemas – Usually Not a Good Option
  • Glycerin Suppositories
  • Polyethylene glycol – PEG – Found to Be Effective Under Close Supervision
  • Biofeedback Therapy
  • Pharmaceuticals
  • Follow Up with Maintenance Measures

Avoid overuse of laxatives that may make the condition worse.

Special Note

If you or your child exhibits the following symptoms contact your doctor right away.

  • Intense & Ongoing Abdominal Cramping or Pain
  • Vomiting
  • Blood in Stool

Contact Genesis Chiropractic regarding more information on functional constipation, IBS, stress, or other related issues by booking an appointment with Dr. Fries. DC today!