A woman looking very anxious, juggling balls with an image of a flare on them, as well as different types of medication.

Juggling IBS-D and IBS-C: To Treat or Not to Treat?

One of my biggest dilemmas is deciding whether or not I should attempt to treat a flare. Having episodes of both IBS-C and IBS-D can leave you feeling like you are fighting a losing battle.

When I was first diagnosed with irritable bowel syndrome, the standard treatment was an antispasmodic medication. These medications were quite effective for me. In fact, they were too effective and triggered constipation. Attempting to adjust the dosage to find a happy medium simply did not work. I gave up and suffered through bout after bout of diarrhea, resorting to fasting when I needed to leave home for more than a short time.

The repercussions of treating acute flares

I generally avoid treating episodes of IBS-D. It is far too easy to trigger an episode of severe constipation. The consequence of not treating an IBS-D flare is being unable to leave the house, awful cramping and bloating, and many other fun things. I simply endure it unless I reach the point of dehydration. I can usually ride out a severe flare by retreating to safe foods until it passes, and that is the extent of how I treat IBS-D.

My initial complaint with IBS was diarrhea, but bouts of constipation became more frequent over time. Any attempt to treat it resulted in disaster and only offered a very brief period of relief. My initial reaction to any treatment is severe cramping no matter how mild the medication is. Eventually, I will be able to go, and that provides a short reprieve from the pain. It never seems to end the flare, as this cycle will repeat until it suddenly resolves on its own. I have been unable to find a treatment that doesn’t cause a great deal of pain. Nothing thus far has been able to help me maintain regularity and avoid the woes of severe constipation. I have tried stool softeners, probiotics, and more. Of course, knowing time is indeed of the essence during these bouts, sometimes it is necessary to endure the pain caused by these treatments to prevent far worse issues.

The consequences of avoiding treatment for IBS-C

When I am in the midst of an IBS-C flare, my biggest concern is knowing the longer it continues the worse it will be. I am certainly not saying either type of flare is worse than the other. I am saying time is of the essence during a flare that involves severe constipation. Four or five days of being unable to go is a dire situation. It has the added benefit of causing physical trauma or injury. Anyone who has ever dealt with a fissure, large hemorrhoids, or a fissure knows exactly what I am talking about. Again, I am not saying one type is worse than the other or that similar problems do not occur in both. I am saying that I experience bigger issues during a severe IBS-C flare. These issues take longer to heal, often lingering for some time after an episode of constipation has ended.

After spending more than two decades repeating this cycle more times than I can count, I have given up on taking anything on a regular basis. I ride out flares and treat only when it becomes absolutely necessary. Bouts of IBS-D have been easier for me to manage as long as I am able to stay home. Recent episodes of IBS-C have caused major issues and demanded treatment. My juggling days are far from over, and I am certain there are other jugglers out there. Keep rolling with the punches.

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