Constipation is a common problem for everyone, particularly people with interstitial cystitis (IC). Not only does it cause discomfort, for many IC patients it can increase IC symptoms such as urgency and frequency by causing additional pressure against the bladder.  Many things may cause constipation, including:

  • Low fiber dietary patterns.
  • Lifestyle factors, such as low activity level.
  • Other health problems (pelvic floor dysfunction and irritable bowel syndrome).
  • Medicines such as antidepressents and opioids.
  • Some Nutrition supplements such as iron and calcium.

For many people, constipation may be due to more than one of the above causes. Figuring out the underlying reason your bowels are irregular is key to getting the right treatment.  Click here to purchase our constipation fact sheet.

Tips for Increasing Fiber

How do you know if you are getting enough fiber? The Academy of Nutrition and Dietetics recommends 25 to 38 grams of fiber daily. Check out the list of IC-friendly sources of fiber.

If you’re not getting enough fiber, use the list to choose foods to add to increase your fiber intake. Check out the serving size for each of these items. You may find it helpful to measure quantities to get a sense of how many servings you typically eat. Two items that some people may find helpful for irregularity are a small glass of prune juice daily and 1-2 tablespoon flax (flaxseed, flaxmeal, or flax oil) each day.  (Make sure flax seed is ground to get the most nutritional value.)

When you are increasing fiber, you must make sure you drink enough fluids. Increasing fiber without getting enough liquids can make constipation worse. A rule of thumb: the more fiber you consumer, the more water you need.

Being Active

Inactivity can also lead to irregularity. It is important to try to get some activity each day. If IC is preventing you from being active, ask your doctor for a consult with a physical therapist (PT), trained in treating people with chronic pelvic pain. A PT can help you create an exercise program. In addition, PT’s can teach you lower abdominal massage techniques that help to encourage bowel movements.

Laxatives

If increasing fiber, fluid, and activity do not help, ask your doctor about taking a laxative. There are different types of laxatives. Some patients require a combination of laxatives. For example, you may need to take both: one to stimulate bowel movements and a different one to soften the stool. Though the research is limiting, initial findings suggest that probiotics may also be helpful. Talk with your doctor about this option as well.

Opioid-induced Constipation (OIC)

Constipation as a result of opioid pain management is called opioid-induced constipation (OIC).  This type of constipation differs from normal constipation in both severity and aggressiveness of treatments.  OIC is the most common and challenging side effect of opioid pain-management. The World Institute of PainPathways Magazine, in partnership with drug manufacturer AstraZeneca recently released the findings of a 6 month survey they conducted with non-cancer pain patients and the results may surprise you:

  1. Patients found that the sooner they spoke to their physician about their symptoms, the better they were able to manage them. It is crucial that both patients and physicians get over their embarrassment about discussing OIC, because 1/3 of doctors do not mention it as a side effect, and 80% of patients said they were not comfortable talking to their doctor about OIC.
  2. 90% of patients that start taking less or stop taking their opioid medication due so because of OIC.
  3. Current OIC literature reports depression in 11-19% of users; this survey shows depression to be an issue in almost 50% of the respondents. Instead of the standard Constipation-Quality of Life questionnaire tool used by physicians, this survey asked about sexual intimacy and diet. Readers also reported embarrassment, low self-esteem, social isolation, anger, frustration and irritability in relation to OIC.

Revised Monday, June 20th, 2016