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Is There a Difference Between IBS-C and CIC?

Learn why some healthcare providers consider IBS-C and CIC to be part of the same continuum of GI disorders.

Is There a Difference Between IBS-C and CIC?

Irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) are common gastrointestinal disorders that affect millions of people. Both disorders cause persistent constipation and related symptoms that can last weeks or months. Here, we look at the overlapping symptoms and other similarities between the two GI disorders, and why some healthcare providers consider IBS-C and CIC to be part of the same continuum of GI disorders.

Symptoms
As the names imply, the major symptom of both IBS-C and CIC is constipation. Constipation occurs when solid waste moves too slowly through the body or the body struggles to eliminate solid waste. People who are constipated have fewer bowel movements than normal—three bowel movements or fewer per week. Constipation can be accompanied by a number of uncomfortable symptoms:

  • Bloating and gas.
  • Abdominal cramping and pain.
  • Stool that is too hard.
  • Straining during bowel movements.
  • Urge to have a bowel movement immediately after having one.
  • Feeling that bowel movements are incomplete.

IBS-C versus CIC
The symptoms listed above are common to both IBS-C and CIC, but the two are considered separate disorders—or at least they have been in the past. Traditionally, the differentiating factor between the two has been the predominance of abdominal pain:

  • Abdominal pain is considered a primary symptom of IBS-C.
  • Abdominal pain is considered a secondary symptom among people with CIC, while constipation is the primary symptom.

In other words, IBS-C is considered “abdominal pain with constipation” while CIC is considered “constipation with abdominal pain.”

However, there is a great deal of overlap in the symptoms between the two disorders. Also, a person’s primary symptoms can change over time. This can make it difficult to distinguish between IBS-C and CIC. More recent research argues that the two disorders are part of a continuum of functional GI disorders. Functional GI disorders occur because of a problem with the normal functioning of the gastrointestinal tract.

Diagnosis and treatment
If you are experiencing persistent constipation or symptoms related to constipation, it is important to seek treatment from a healthcare provider. There is no specific test for IBS or CIC, and diagnosis involves a careful study of your medical history and diagnostic tests to rule out other problems that could potentially be causing symptoms. These may include testing blood and stool samples, X-rays, and/or a colonoscopy.

While IBS-C and CIC are common, constipation has many different causes, ranging from simple things like dehydration, diet, medications, and lack of exercise, to serious health conditions such as colorectal cancer and diseases or injuries that impact the nervous system.

Whatever the cause, seeing a healthcare provider is the first step toward treatment.

Medically reviewed in March 2020.

Sources:
Hung-Da Chena, Ming-Jong Bair, et al. "Similarities and differences between IBS-C and FC with regards to symptomatology, sleep quality and psychological attributes." Journal of the Formosan Medical Association, January 2020. Vol. 119, No. 1.
Brooks D. Cash. "Understanding and Managing IBS and CIC in the Primary Care Setting." Gastroenterology & Hepatology, 2018. Vol. 14, No. 5.
UpToDate. "Clinical manifestations and diagnosis of irritable bowel syndrome in adults."
American Society for Gastrointestinal Endoscopy. "Understanding Irritable Bowel Syndrome with Constipation (IBS-C)."
Ada. "Chronic Idiopathic Constipation."
Brian E. Lacy. "Update on the Management of Chronic Idiopathic Constipation." American Journal of Managed Care, March 2019.
Merck Manual Professional Version "Constipation."
MedlinePlus. "Constipation."
National Institute of Diabetes and Digestive and Kidney Diseases. "Definition & Facts for Constipation."
Mayo Clinic. "Constipation."
Eamonn M. M. Quigley. "Editorial: differentiating chronic idiopathic constipation from constipation‐predominant irritable bowel syndrome – possible and important?" Alimentary Pharmacology and Theraputics, May 2015. Vol. 41, No. 12.
Eric D. Shah, Christopher V. Almario, Brennan M. R. Spiege, and William D. Chey. "Lower and Upper Gastrointestinal Symptoms Differ Between Individuals With Irritable Bowel Syndrome With Constipation or Chronic Idiopathic Constipation." Journal of Neurogastroenterology and Motility, 2018. Vol. 24, No. 2.
UNC Center for Functional GI & Motility Disorders. "Ask the Expert: What is a Functional GI disorder?"
Mayo Clinic. "Irritable bowel syndrome."

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